Referral intake & eligibility
Every referral becomes a verified case — on arrival
A case's fate is mostly set in its first days: whether the facts got captured right, whether coverage actually holds, whether anything started moving. Perivanta opens the case the moment the referral arrives and does that work itself.
Perivanta is in development with founding design partners — this page describes the capability we’re building together.
- *** REFERRAL — RIVERBEND ORTHOPEDIC ASSOC ***
- PT: DANIELS, M · DOB 04/12/1968 · MRN 88213
- PROC: LEFT KNEE ARTHROSCOPY (CPT 29881)
- INS: MERIDIAN PPO · POL MP-4471 · GRP 2203
- NOTES: SEE ATTACHED — H&P TO FOLLOW
↓ extracted · source linked
- Patient✓ M. Daniels · 04/1968p.1
- Procedure✓ 29881 · left kneep.1
- Payer & plantwo active plansprimary confirmedp.1 + payer
- Eligibility✓ verified · ASC benefitpayer
- H&Pnot includedrequested · 08:31surgeon
- Every fact carries its source — nothing re-keyed by hand
- The coverage conflict surfaced on day one, not at preop
Every case still starts its life as a fax
Referrals arrive by fax, portal, phone, and email, and someone has to turn each one into a case: re-keying demographics into the PM system, calling the payer or running a portal check, spotting that the plan on the referral isn't the plan that's active. That work is slow, interrupt-driven, and invisible until it fails.
And it fails late. Eligibility gets checked once, then goes stale while the case waits. Coverage conflicts — a second active plan, a terminated policy, an out-of-network payer — surface at preop or, worse, after surgery as a denial. By then the room, the team, and the procedure are already spent.
What Perivanta does with a new referral
Perivanta treats intake as work to complete, not a queue to watch — every fact extracted, verified, and carried forward with its source attached.
Referral & order capture
Reads referrals from fax, portal, and inbox; opens the case; and extracts patient, procedure, surgeon, and payer facts as structured data with the source document linked.
Benefits & eligibility verification
Runs eligibility automatically — plan active, ASC benefit, deductible and out-of-pocket status — and records the evidence, not just a checkmark.
Coverage conflict detection
Flags two active plans, terminated coverage, out-of-network payers, and referral-vs-payer mismatches while there's still time to resolve them calmly.
Record reconciliation
Matches the referral against existing patients and prior cases, so duplicates and mismatched demographics are caught at the door.
Estimate groundwork
Carries verified benefits and deductible status straight into the patient estimate, so financial clearance starts from facts instead of a second lookup.
Continuous re-verification
Facts age. When the surgery date, payer, or procedure changes — or too much time passes — the affected checks re-run on their own.
Your intake team supervises. It stops re-keying.
Perivanta doesn't replace your practice-management or scheduling system — the case writes back to your systems of record through explicit, auditable workflows. What changes is who does the typing and the portal-checking.
Every extracted fact keeps its source lineage, and anything ambiguous — a conflict the payer can't resolve, a referral missing the essentials — is escalated to your team with the evidence assembled, not dropped into a work queue to be rediscovered.
Common questions
- How does Perivanta receive our referrals?
- Through the channels you already have: fax lines, referral portals, direct messages from physician offices, and email inboxes. The goal is that referring offices don't have to change how they send work for your center to stop re-keying it.
- Does this replace our PM or scheduling system?
- No. Your PM system keeps the booking and your EHR keeps the chart. Perivanta maintains the case record alongside them and keeps everything in sync — extracted facts flow in once and land everywhere they're needed, instead of being typed into each system separately.
- What happens when eligibility changes after intake?
- Verification isn't a one-time event. Perivanta re-runs the affected checks when the case changes — new date, new payer, new procedure — and on age, so the eligibility the schedule relies on is current, not a snapshot from three weeks ago.
- What if a referral is incomplete?
- Perivanta identifies exactly what's missing, requests it from the referring office on their channel, and tracks the follow-up. If the office goes quiet, the case escalates to your team with the history attached — it doesn't just sit.
Design partner program
Help build the system that does the work
We are selecting a small group of founding centers to shape the platform. Design partners get early access, direct input on the roadmap, and founding-partner terms.