Closed Loop Referral
Through this module, a provider should be able to send a referral and know, not guess, whether the client got connected to the service on the other end.
Why this matters
A referral that ends at the handoff is not much better than no referral at all. Without a way to track what happens after a referral is sent, providers are left guessing whether a client followed through, and counties have no reliable way to close gaps in care. As an interoperability accelerator, Connex Closed-Loop Referrals aligns directly with regulatory care coordination requirements by facilitating real-time data exchange as part of any referral.
What this is
The Closed Loop Referrals module, part of Connex's care coordination capabilities, gives providers secure, two-way referral tracking. A referral sent through the system is not just transmitted: the sending and receiving parties can exchange status updates, so the originating provider can confirm the client was linked to services rather than assuming the referral worked. The module also includes Prior Authorization API functionality, aligned with CMS Interoperability requirements, both as a standalone function and for the authorization workflows that often run alongside a referral.
Who it is for
Providers and care coordinators who send referrals both internally and to outside organizations, whether managed care plans, other behavioral health providers or community-based organizations, and who need confirmation the client was actually connected to care. It is also for county compliance teams tracking CMS and DHCS interoperability requirements tied to referral and prior authorization workflows.
Capabilities
What the module does
Bidirectional referral tracking
Sends and tracks referrals with the receiving organization, so providers can confirm the referral loop actually closed instead of assuming it did.
Prior authorization support
Includes Prior Authorization API functionality aligned with CMS Interoperability requirements and state compliance standards, supporting the authorization steps that often accompany a referral.
Regulatory alignment
Built to align with federal and state interoperability requirements.