Provider Referral Guided Flow

A government agency learns about constituents who need assistance when they apply for benefits or when someone reports a concern about them or refers them to the agency. Caseworkers understand the issues that constituents are facing and identify benefits and services to improve their wellbeing. Many times caseworkers refer constituents to other agencies or providers to help them get the assistance they need:

• Caseworkers review benefit applications and assign benefits to eligible constituents. If the agency uses certified providers to deliver the benefit, caseworkers search for providers offering the benefit and refer constituents to a suitable provider.
• Caseworkers assess a case and find the benefits or services that a constituent needs. If none of the certified providers deliver the required benefits or services, caseworkers refer the constituent to another agency or provider that offers them.
• Caseworkers review an inbound referral to check whether you can serve the referred constituent. If the assistance that the constituent needs isn’t included in the agency’s programs, caseworkers refer the constituent to another agency or provider.

When caseworkers refer constituents to providers, the provider referral guided flow streamlines how caseworkers share relevant information with the providers. The flow helps caseworkers complete these tasks:

• Include constituent and the provider information from records in the referral.
• Enter the referral details and describe the required services.
• Attach documents from a case, inbound referral, or benefit assignment to the referral.
• Share additional information from constituent records in service-specific PDF templates so that the provider or agency can customize their services.
• Review the information and create a referral.

The flow creates a referral, attaches documents and filled PDF templates, and shares the referral with the selected providers or agencies. Providers and agencies use the information in the referral to determine whether they can sign up and serve the constituents.

The Provider Referral flow is available as an Omniscript guided flow. Customize the Omniscript and the child Omnistudio components for your programs and processes. Create fillable PDF templates to share information with providers for the services that you deliver to constituents.

• Set Up the Provider Referral Guided Flow
  Create your own fillable PDF templates to share information with providers. Enable caseworkers to open the guided flow from a case or referral record page or the provider search results page.
• Refer Beneficiary Constituents to Providers
  Search for suitable providers for a constituent who is assigned benefits. You can select up to three provider and provider facility combinations and start the provider referral flow.
• Refer Constituents from a Case or Inbound Referral to Providers
  Connect constituents from a case or inbound referral to network or external providers that deliver the appropriate services.