Every referral, worked to the end. The agent finds a specialist who will accept, clears the authorization, books the patient and brings the consult note back into your chart. Your coordinators handle the exceptions.
Referral
“It used to take us two or three weeks. Now it's done in two days using First Outcomes AI Referral Coordinators.”Carlos Peralta, COO, Ampla Health
The problem
Ordering a referral takes seconds. Then a coordinator faxes it, waits on a portal, sits on hold with the specialist office and chases the consult note for weeks. With too few coordinators, referrals stall and the loop stays open, even though PCMH requires you to track it to the end.
How the agent works
Pulls the referral and clinical documents from your EHR. Matches in-network specialists on plan, distance and wait. Calls the office to confirm they will take the patient, and works down your panel in your order if they won't.
EHR
Specialist match Office confirmed
Submits the eRAF or prior authorization by plan portal, IPA portal or fax. Rechecks and answers follow-ups until the authorization posts.
eRAF
Portal / Fax
Auth
Faxes the referral and records to the accepting office. Calls the patient with the doctor's name and address and, if they want help, schedules the visit on a three-way call.
Fax to office
Patient call
Three-way call
Confirms the visit happened, requests the consult note, retrieves the fax and files it to the patient record. Books the PCP follow-up in your EHR if you want it.
Office
Consult note
EHR
What your coordinators do
Pulls referrals and documents from the EHR
Sets the specialist panel order and referral rules
Calls specialist offices and works down your panel
Decides on a referral no office will accept
Submits and tracks authorizations
Handles denials that need clinical input
Calls, texts and books patients, including three-way calls
Talks with patients who ask for a person
Retrieves and files consult notes, books PCP follow-up
Reviews the monthly report: referrals, calls, auths, hours saved
Results at Ampla Health
Ampla Health uses the AI Referral Agent across its 18 locations.
“At Ampla Health, our AI Referral Agents do 75% of the referral work; human coordinators handle the exceptions.”Carlos Peralta, COO, Ampla Health
Getting started
| Who | What they provide | Time |
|---|---|---|
| Your IT team | EHR credentials, plan portal credentials, fax routing | About 20 hours total |
| Your referral team | Specialist panel order, referral rules, portal navigation steps, an owner for exceptions | A few working sessions |
| First Outcomes | Workflow setup, testing on your real referrals, patient call and text disclosures and opt-outs | Included in implementation |
Questions health centers ask
No. The agent does the repetitive steps. Coordinators handle the exceptions and the patients who need a person.
athenahealth, eClinicalWorks, NextGen, Epic, CureMD, MidMed and most FHIR-enabled EHRs.
By fax, which most specialist offices still rely on, and by portal or Direct messaging where the office supports it.
Every patient call announces that it is recorded. If you don't have consent language for calls and texts, we provide it.
A monthly fee plus a per-referral rate, sized to your volume. We quote after reviewing your workflow.
Book 30 minutes with Dinesh Gambhir, CEO. We will walk a real referral from order to closed loop.
Book time with Dinesh >