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Referral Pending SOP

examples/sandbox/healthcare_support/policies/referral_pending_sop.md

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Referral Pending SOP

  • Confirm referral ID, patient identity, and rendering specialist before escalation.
  • If referral status is pending for more than two business days, send to care-team intake queue.
  • If referral is pending and prior authorization is also likely, send to auth-review queue with a note that referral clearance is still outstanding.
  • Patient messaging should distinguish referral review from payer authorization.