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Referral Form
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Healthcare Document Intelligence
The world's best referral form extraction
Accelerate specialist referral workflows with automated form processing. Extract referring and receiving provider details, patient demographics, clinical indications, and urgency levels. Reduce referral leakage and improve care coordination.
referral-form.pdf
REF-2024-45678
Routine
Emily R. Johnson
1989-07-12
(555) 867-5309
456 Maple Drive, Seattle, WA 98101
Aetna PPO
AET789456123
Dr. Michael Torres, MD
1234567890
Seattle Family Medicine
(555) 234-5678
(555) 234-5679
Cardiology
Dr. Lisa Wang, MD
0987654321
Pacific Heart Specialists
(555) 345-6789
(555) 345-6790
Palpitations
R00.2
Secondary diagnoses
1 item| Diagnosis | Icd10 code |
|---|---|
Anxiety disorder | F41.9 |
Patient experiencing frequent palpitations, episodes lasting 5-10 minutes, occurring 2-3 times weekly for past 2 months. ECG showed occasional PVCs. Requesting cardiac evaluation and possible Holter monitoring.
No prior cardiac history. Family history positive for atrial fibrillation (mother). Non-smoker. Moderate caffeine intake.
Current medications
1 item| Medication | Dosage |
|---|---|
Sertraline | 50mg daily |
Tests performed
3 items| Test | Date | Result |
|---|---|---|
12-lead ECG | Mar 15, 2024 | Occasional PVCs, otherwise normal |
CBC | Mar 15, 2024 | Within normal limits |
TSH | Mar 15, 2024 | 2.1 mIU/L (normal) |
Services requested
3 items| Value |
|---|
Cardiac evaluation |
Holter monitor |
Echocardiogram if indicated |
Pending
—
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DocuPipe captures referral forms from fax queues, EHR exports, or scanned documents. Extract patient info, clinical reasons, and provider details, then route to appropriate specialists and sync with practice management systems.
Sources
EHR/EMR
Fax/eFax
P
Patient Portal
Document Scanner
Destinations
EHR/EMR
Claims Platform
P
Practice Management
API
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Your business has specific documents with your own rules of how you need to understand them and act on them. Define exactly what you need to extract, reliably, for any layout and language.
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Better in every way
Experience accuracy, flexibility, and speed with DocuPipe.
| Feature | DocuPipe | Textract | Google OCR | GPT |
|---|---|---|---|---|
| OCR printed text | ||||
| Handle simple tables | ||||
| Handle long documents | ||||
| OCR handwriting | ||||
| Nested tables | ||||
| Complex forms | ||||
| Crossed out text | ||||
| Support for 60+ languages | ||||
| AI document standardization | ||||
| Speed | ||||
| Document type classification | ||||
| Document Splitting | ||||
| Highlight information source on document | ||||
| Visual Review |
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