Inbound referral intake

How do we take an inbound referral from a fax, a portal or an e-referral, capture the reason, the notes and the coverage, chase what is missing from the referring office, and queue it for scheduling?

Turn every referral into one classified case with the referring office on a link. When a referral arrives by fax, portal, e-referral or direct message, Callvu reads it, matches or creates the patient in the EHR, classifies the referral (the specialty, the urgency, the reason and diagnosis, the visit type, the coverage and its referral and authorization requirements, the referring provider), lists what the specialty's intake requires (the clinical notes, the imaging and results, the medication list, the signed referral where the plan needs it, the insurance details), chases the missing items from the referring office through its link on a clock set by the urgency, reads and checks each on arrival, routes a referral the practice cannot accept or an urgency question to the referral coordinator in the Decision Desk, and writes the complete referral to the EHR referral queue for scheduling with the patient contacted.

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

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Last updated November 7, 2026.

The problem today

The referral fax sat in the queue for nine days, and when it was worked, the imaging it needed was still at the other practice.

Today, without Callvu

Referrals arrive in every format: a fax with a cover sheet, an e-referral with structured fields, a portal message, a phone call from a referring office. A coordinator works them in order from a fax queue, calls the referring office for the missing notes, leaves messages, and schedules the patient when the file is complete, often weeks later. Urgent referrals are urgent only if someone reads the cover sheet.

A referral is a case: it has a specialty and an urgency the practice's triage rules define, a patient who may or may not be in the EHR, coverage with its own referral and authorization requirements, and a set of documents the specialty's intake needs from the referring office. HIPAA permits the exchange for treatment; the practice's access standards set the time to contact and to schedule by urgency. The chase to the referring office is the critical path.

A referral classified on arrival and chased on a clock is a patient scheduled in days, not weeks.

How it runs

From the requestto the system of record.

A referral arrives by fax, e-referral, portal, direct message or a call from a referring office. Callvu reads it and opens the intake.

Referring office: Receives the request for the missing items through its link and sends them.
Patient: Is contacted about the referral, confirms coverage details and is scheduled.
Referral coordinator: Decides acceptance and urgency questions in the Decision Desk.
Callvu: Reads, matches, classifies, lists and chases the items, checks, routes and writes to the EHR queue.

Read, match and classify
The referral document or message is read (the patient's identifiers, the referring provider, the specialty requested, the reason and diagnosis, the urgency marked, the insurance), the patient is matched to the EHR or created with the registration process, and the referral is classified: the specialty and the sub-specialty, the urgency under the practice's triage rules (the diagnosis codes and the referring provider's flag), the visit type, the coverage's referral and authorization requirements, and the provider's network status for the plan.
Chase and verify the missing items
The specialty's intake requirements (the clinical notes, the relevant imaging and results, the medication list, the plan's signed referral form, the insurance card and the demographics) are compared with what arrived, and the missing items are requested from the referring office through its link with the specifics, chased on a clock set by the urgency; each item is read on arrival and checked (the patient matches, the dates, the study is the one requested); the patient is contacted in their channel to confirm the coverage and the contact details.
Decide
A complete referral the practice accepts proceeds by rule; a referral outside the practice's scope, a plan the practice does not accept, an urgency the coordinator must confirm, a duplicate referral or a referring office that does not respond goes to the referral coordinator in the Decision Desk with the referral and only the allowed outcomes (accept and queue, accept with a different urgency, redirect to another practice with the referring office told, or decline with the reason to the referring office and the patient).
Write back
The complete referral with the classification, the documents, the coverage result and the urgency is written to the EHR referral queue with the target date for scheduling under the access standards, the scheduling process picks it up with the referral rules already checked, the referring office receives the acknowledgment with the status, and the referral is tracked until the visit is booked and the consult note returns.

Where it ends: Every referral was read and classified on arrival, the referring office was asked once for the missing items on a clock, and the EHR referral queue holds a complete referral with its urgency and target date, with the referring office told. The Decision Trace shows the classification, the requirements and any decision; the Audit Trace shows the arrival, each chase and the queue write 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 and the minimum necessary exception (45 CFR 164.506 and 164.502(b)(2)(i)): Protected health information may be exchanged between the referring and the receiving provider for treatment without the patient's authorization, and the minimum necessary standard does not apply to disclosures to a provider for treatment, so the intake may request the notes and results the specialty needs; the exchange is logged and the referral document becomes part of the designated record set.
Referral and authorization requirements of the plan and the HIPAA 278 transaction (45 CFR 162): The plan's product sets whether a referral document from the primary care provider and an authorization are required for the specialty visit, with validity periods and visit counts; the intake checks them so the visit is billable, and the authorization request runs on the standard transaction where supported.
Patient access and referral management standards (the practice's access policy, the NCQA patient-centered medical home and specialty practice standards on referral tracking): The practice sets target times to contact the patient and to schedule by urgency (for example urgent within days, routine within weeks), and the recognition standards expect referrals to be tracked from receipt to the consult note's return, which the queue and the tracking provide.

Company policies

Every referral is read and classified on arrival, whatever its format; urgency is set by the triage rules, not by the queue order.
The referring office is asked once, through its link, for exactly the items the specialty needs.
Acceptance, redirection and declines are the coordinator's decisions, with the referring office and the patient told.
The EHR referral queue is the system of record for the referral, its documents and its status.

Controls

Document reading and patient matching.
Referral classification with urgency and coverage rules.
Requirement comparison and chases to the referring office on the urgency clock.
Reading and checks on arrival.
Decision Desk for acceptance and urgency questions.
EHR queue write with target date and tracking to the consult note.

Clocks and deadlines

Patient contact: Within the access policy's time by urgency from receipt.
Referring office chase: Reminders on the urgency clock until the items arrive.
Scheduling target: The access policy's time by urgency, on the queue entry.

Documents and checks

The referral as received and read
The classification with urgency
The requirements and each item as received and checked
Any coordinator decision
The EHR referral queue entry and the acknowledgment

In the Decision Trace

The classification and the triage rule applied.
The requirements and each check.
Any decision and the person.

In the Audit Trace

The arrival with source and time.
Each chase and arrival with time.
The queue write and the acknowledgment.

The handoff

Between the front doorand the back office.

The front door

Fax, e-referral, portal, direct message or a call; the referring office works through its link; the patient is contacted in their channel.

The back office

The coordinator decides only acceptance and urgency questions; scheduling picks up complete referrals with the rules checked.

The Decision Desk

A referral outside scope, a plan not accepted, an urgency to confirm, a duplicate or a non-responsive referring office goes to the referral coordinator in the Decision Desk with the referral and only accept and queue, change urgency, redirect, or decline 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 happens to a faxed referral?

It is read on arrival, the patient is matched or created in the EHR, and it is classified by specialty, urgency and coverage like any other referral; the format does not change the process.

How are missing notes obtained?

The specialty's intake requirements are compared with what arrived and the missing items are requested from the referring office through its link, once, on a clock set by the urgency.

When is the patient contacted?

Within the access policy's time by urgency, to confirm coverage and contact details, with the scheduling process picking up the complete referral with the rules already checked.

Related processes

Scheduling with referral rules Outbound referral to a specialist New patient registration Outside results and records intake Try it in the sandbox All healthcare processes

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