Referrals & external care

Refer a patient to a specialist (order a referral)

To refer a patient, order a referral in the visit, or from the chart with New orders when there is no visit (see Prescribe without a visit). A referral is an order type, placed from the same Orders search you use for prescriptions and labs (see Order medications, labs, imaging & more). You pick the receiving provider from your practice’s own list or the national registry, describe why you’re sending the patient, and Hero EMR generates and faxes the referral letter when you sign the order.

1. Find New Referral. In the encounter’s Orders section, type ref into the order search (F7 or Ctrl+O jumps straight to it), or open the Search Orders window and switch to the Referral tab. Pick the result New Referral — “Refer patient to specialist”.
2. Choose who you’re referring to. The window is titled New referral until you pick someone. Under Refer to, Your practice’s list comes first: the outside providers saved under Admin → Referring providers, searched by name, practice or NPI, with the fax number you saved. The NPI is optional: a clinic or center with none on file can still be chosen, and shows No NPI. National registry searches the national NPPES registry: fill in at least one of First Name, Last Name, Specialty, City, or State, then click Search Providers (Enter works too); each result shows the credential, specialty, city and NPI, plus a fax number when NPPES has one. Click a result to select it — a summary shows their contact details, and Change Provider reopens the search.
3. Describe the referral. Enter the Reason for Referral (required — for example “Evaluation of chest pain and abnormal EKG”), set the Urgency (Routine, Urgent, or STAT), and add Clinical Notes with the history and exam findings the specialist should see.
4. Check the fax number. Referrals are always Sent by fax: The referral is faxed to the number below. If the provider you chose has no fax number on file, an Enter Fax Number Manually field appears (No fax number on file for this provider.) — get the number from the specialist’s office and type it in. If fax isn’t part of your practice’s plan, the window says Hero can’t send the referral for you.
5. Click Add referral. Hero checks first: a provider name, a provider specialty, a reason and a fax number are all required, along with the required questions of an order form, and any problem is shown next to the button in plain words. Specialty normally arrives prefilled, but some registry rows and saved contacts have none — type it in yourself. Once it passes, the referral lands on the encounter’s order list with a Ref badge, the provider’s name and specialty, and a Reason: line.

Send a referral the center won’t reject: referral order forms (sleep study order)

Some places reject a referral over small things: which study you want, their preferred diagnosis codes, a screening score. A referral order form adds exactly those questions to the referral. Hero fills them in where you write the referral, won’t send it until the required ones are answered, and prints the answers on the faxed or printed referral in an Order details section, right after the patient’s information and insurance.

A referral with an order form always includes the patient’s insurance: plan, member ID, group and subscriber, and the card images too when Insurance card images is ticked.

The Sleep study form every practice starts with

You can change any of it, or add forms for other places (13.1b).

Refer with a form

1. Start the referral. In the visit’s Orders, search referral and choose New Referral, or use New referral from the chart or Inbox → Referrals.
2. Under Refer to, choose the place. For example the sleep center, or add it by hand with its specialty and fax.
3. Check the Order form. If the place or its specialty matches a form (for the Sleep study form: Sleep medicine, Sleep center, Sleep study), the form opens by itself and says Chosen for Sleep medicine. Otherwise pick it from the Order form list.
4. Answer the questions. One click on the study, then tick the diagnoses. Required questions have a red star, and Sent to the specialist on the right sums up what will go out.
5. Click Add referral (or Send referral). If something required is missing, Hero names the question and outlines it.
6. Send as usual. The referral’s PDF and fax show Order details: Sleep study with your answers, after the Insurance section.

• No form this time. To send a referral without the form, choose No order form in the list; Hero won’t pick one again for that referral.
• Insurance always goes with it. Insurance details is ticked and locked while a form is chosen.
• Sent referrals keep their answers. Changing a form later never changes referrals you already sent: each keeps the questions and answers it printed.

Make or change a referral order form: Admin → Referral forms

Open Admin → Referral forms. It is also linked from Admin → Orders & referrals, and from Manage forms inside the referral window, which opens in a new browser tab so your referral stays as it is. Providers, administrators and staff who send referrals can make and change forms.

1. Pick a form on the left, or click New form.
2. Name it, and say where it is used. Under Use it by itself for, type the specialty or the place’s name and press Enter after each, so the form opens by itself for those referrals.
3. Edit the Questions. Click a question to change its label and kind (Pick one, Pick any, Diagnosis list, Checkbox, Short answer, Paragraph, Number, Date), whether it is required, a hint, and its choices. For a diagnosis list, search ICD-10 by code or name to add the place’s preferred codes. For a number, set a unit, the lowest and highest values, and whether it is filled from the chart (BMI, last weight, last height).
4. Arrange them. Use the arrows to reorder questions, the trash can to remove one, and Add a question for more.
5. Try it out on the right. In the referral window shows the form exactly as it will look when you refer.
6. Click Save form (or Add form). Duplicate copies a form; Delete removes it after asking, and referrals already sent keep what they printed.

Sign & send the referral letter

There is no separate letter to compose. When you send a referral, Hero EMR generates the PATIENT REFERRAL FORM — a PDF carrying your referring-physician block and saved signature, the patient’s information, the receiving provider, the reason, clinical notes and urgency, and the visit’s diagnosis codes — and faxes it from your practice’s fax line. That PDF is the referral letter.

1. Link a diagnosis first. The referral row’s Sign & Send button stays disabled until the encounter has at least one diagnosis and that diagnosis is tied to the referral in the Associations grid. The tooltip tells you what’s missing — Cannot send: Add a diagnosis to the encounter, or Associate a diagnosis with this referral.
2. Click Sign & Send. Hero assembles the letter (STAT and Urgent referrals carry a warning banner on the form) and faxes it from your practice’s fax line (Hero Fax or SRFax) with a cover page reading Referral for <patient name>. While a send is in flight, other users see a lock badge (“<name> sending…”); if a lock looks stuck, Hero offers to override and send anyway.
3. Confirm the green Sent badge. A successful send turns the row’s badge to Sent with a Referral ID: reference — check that you actually see it before moving on (see the failure note below if you don’t). A sent referral is immutable; reprint or re-download the letter any time from the Referrals inbox with its PDF button.

Order an imaging study

Imaging goes through the same Orders search, but the catalog behind it is your practice’s own: studies come from the radiology providers configured under External providers, with contrast variants of the same study consolidated into a single result.

1. Find the study. Search by name (for example mri) or use the Imaging tab of the Search Orders window. If the search instead reports “Imaging provider visibility is misconfigured. Ask an admin to select at least one send-ready provider or switch mode to all.”, an admin needs to adjust the imaging-provider visibility setting first.
2. Describe the study. The dialog opens titled with the composed study name (for example MRI Brain With Contrast). Enter the required Clinical Indication (“Reason for imaging study…”), then set Contrast (Without Contrast, With Contrast, or With and Without Contrast — only the variants the chosen provider actually offers), Laterality (Left / Right / Bilateral, required only for sided studies), the Provider, the Urgency, and any Special Instructions.
3. Confirm the patient weight. Patient Weight (lbs) auto-fills from the latest chart vitals. It’s mandatory for RadNet-routed orders — the helper text reads Required for RadNet submission if no recent weight is available in vitals. — and must be a whole number between 1 and 999.
4. Answer the Contrast Safety Questionnaire. Choosing any contrast option reveals safety checkboxes, including Patient has known allergy to IV contrast (which warns “Warning: Consider alternative imaging or consult with radiology.”) and a diabetes question. Then click Save Changes to add the order.
5. Sign & send — and cancel if plans change. The order appears with an Img badge and sends like a referral: link a diagnosis (“Associate a diagnosis with this imaging order”), then Sign & Send. If contrast or laterality is still missing, Imaging order needs an update reopens the dialog. On success the row shows Sent and Order ID:, and gains a Cancel button that opens the Cancel Imaging Order dialog (“Are you sure you want to cancel this imaging order?”) with reasons Duplicate Order, Ordered by Mistake, and Testing Not Needed. Cancellations of RadNet orders are forwarded to the imaging center.

How RadNet Connect orders flow

If your practice has RadNet Connect configured (an admin sets it up under External providers), imaging orders routed to a RadNet provider transmit electronically in the background the moment you Sign & Send — no fax to dial, no phone call to make.

1. Hero matches the patient. The patient’s demographics and primary insurance are mapped to RadNet’s format, and Hero finds — or creates — the matching patient on RadNet’s side. Orders missing required demographics fail with a specific reason, so keep the chart complete.
2. The order is submitted. The exam from your procedure catalog is sent with the order details, and RadNet’s confirmation reference is stored on the order for later lookup.
3. Failures come back to you. If transmission ultimately fails, the ordering provider receives an entry in the Results inbox titled RadNet order failed: followed by the study — including the failure reason, modality, body part, and reason for study. Failures are never silent.

Track sent referrals in the Inbox

Every referral you send is tracked in the Referrals view of the Inbox — the Referrals item (send icon) in the left sidebar, with an unread-count badge. It lists every non-draft referral for the practice, newest first, each entry titled Referral to <provider name>.

1. Open a referral. The header shows Referral with a status badge, the subject, a Patient: line, a Referred to: line with the provider’s name and specialty, the ordering physician, Sent by <name> when a staff member sent it, and Fax: with the number on file.
2. Read the detail. The body shows a Reason section with the referral reason, any diagnoses, the fax failure reason when a send didn’t go through, a Last status change time, and a History of who did what (and for which physician).
3. Reprint the letter. The PDF button (it reads Preparing… while generating) regenerates the PATIENT REFERRAL FORM and opens it in a new tab — this is how you re-download or reprint a referral letter after the fact.
4. Follow up. People who can send referrals get Resend (for a failed or unsent referral), Update status (Received by the specialist, Appointment scheduled, Completed (patient was seen), once the referral has gone out) and Cancel referral (a reason is required). Everyone else sees one line saying who can. A sent referral is never deleted: cancel it instead.
5. Triage like any inbox item. Mark referrals read or unread and flag the ones you’re chasing — flags and read state are shared across the organization.

Receive consult reports & review the Letters tab

What comes back from outside care lands in three places: incoming documents arrive in the Faxes inbox, returned imaging surfaces on the chart’s Imaging tab, and the chart’s Letters tab keeps the history of every letter generated for the patient.

1. Import incoming faxes. Consult notes and imaging reports from outside providers usually arrive on your fax line. In Faxes, use Link patient & import (the button reads Linking & importing… while it works) to attach the document to the right chart — full mechanics in Import faxes into the chart. Imported documents are auto-classified — consultation notes file as clinical notes, referral paperwork as Referral — and land on the chart’s Media tab.
2. Review returned imaging. Reports attached to an imaging order surface on the chart’s Imaging tab with status chips Pending, No findings available, Normal study, and Abnormal. Opening a study shows the Technique, Findings, and Impression parsed from the report, the Accession Number:, and an Add to Note button to pull results into your documentation — report review in depth lives in Imaging results.
3. Check the Letters tab. It lists every generated letter and form with columns Date Requested, Physician, Type of Letter, Approval Status, and a View action, sortable by Date, Physician, Type, or Status. Status chips run Pending Review, Approved, Rejected, Completed, Processing, and Failed; letter types include Referral, FMLA Letter, Work/School Note, Insurance Letter, and Medical Summary.
4. Spot records the patient imported. Records a patient pulls in from Epic-based health systems through the portal’s record-import flow appear in the chart with an Imported from Epic badge on imaging studies and medications — handy when reconciling outside care.