This data model communicates patient demographic and clinical information from a referring provider to send the patient's case to another provider.
This typically differs from a consultation, where a provider may review a patient without assuming authority over the patient’s care. Referrals can be internal to an organization (e.g., from one department to another) or external between organizations.
A referral is useful to maintain the administrative aspects of a referral order. You can receive notifications when:
- A new referral order is placed.
- An existing referral order is modified or canceled.
- An authorization review is requested or responded to.
Or, you can search for referral orders based on a patient's demographic and insurance information.
Receive a notification when a new referral order is placed in the EHR system.
Request Body Schema
- Metarequired, object
- DataModelrequired, stringReliable
Referral
- EventTyperequired, stringReliable
New
- EventDateTimestring, nullReliable
Displays the UTC date and time that an outgoing request is delivered or an incoming request is received.
ISO 8601 Format - Testboolean, nullReliable
Indicates whether the request is a test or not.
- Sourceobject
Contains the information for the system initiating the message, including the source ID and name.
Included in messages from Redox- IDstring, nullReliable
Identifies the system initiating the message. If you have multiple OAuth API keys per environment type, this value is required. If you have only one OAuth API key per environment type, or you're using legacy API keys, this value is optional.
UUID - Namestring, nullReliable
Displays the name of the system initiating the message.
- DestinationsArray of object
Contains the information for the endpoint(s) receiving the request. A request must contain at least one destination, but asynchronous requests can have more than one destination. Synchronous requests like queries can only support one destination.
Required when sending data to Redox.- IDstring, nullReliable
Identifies the endpoint that the request is directed to.
UUID - Namestring, nullReliable
Displays the name of the endpoint that the request is directed to.
- LogsArray of object
Contains the log identifier(s) for the request.
- IDstring, nullReliable
Identifies the request log(s) that correspond to this request. You can use this value to locate the relevant log in the Redox dashboard for support and reference.
UUID - AttemptIDstring, nullReliable
Identifies the request log attempt value, which is useful when retries are possible.
UUID
- FacilityCodestring, nullPossible
Code for the facility related to the message.
Only use this field if a health system indicates you should. The code is specific to the health system's EHR and might not be unique across health systems. In general, the facility fields within the data models (e.g. OrderingFacility) are more reliable and informative.
- Patientrequired, object
- Identifiersrequired, Array of object
List of IDs and ID types that identify the patient
- IDrequired, stringReliable
ID for the patient
- IDTyperequired, stringReliable
Type of ID.
E.g. MRN, EPI
- Demographicsobject
- FirstNamestring, nullReliable
Patient's first name
- MiddleNamestring, nullPossible
Patient's middle name or middle initial. For patients with multiple middle names, all their middle names are included in this field.
- LastNamestring, nullReliable
Patient's last name
- DOBstring, nullReliable
Patient's date of birth.
In ISO 8601 format - SSNstring, nullProbable
Patient's social security number
- Sexstring, nullReliableValue Set
Patient's sex
- Racestring, nullPossibleValue Set
Patient's race
- IsHispanicboolean, nullPossibleValue Set
Indicates if the patient is of hispanic origin.
- Religionstring, nullPossibleValue Set
Patient's religious affiliation
- MaritalStatusstring, nullPossibleValue Set
Patient's marital status
- IsDeceasedboolean, nullPossible
Indicates if the patient is deceased
- DeathDateTimestring, nullPossible
Date and Time the patient was proclaimed deceased.
ISO 8601 Format - PhoneNumberobject
- Homestring, nullProbable
Patient's home phone number.
In E. 164 Format. (e.g. +16085551234) - Officestring, nullProbable
Patient's office phone number.
In E. 164 Format. (e.g. +16085551234) - Mobilestring, nullProbable
Patient's mobile phone number.
In E. 164 Format. (e.g. +16085551234)
- EmailAddressesArray of string
Patient's email address(es)
- Languagestring, nullPossibleValue Set
Patient's primary spoken language.
In ISO 639-1 alpha values (e.g. 'en'). Supported Values - CitizenshipArray of string
Patient's nation(s) of citizenship.
In ISO 3166 alpha 2 format (e.g. 'US'). - Addressobject
Patient's home address
- StreetAddressstring, nullProbable
Street address
- Citystring, nullProbable
City
- Statestring, nullProbable
State
- ZIPstring, nullProbable
ZIP
- Countystring, nullPossible
County
- Countrystring, nullPossibleValue Set
Country
- NotesArray of string
Patient-level notes
- ContactsArray of object
- FirstNamestring, nullPossible
First name of the contact
- MiddleNamestring, nullPossible
Middle name of the contact
- LastNamestring, nullPossible
Last name of the contact
- Addressobject
Address of the contact
- StreetAddressstring, nullPossible
Street address
- Citystring, nullPossible
City
- Statestring, nullPossible
State
- ZIPstring, nullPossible
ZIP
- Countystring, nullPossible
County
- Countrystring, nullPossibleValue Set
Country
- PhoneNumberobject
- Homestring, nullPossible
Home phone number.
In E. 164 Format. (e.g. +16085551234) - Officestring, nullPossible
Office phone number.
In E. 164 Format. (e.g. +16085551234) - Mobilestring, nullProbable
Mobile phone number.
In E. 164 Format. (e.g. +16085551234)
- RelationToPatientstring, nullPossibleValue Set
Personal relationship to the patient.
e.x. Father, Spouse - EmailAddressesArray of string
Email address(es) of the contact person
- RolesArray of string
Role of this contact for the patient.
e.x. Employer, Emergency Contact
- Guarantorobject
Person ultimately responsible for the bill of the appointment
- Numberstring, nullProbable
Number of the guarantor
- FirstNamestring, nullProbable
First name
- MiddleNamestring, nullPossible
Middle name
- LastNamestring, nullProbable
Last name
- SSNstring, nullPossible
Guarantor's social security number
- DOBstring, nullPossible
Guarantor's date of birth.
In ISO 8601 format - Sexstring, nullPossibleValue Set
Guarantor's sex.
One of the following: Female, Male, Unknown, Other - Spouseobject
- FirstNamestring, nullProbable
Spouse's first name
- LastNamestring, nullProbable
Spouse's last name
- Addressobject
Address of the guarantor
- StreetAddressstring, nullProbable
Street address
- Citystring, nullProbable
City
- Statestring, nullProbable
State
- ZIPstring, nullProbable
ZIP
- Countystring, nullPossible
County
- Countrystring, nullPossibleValue Set
Country
- PhoneNumberobject
- Homestring, nullProbable
Home phone number.
In E. 164 Format (i.e. +16085551234) - Businessstring, nullProbable
Business phone number.
In E. 164 Format (i.e. +16085551234) - Mobilestring, nullProbable
Mobile phone number.
In E. 164 Format (i.e. +16085551234)
- EmailAddressesArray of string
Guarantor's email address(es)
- Typestring, nullProbable
Type of guarantor.
E.g. institution, individual - RelationToPatientstring, nullProbableValue Set
Relation to the patient
- Employerobject
- Namestring, nullProbable
Employer's name
- Addressobject
Employer's address
- StreetAddressstring, nullProbable
Street address
- Citystring, nullProbable
City
- Statestring, nullProbable
State
- ZIPstring, nullProbable
ZIP
- Countystring, nullPossible
County
- Countrystring, nullPossibleValue Set
Country
- PhoneNumberstring, nullProbable
Employer phone number.
In E. 164 Format (i.e. +16085551234)
- InsurancesArray of object
List of insurance coverages for the patient
- Planobject
- IDstring, nullProbable
Identifier of insurance plan
- IDTypestring, nullProbable
ID type of insurance plan
- Namestring, nullProbable
Name of insurance plan
- Typestring, nullPossible
Type of insurance plan
- MemberNumberstring, nullPossible
Patient member number
- Companyobject
- IDstring, nullProbable
ID of insurance company (payor)
- IDTypestring, nullProbable
ID type of insurance company (payor)
- Namestring, nullProbable
Name of insurance company (payor)
- Addressobject
Insurance company's address
- StreetAddressstring, nullProbable
Street address
- Citystring, nullProbable
City
- Statestring, nullProbable
State
- ZIPstring, nullProbable
ZIP
- Countystring, nullPossible
County
- Countrystring, nullPossibleValue Set
Country
- PhoneNumberstring, nullProbable
Insurance companys phone number.
In E. 164 Format (i.e. +16085551234)
- GroupNumberstring, nullProbable
Insurance policy group number
- GroupNamestring, nullProbable
Insurance policy group name
- EffectiveDatestring, nullProbable
Effect date of this insurance policy.
In YYYY-MM-DD format - ExpirationDatestring, nullProbable
Expiration date of this insurance policy.
In YYYY-MM-DD format - PolicyNumberstring, nullProbable
Insurance policy number
- Prioritystring, nullPossibleValue Set
The insurance priority sequence.
If the insurance works in conjunction with other insurance plans, this field contains priority sequence. - AgreementTypestring, nullProbableValue Set
Type of insurance agreement.
- CoverageTypestring, nullProbableValue Set
Type of insurance agreement.
Indicates who will be receiving the bill for the service. - Insuredobject
Individual who has the agreement with the insurance company for the related policy
- IdentifiersArray of object
List of IDs and ID types that identify the insured
- IDstring, nullPossible
ID for the insured
- IDTypestring, nullPossible
Type of ID.
E.g. MRN, EPI
- LastNamestring, nullPossible
Last name of the insured
- MiddleNamestring, nullPossible
Middle name of the insured
- FirstNamestring, nullPossible
First name of the insured
- SSNstring, nullPossible
Insured's social security number
- Relationshipstring, nullPossibleValue Set
Relationship of the insured to the patient
- DOBstring, nullPossible
Date of birth of the insured.
In YYYY-MM-DD format - Sexstring, nullPossibleValue Set
Sex of the insured
- Addressobject
Address of the insured
- StreetAddressstring, nullProbable
Street address
- Citystring, nullProbable
City
- Statestring, nullProbable
State
- ZIPstring, nullProbable
ZIP
- Countystring, nullPossible
County
- Countrystring, nullPossibleValue Set
Country
- Referralobject
- IDstring, nullReliable
The Health System ID of the referral
- IDTypestring, nullReliable
The ID type
- AlternateIDstring, nullReliable
The alternate ID of the referral, often used by external/3rd party systems
- Typestring, nullReliableValue Set
The type of the referral
- Categorystring, nullReliableValue Set
The category of the referral
- Prioritystring, nullReliableValue Set
The priority of the referral
- Statusstring, nullReliableValue Set
The status of the referral
- DateTimestring, nullReliable
The date and time the referral is considered active.
ISO 8601 Format - ExpirationDateTimestring, nullReliable
The date and time the referral expires.
ISO 8601 Format - ProcessDateTimestring, nullReliable
The date and time the referral was processed.
ISO 8601 Format - Reasonstring, nullProbableValue Set
The reason for the referral
- ProviderSpecialtystring, nullPossible
The provider specialty of the referral
- DepartmentSpecialtystring, nullPossible
The department specialty of the referral
- NotesArray of string
Referral Notes
- Authorizationobject
- Planobject
- IDstring, nullPossible
The ID of the plan
- IDTypestring, nullPossible
The ID type
- Namestring, nullPossible
The name of the plan
- Companyobject
- IDstring, nullPossible
The ID of the payor
- IDTypestring, nullPossible
The ID type
- Namestring, nullPossible
The name of the payor
- DateTimestring, nullPossible
The date and time the authorization is effective.
ISO 8601 Format - ExpirationDateTimestring, nullPossible
The date and time the authorization expires.
ISO 8601 Format - Numberstring, nullPossible
The identifier for the authorization assigned by the payor
- ReimbursementLimitstring, nullPossible
The reimbursement limit for this referral
- RequestedTreatmentCountstring, nullPossible
The number of treatments requested
- RequestedTreatmentUnitsstring, nullPossible
The units associated to the treatment count.
e.g. 'instances' or 'days' - AuthorizedTreatmentCountstring, nullPossible
The number of treatments authorized
- NotesArray of string
Notes about the authorizations
- DiagnosesArray of object
List of diagnoses
- Codestring, nullProbable
Code for the diagnoses
- Codesetstring, nullProbableValue Set
Code set used to identify the diagnoses.
One of the following: ICD-9, ICD-10, HCPCS, CPT - Namestring, nullProbable
Name of the diagnoses
- Typestring, nullPossibleValue Set
Type of the diagnosis
- DocumentedDateTimestring, nullPossible
DateTime the diagnoses was documented.
ISO 8601 Format - NotesArray of string
Notes about the diagnosis
- ProceduresArray of object
Ordered procedure
- Codestring, nullReliable
Code for the procedure
- Codesetstring, nullReliable
Code set used to identify the procedure.
CPT, HCPCS, SNOMED, or LOINC. If no code set is specified, a health system specific identifier is being used. - Descriptionstring, nullReliable
Description of the procedure
- NotesArray of string
Notes about the procedure
- Quantitystring, nullPossible
Number of instances for the procedure
- Unitsstring, nullPossible
Related units associated to the procedure quantity
- ModifiersArray of string
Associated procedure modifiers
- ProvidersArray of object
- IDstring, nullPossible
ID of the provider.
This ID is often required for Inpatient Visits. - IDTypestring, nullPossible
ID type of the ID for the provider
- FirstNamestring, nullPossible
First name of the undefined
- LastNamestring, nullPossible
Last name of the undefined
- CredentialsArray of string
List of credentials for the undefined.
e.g. MD, PhD - Addressobject
Provider's address
- StreetAddressstring, nullPossible
Street address
- Citystring, nullPossible
City
- Statestring, nullPossible
State
- ZIPstring, nullPossible
ZIP
- Countystring, nullPossible
County
- Countrystring, nullPossibleValue Set
Country
- EmailAddressesArray of string
Provider's email address(es)
- PhoneNumberobject
- Officestring, nullPossible
Provider's office phone number.
In E. 164 Format. (e.g. +16085551234)
- Typestring, nullPossibleValue Set
The type of provider
- ContactInfostring, nullPossible
Additional contact information for this provider
- Locationobject
Provider's location
- Typestring, nullPossible
Type of location.
Examples: Clinic, Department, Home, Nursing Unit, Provider's Office, Phone - Facilitystring, nullPossible
Facility.
Example: Community Hospital - FacilityIdentifiersArray of object
List of IDs specific to this facility
- IDstring, nullPossible
An ID specific to this facility
- IDTypestring, nullPossible
The source or system to which this ID pertains.
Could be an OID or a human-readable name
- Departmentstring, nullPossible
Department
- DepartmentIdentifiersArray of object
List of IDs specific to this department
- IDstring, nullPossible
An ID specific to this department
- IDTypestring, nullPossible
The source or system to which this ID pertains.
Could be an OID or a human-readable name
- Roomstring, nullPossible
Room.
Example: 136
- Visitobject
- VisitNumberstring, nullPossible
Visit Number.
Unique ID of the visit associated to the referral
- Visitobject
- VisitNumberstring, nullPossible
Visit Number.
Unique ID of the visit associated to the referral