Outbound referral to a specialist

How do we send a referral to a specialist with the clinical notes and the coverage packaged, and track it until the appointment is booked and the consult note comes back?

Package the referral from the EHR order and track it to the consult note. When a provider orders a referral, Callvu prefills the referral from the order and the EHR (the patient, the reason and diagnosis, the relevant notes, results and imaging, the medication list, the coverage and its referral requirement), selects the specialist by the plan's network, the patient's preference and the access times, chases what the specialist's intake requires from the ordering office or the patient through links, sends the package through the specialist's channel (e-referral, direct message, fax where that is all they take), tracks the acknowledgment and the appointment date with the specialist and the patient on a clock, chases the consult note after the visit, and writes the referral's status and the note to the EHR so the ordering provider closes the loop.

In scopeComplex: multi-party handoffsCallvu moves: prefill, chase and verify, write back

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Last updated November 7, 2026.

The problem today

The primary care physician referred the patient in March and learned in September, from the patient, that the specialist had never received it.

Today, without Callvu

An outbound referral leaves the practice as a fax or an e-referral and disappears. The specialist's office may not receive it, may not have the notes it needs, may schedule the patient without telling anyone, or may see the patient and never send the consult note back. The ordering provider's loop stays open, the patient falls through it, and the quality measures that track referral completion suffer.

The referral has a package the specialist needs (the reason, the notes, the results, the medication list, the coverage and the plan's referral form), a specialist chosen under the plan's network and the patient's preference, a channel the specialist actually reads, and a loop to close: the acknowledgment, the appointment, the consult note. HIPAA permits the exchange for treatment; the medical home standards expect the practice to track every referral to closure.

A referral tracked to the consult note is the one the ordering provider can act on.

How it runs

From the requestto the system of record.

A provider orders a referral in the EHR. Callvu opens the referral from the order.

Ordering provider and office: Order the referral and supply what the specialist's intake needs beyond the EHR.
Patient: Chooses the specialist where options exist, confirms contact details and is reminded to book.
Specialist office: Acknowledges, schedules and returns the consult note through its channel.
Referral coordinator: Decides network, access and non-response questions in the Decision Desk.
Callvu: Prefills the package, selects the specialist, chases, sends, tracks, and writes the status and the note to the EHR.

Prefill the package
The referral is prefilled from the order and the EHR: the patient's demographics and coverage, the reason and the diagnosis, the referring provider, the relevant notes, results and imaging the order specifies, the medication and allergy lists, the urgency, and the plan's referral form where the plan requires one; the specialist's intake requirements by specialty are compared with the package.
Select the specialist and chase the gaps
The specialist is selected by the plan's network for the patient's product, the patient's preference and location, the access times and the practice's preferred list, with the patient choosing where options exist on their phone; items the specialist's intake needs that the EHR does not hold (a prior outside study, a form the patient signs) are chased from the ordering office or the patient through links.
Chase and verify the loop
The package is sent through the specialist's channel (e-referral or direct message where they accept it, fax where that is all they take) with a link for the acknowledgment and the appointment date; the acknowledgment is chased on a clock, the appointment date is confirmed with the specialist and the patient, the patient is reminded to book and attend, and after the visit the consult note is chased from the specialist and read on arrival for the patient and the visit; a specialist who does not acknowledge, a patient who does not book, or a network question goes to the referral coordinator in the Decision Desk with only the allowed outcomes.
Write back
The referral's status (sent, acknowledged, scheduled, completed, note received, or closed without completion with the reason) and the consult note are written to the EHR against the order so the ordering provider closes the loop, and the referral completion is recorded for the quality measures.

Where it ends: The referral left with the package the specialist needed, through a channel they read, and was tracked until the consult note returned to the EHR and the ordering provider closed the loop. The Decision Trace shows the package, the specialist selection and any decision; the Audit Trace shows the send, the acknowledgment, the appointment and the note with time.

Runtime enforcement

What is enforcedwhile the work runs.

The regulations preloaded in Callvu Studio and the bank's own policies, applied as steps that run, not lines in a binder. A step that breaks a rule does not run, so a completed run was compliant.

Regulations

HIPAA Privacy Rule, disclosures for treatment (45 CFR 164.506) and the transmission security standards (45 CFR 164.312(e)): The referral package may be disclosed to the specialist for treatment without authorization, and must be transmitted through a channel with the security the rule requires (direct secure messaging, an e-referral network, or a fax under the practice's safeguards), with the disclosure logged.
Plan referral and network rules and the HIPAA 278 transaction (45 CFR 162): The plan's product sets whether a referral form from the primary care provider is required, its validity and visit count, and which specialists are in network; the selection applies them so the specialist visit is covered, and the referral or authorization is submitted on the standard transaction where supported.
Referral tracking standards (the NCQA patient-centered medical home standards and the care coordination quality measures) and 42 CFR Part 2 where substance use records are involved: The medical home standards require the practice to track referrals from order to the receipt of the consult note and to act on open ones; records covered by 42 CFR Part 2 may be included only with the patient's specific consent through its process.

Company policies

The package is prefilled from the order and the EHR and compared with the specialist's intake requirements before it is sent.
The specialist is selected under the plan's network with the patient's choice where options exist.
Every referral is tracked to the consult note; an open loop is a case, not a memory.
The EHR holds the referral's status and the note against the order.

Controls

Package prefill with intake comparison.
Network-based specialist selection with patient choice.
Gap chases to the office or the patient.
Secure send with acknowledgment and appointment tracking.
Consult note chase and reading.
Decision Desk for non-response and network questions, and EHR status write.

Clocks and deadlines

Acknowledgment: Chased from the specialist on the practice's schedule from the send.
Appointment: Confirmed by the urgency's target; the patient reminded to book.
Consult note: Chased after the visit date until received, with the open loop visible to the ordering provider.

Documents and checks

The order and the prefilled package
The specialist selection
The send record and the acknowledgment
The appointment confirmation
The consult note and the EHR status

In the Decision Trace

The package and the intake comparison.
The specialist selection and the network rule.
Any decision and the person.

In the Audit Trace

The send with channel and time.
Each chase and response with time.
The note receipt and the write.

The handoff

Between the front doorand the back office.

The front door

The EHR order; the patient chooses and confirms on their phone; the specialist works through its channel and link.

The back office

The coordinator decides only non-response and network questions; the ordering provider sees the status in the EHR.

The Decision Desk

A specialist who does not acknowledge, a patient who does not book, or a network or access question goes to the referral coordinator in the Decision Desk with the referral and only resend, select another specialist, contact the patient, or close with the reason.

Proof

In scope.Proof at scale, not one process at a time.

The kind of process Callvu runs in production for customers in this industry. Ask for a reference on this exact process. The results below are the industry's published proof; each claim code links to its record on agents.callvu.com.

23 hospitals in the Ministry of Health network run on Callvu.

Across Callvu customers

More than 1,000 processes are live across Callvu customers.

Across Callvu customers

Questions

What buyers ask next,answered plainly.

What is in the package?

The reason and diagnosis, the relevant notes, results and imaging, the medication and allergy lists, the coverage and the plan's referral form where required, prefilled from the EHR order and compared with the specialist's intake requirements.

How is the specialist chosen?

By the plan's network for the patient's product, the patient's preference and location, the access times and the practice's preferred list, with the patient choosing on their phone where options exist.

How is the loop closed?

The acknowledgment, the appointment date and the consult note are each chased on a clock, and the status and the note are written to the EHR against the order for the ordering provider.

Related processes

Inbound referral intake Scheduling with referral rules Outside results and records intake Medical clearance from the primary care physician Try it in the sandbox All healthcare processes

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