Referrals workflow

Reviewing an incoming referral, field by field.

A practical guide to how a referral travels through Fertiligent: from the moment it arrives, through review and confirmation, into outreach and booking, and finally into the patient's care journey.

The one idea that ties it all together

A referral is just the intake stage. Confirming it is a hand-off, not another step. From that moment, one referral feeds two trackers that run side by side:

• A Prospect, the outreach & booking funnel (call attempts, follow-ups, booked).
• A Patient, the clinical lifecycle (Referred → … → Active).

Once confirmed, the referral freezes and becomes a read-only record of what arrived. Everything after that (chasing the patient, booking the appointment) happens on the Prospect, not the referral.

1. The big picture

The whole journey, in one line: stages 1–3 happen in the Referrals inbox; from Confirmed onward you work in the Prospect and Patient records.

One referral, two trackers. Confirming splits the work; the referral itself stops at Confirmed.

To see whether a confirmed referral got booked, look at the Prospect, not the referral: intake is one job, outreach is another, and they're deliberately kept apart. The referral detail page has an Outreach link that jumps straight to the matching prospect.

2. The Referrals inbox: finding your work

Open Care → Referrals. The inbox is organized into lanes; click a lane to filter:

Lane	What's in it
Needs me	Your real work: referrals waiting for review, plus documents still being read (shown with an "Extracting…" indicator that updates on its own when ready).
Failed	Documents the system couldn't process. Open one and click Retry.
Auto-confirmed	High-confidence referrals the system accepted for you. Each has a 24-hour Undo window in case you want to step in and review it yourself.
Confirmed	Accepted referrals, read-only history.
Rejected	Declined referrals, history.

Referrals normally arrive by fax or email, but staff can also upload one directly, either into the inbox, or from an existing patient's own page when a new referral comes in for someone already on file. An upload from the patient page arrives attached to that patient, so nobody has to re-identify them.

A summary strip at the top of the inbox shows how many referrals were handled automatically, the auto-confirm accuracy over the last few days, and a pipeline-health indicator. Each row shows: received date & file name, patient (with a "+ Partner" name and a "Results attached" indicator where relevant), date of birth, reason & referring physician, why it was flagged, and a confidence score. The list refreshes in real time.

3. Reviewing a referral

Click a row in Needs me to open it. The page shows the extracted information in five sections:

• Letter details: date of referral, who it's addressed to, urgency, notes.
• Patient: name, DOB, health card (OHIP), contact details, address.
• Partner: the same fields for a partner, when present.
• Referring physician: name, billing number, fax, contact.
• Reason for referral: the reason code and any free text.

Handle the flagged fields

Anything the system is unsure about is gathered at the top under "Needs your attention." For each one you either:

• Accept: the extracted value is correct, keep it; or
• Edit: type the correct value yourself.

You must make a decision on every flagged field before you can confirm.

Dates (the patient's and partner's date of birth, and the referral date) are entered with a date picker, so day-first and month-first can't be confused, and a date of birth can't be later than today. When the letter writes a date in a form the system couldn't read, the letter's own text is shown under the picker, for example On the letter: 15/03/85, so you can enter it.

A health card (OHIP) number, the patient's or the partner's, that fails the card's own check digit is flagged as having failed a format check, and the referral goes to full review. This catches a typo or a misread digit; it does not confirm the card with the Ministry of Health.

Resolve who the patient is

The system tries to match the referral to an existing patient:

• Clear match → it links automatically.
• Several possible matches → you pick the right patient from the candidates, or choose create new.
• No match → confirming will create a brand-new record.

Watch for the banners

• Cross-attachment mismatch: the cover letter names one person but the attached results name another. You must acknowledge it before confirming.
• Related referrals: shows this patient's other Confirmed/Rejected referrals, with links to each.
• Couple link: the system suggests this referral pairs with a partner's referral. It only suggests; you click Confirm couple or Not a couple. Confirming links the two prospects as partners, so they can be booked into the same appointment; see Partners booked together.
• Possible duplicate: the referral looks like a re-send of one already on file for the same patient, within your clinic's duplicate window (about six months by default; your Fertiligent contact can change it). The page opens with a warning banner that names the earlier referral and a Reject as duplicate button that records the reason for you. In the inbox the Possible duplicate label shows first rather than being folded into "+N more".

Then: Confirm, Reject, or Retry

• Confirm: accepts the referral (see below). Blocked until all flagged fields are decided, any ambiguous match is resolved, and any cross-attachment mismatch is acknowledged. A new patient also needs a name and a date of birth: while either is empty, Confirm stays unavailable and a note under the buttons says what is missing, such as Enter the patient's date of birth first. If a confirm is refused, the message says why.
• Reject: declines it; you'll be asked for a reason.
• Retry: re-runs the document through extraction (useful on a Failed item). It reads the same document again, so it won't find a date of birth the letter doesn't contain; enter the date instead.

Re-engagement safety check

If the patient you're confirming into was previously marked Declined, Lost, or Do-Not-Contact, the system stops and asks you to explicitly confirm that you want to re-engage them. This prevents accidentally re-contacting someone who asked not to be.

4. What happens the moment you confirm

A referral can be accepted two ways: manually (you open it and click Confirm) or auto-confirmed (a high-confidence extraction accepts itself and sits in the Auto-confirmed lane with a 24-hour Undo).

Either way, the system does the following automatically, in one go:

1. Saves your corrections for the record, and clears anything you marked unreadable.
2. Finds the patient, links an existing one, or creates a new patient at status Referred.
3. Runs the re-engagement check before going further.
4. Creates or links the Prospect: matched on phone, email, and name, or a new one at Not started. A "Referral received" note lands on the prospect's timeline.
5. Marks the referral Confirmed, read-only from here on.

5. Driving the booking: on the Prospect

From here you work the Prospect record. Get to it from the Outreach link on the referral, or from Prospect → Records.

Returned and Withdrawn are different off-ramps: Returned is your clinic sending the referral back, and needs a reason; Withdrawn is the patient saying they no longer wish to proceed. See Prospect management.

Booking the nurse intake moves the prospect to Intake booked, still in progress; booking the physician consultation moves it to Booked, and the referral is complete. See Nurse intake first, then the consultation.

Booked → the patient moves to Active, with the appointment date recorded.

You move the stages by hand, logging a call does not move the funnel. Booked is the one stage that reaches back to the patient record.

On the Prospect page you can:

• Log a contact attempt: choose an outcome (No answer, Left message, Reached, or Other), the date, and an optional note. This adds an entry to the timeline but does not change the stage. It's a record of the call, not a status move.
• Move the outreach stage: when you're ready, set the stage (Not started → 1st contact → …). Two special cases: Booked requires an appointment date, and Returned requires a return reason.
• Add notes: a per-change status note, and signed, dated notes on the Notes card (see Notes).
• Read the timeline: every status change, call, note, the original "Referral received" entry, and system events, in order.

Booked is the moment it all connects

When you mark a prospect Booked with an appointment date, the patient is automatically promoted to Active, and the appointment date is recorded for reporting (time-from-referral-to-booking). That's the single place outreach touches the clinical record, everything else on the prospect is yours to drive.

The booking confirmation

When an appointment is booked, whether by the visitor through Eva, over the phone with the assistant, or by your team with Book appointment, the person gets one confirmation, by text or by email: the type of appointment, the time in the site's local time, your clinic by its brand name, and how to change or cancel. A text always fits in a single message. Confirmations are on by default. For how the channel is chosen and how to turn them off, see The booking confirmation.

6. The patient phone line

When a patient calls in about their referral, an automated voice agent can handle the conversation. It is deliberately cautious:

The only things it is allowed to say: the referral was received and is in review; it's confirmed and staff will call to schedule; or, if it can't determine either, it queues a callback for a human to follow up (needs human follow-up, or not found).

In the same call, the agent can offer to collect missing details: health card (OHIP) number, OHIP version code, email, or mobile number. Nothing the caller says is written onto the referral automatically. It is saved as a draft for a staff member to review.

What you do with a call

• Open Conversations to see recent conversations, then open a call's detail.
• If the caller provided missing details, you'll see them as a draft, review and apply with one click to fill the referral. A person always stays in the loop.
• If the call ended in "Needs follow-up" or "Not found," a callback has been queued for the team to action.

7. Quick reference: "Where do I look for…?"

I want to know…	Look at…
What came in on the referral	Referral record (read-only once Confirmed)
Whether we've reached the patient / booking progress	Prospect, call attempts & outreach stage
Whether the appointment is booked	Prospect at stage Booked
The appointment date	Prospect, entered when you set Booked (also feeds reporting; not shown on the referral page)
Where the patient is in their care journey	Patient: Referred → … → Active
To jump from a referral to its outreach	The Outreach link on the referral detail
A detail the patient gave by phone	Conversations → open the call, then apply the draft to the referral
How referrals are converting, and how long each step takes	The Referral funnel report (section 9)

8. Glossary of statuses

Referral status (intake inbox): Uploaded, Extracting, Needs review, Auto-confirmed, Confirmed, Rejected, Failed. Confirmed (and Auto-confirmed) is the finish line. The referral has no status beyond it.

Outreach stage (Prospect): Not started, 1st contact, 2nd contact, Pending, Intake booked, Booked, Returned, Withdrawn, Repeat.

Patient lifecycle: Referred, Scheduled, Active, On hold, Discharged, Declined, Lost, Do not contact.

In one sentence

A referral's job ends at Confirmed, after that the Prospect tracks getting the patient booked and the Patient tracks the care journey, with Booked being the single moment the two reconnect.

9. The Referral funnel report

Referral funnel, linked from the inbox, is the report for the last 7, 30 or 90 days or 12 months, or a date range of your own: for all physicians or one, all urgencies or one, complete or incomplete referrals. A period runs on calendar days in your clinic's own time zone.

Count by chooses which date places a referral in the period:

• Date received (the default): the day the referral reached you.
• Date on referral letter: the date the referring office wrote. A referral whose letter carries no date can't be placed in a period and is left out; the report says how many (2 referrals have no date on the letter and aren't counted).

The report shows:

• Funnel: how many referrals were received, auto-confirmed, pending review and rejected, each against the previous period. Referrals rejected as duplicate re-sends are counted on their own line, so a clinic that receives many re-sends can see that separately from other rejections.
• Routed to physician and Reasons for referral: what the referral letters asked for, each with an after-review twin beside it showing what your coordinators recorded on the patient once they had reviewed the referral: the physician the patient was actually assigned to, and the reasons kept. The letter's claim and your clinic's decision sit side by side, so the cases where they differ are visible.
• Time to initiate and time to first appointment: how long a referral waits before someone acts on it, and how long from arrival to the first appointment.
• Non-referrals detected: documents that arrived as referrals and were not.
• Staff time saved: the reading and data entry the system did instead of a person.
• Data quality: how many referrals arrived complete, and how many carried every field the clinic needs.

The period-over-period comparison stays blank rather than showing a figure when the previous period reaches back before your clinic's first referral, an empty baseline would otherwise read as dramatic growth.

Three physician filters

• Physician on letter: the physician the referral letter was addressed to.
• Referring physician: the doctor who sent the referral.
• Assigned physician: the physician your team assigned the patient to after review. A referral not yet linked to a patient, or still set to First available, isn't counted under any assigned physician.

They answer different questions. Filter by Physician on letter and the after-review panels show of the letters addressed to Dr. Chan, who did we actually assign those patients to? Filter by Assigned physician for the referrals that ended up with a physician, whoever the letter named. Names are matched ignoring capitals, and the panels group the same way, so a panel row matches what its filter selects.

Download CSV exports the period for a board pack or a spreadsheet. Each row carries the Received date (the day the referral arrived), the Date of referral (the letter's date), the Assigned physician and the Referring physician billing number. The summary at the top says which date the report counted by and how many referrals were left out.