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referralMedica

Under the managed care system, most plans require the Primary Care Physician to approve "referrals" to a higher-cost "Specialist". Patients requesting such a referral can leave their request with TelMedica. The system matches the patient’s request to individual plan guidelines, can recommend an eligible physician, and then routes the request to the TelMedica desktop for the physician’s approval. Once approved, the system automatically completes the "Referral" document and can send the documents via paper, fax or electronically to the patient, specialist and insurance carrier. Referral history is maintained for patients' EMR in the database of the application. Future versions will interface with EDI networks and provide for on-line authorization as designated by insurance carriers. It will also facilitate secure communication of various patient data over the telephone and the Internet.