Print Manual

Please provide this link for all staff who will use Barnestorm Office to add Referrals. 

Have them use the guide, YouTube videos, and other supporting materials.  

We recommend saving the link to your favorites list in your web browser 

versus printing, as changes are made often. 

Table of Contents

Create a Patient Referral

Starting a Referral

You have the option to enter a completely new referral or you can re-admit a patient that was discharged from your services in the past.

From the Main Menu bar in Barnestorm Office click on the Referrals tab at the top of the page. The first page of the referral will open.  From here you have two options that will appear in the upper, left corner of the screen: 

New Referral:  If the patients has never been entered into the system before you can click on Start a New Referral.  

Re-Admit:  If you have a patient from the past that needs a new chart number pull that patient up from the Select Patient screen first.  Click on the Referrals screen. Click on the Re-Admit this Patient button and select all of the information you would like to copy from the old chart over to the new chart. Click on Proceed With Re-Admit.

Next:  The Click for Next Chart # field will become active.  You can either 1) Enter the first three digits of the sequence you are currently using; or 2) Leave this field blank.  Click on Next Chart # button.  The system will pick up the next available chart number.  Ex.  Enter 003 and the system will pick up the first chart that has not been used yet that starts with 003.  You can also enter the entire six digit chart number. If the number is acceptable then click on Accept Chart#.  The referral screen will become active.

Helpful Tip:  Throughout Barnestorm you'll be asked to enter pre-existing codes already entered in Barnestorm (ex Doctors, Employees, Facility).  The search box typically has one box on the left  and one on the right.  The box to the left will handle all numeric or code entries and the box to the right will handle all of the description or text entries. To fire a search, you can type the first 1-3 letter(s) or number(s) depending on your search criteria.  If you type a "W" in the numeric portion of the search box, the "W" will be moved over to the description box to perform the search.  This will return results immediately.  Below is an example of a search box. 

Start Screen

Next, enter the patient's name, address, and phone number. The patient's name cannot have a slash (/) in it.  You'll notice when you enter the zip code that the city and state are filled in automatically.  The county name will appear in black next to the City field.  This will help you identify which county code to use; if there's only one county code with that description then the county code will automatically be filled in, otherwise, you'll need to manually enter the code. The county must be identified correctly because it affects billing.  Be sure you have a process in place for the admitting nurse to let you know if the patient’s home is actually in another county from the one you identify at referral time.  Community codes are a way to break down geographical areas in whatever way makes sense for your home health business. NEW---PATIENT PORTAL: There is also a section to enter the patient's email address, and invite that patient to the Patient Portal.  Click here for information on this NEW feature.  There is an icon located beside the email section which allows you to send an email directly to the patient. Click on the icon, a box will appear for you to put in your information and hit Send to send the email to the patient.

NOTE:  Entering the SSN helps to determine "unduplicated" patient counts.  The birthdate appears on the claim and eligibility reports.

Often, this is all the information you are given on the initial phone call or faxed referral, besides an order to ‘Assess and treat’.


Important information to collect on this tab: Primary Emergency Contact and Patient Selected Representative.  Note, there should only be one contact marked as the Primary Emergency Contact check box that is located at the top, near the contact name.  All others can be marked under the Role option. 

Emergency Plan

The emergency plan is a new screen added to correspond to some of the 2018 CoP updates and can be located in Barnestorm Office on the Referral, from Point of Care on the Main Menu, and within a SOC, ROC or Recert assessment type. 

Risk identifies patients who must be located and possibly moved in the event of an emergency. This is required to be answered for Medicare patients. 

Acuity is the level of difficulty of the visit on a scale of 0 to 9, and each home health agency defines what the acuity levels mean for them.


Items to document are: additional services, advance directives, resuscitate status and physical parameters. Other articles related to parameters, here:  50785 and 50783.


If you have directions, you can type them in. If not, the Get Directions button will go to Google maps for you and find directions from the home health agency address to the patient's address. Notice that all the directions appear in the box. You can then change the directions, make them neater, and you can add additional information as needed.  There's a 1200 character limit - If the directions exceed that limit a warning will appear directing you clean up the directions.

History Tab

If you have any information about the patient's history at the time of referral, you may add it here. More commonly, this information will be completed after the initial assessment. Some examples of information on this page are the patient's nutritional requirements, for example, if they are diabetic; other items include allergies, infections, and other medical history information.


This is a blank text box to type information not found elsewhere in the Referral. 

Referral Information 

Enter the information you have from the referral: the person or facility who called or faxed information about the patient. It can be a doctor, facility, or hospital.

On the field for the doctor, you can look the doctor up in your list of doctors so you can be sure to get the right doctor code. You do this by typing in the first three letters of the doctor’s last name.

For example, if you want to enter Dr. Jeffrey Moore, type the first three letters of the doctor's last name: MOO. Then you will get a list of all doctors who have MOO in their names. From there, you can select the doctor and both the name and code will be filled in for you.

The source of admission options include:  1 = Nonhealthcare Facility Point of Origin, previously known as physician referral; and 4 for hospital referral, along with others listed on the dropdown list.

If you know the planned start of care date, enter it here. The rule is that the initial assessment must be within 48 hours, unless the doctor explicitly says otherwise, so you can enter the planned start of care as two days from now.  This date is for information and statistical purposes only - the actual admit date is noted on the last tab of the Referral.

You will indicate the patient status. You can list the patient as Active if they have been admitted, but more commonly, at the time of referral we just want to indicate that they have been referred but not yet admitted.

The admission date is set by default to the current date. In the point of care system used by the admitting nurse, this date will be changed during the admission process.

Finally, you need to add in the name or code of the person who is taking the referral--that's you.

Payers Tab

Under the payers tabs, you will indicate who will be providing payment for the patient's services.  Select the Payer1 tab to add the program and the payer codes. Click the Payer 2 panel near the top to add a second, third, and fourth payer.

For Medicare, it copies the patient's SSN into the HIC number field. Note that many insurers are moving away from using the SSN as the policy id, so you need to verify the information you have. Add an A to the end of the social security number to form the Medicare HIC number. The patient's information is automatically populated as the insured.

For Medicaid, you may need to change the HIC number.

The "Extra Billing Info" tab.  This is where you will add additional information for the payer, i.e. Carolina Access number, condition codes, occurrence codes, authorization numbers, etc.

The "Check Eligibility as of" uses Waystar to verify the patients eligibility as of the date selected. Note, you must have a Waystar account setup to use this feature. 

You MUST click the Save Payer button in order to Save your changes, and collapse the Payer screen. 

Select the patient's Current Payment Sources for Home Care. 

Doctor and Pharmacy Tab

Under the doctor and pharmacy tab, you will fill in all the doctors who are treating the patient and a pharmacy. To enter a doctor, you can use the same lookup technique you used on the first tab. if you know the first three letters of the doctor's last name, you can type those in and it will find the doctor for you.

If you know of other doctors who are treating the patient, consulting physicians, you can add them in by clicking on the consulting physician tabs and filling in their information. You can add up to 8 consulting physicians that way.

For consulting doctors, the Print Consulting Dr on the 485 will default as checked.  There is a global setting to leave the box unchecked when adding a new consulting doctor - Codes > Security > Global Setting > 0105. 

If a doctor has a license expiration date or an inactive date, the date will appear next to the doctor.  

For the pharmacy, you can look up a pharmacy by name or code if you know it, or if the pharmacy you want is not in the system, you may have to add it.  You have space to list three different pharmacies. 

To insert Oxygen, DME or Funeral Home information, select the search icon and search by name for the company.  Select the company and then select the Insert button. 

Employees Tab

On the employees tab, you add in which nurses or case managers are assigned to the patient. This information is usually not known until after the initial assessment, so it is normally filled in later.

You can fill in an employee by name or by code if you know the employee code.

Print Tab

You can print/preview this referral. When you click the Print Preview button, notice that all the information entered is on this sheet, as well as your signature if you have entered one into the system. You can print using the button in the upper left.

Print your admission package from this screen if your agency is setup for this feature. 

Main Menu to the left

Throughout the Referral screen you'll have access to pop up windows for ICD, Surgery, Med and Facility History, Orders and Authorizations.  These can also be accessed from the Main Menu > Patient Histories. 

Start a Readmit

To enter minimal information at referral time you can readmit a patient's previous chart number.

  1. Pull up the previous chart from the Main Menu in Barnestorm Office.
  2. Click on the Referrals button.
  3. Click on the Re-Admit this Patient button.
  4. Select which information you would like to have copied from previous chart to new chart: ICD Codes, Surgery Codes, Medications, Facility, Immunizations, Schedule, Aide Care Plans, Physicians or Contacts.
  5. Click on Proceed with Re-Admit.
  6. Enter the first three numbers of a chart you would like to start with then click on Get Next Chart #.
  7. Click on Accept Chart #.
  8. The patients demographics and selected information will copy over.  
  9. Enter needed information then click on Save All Patient Data

Save a Referral

Any time you click on a different tab, you save the information you have typed. So, as you move from tab to tab, the system is automatically saving what you have typed on the previous tab.

If you ever type in something and then plan to close that window without moving to another tab, you will need to use the Save All Patient Data button on the left menu above the Exit button. You only need to use this button if you do not click on another tab after you type in information.

So, you can save either by clicking another tab or by clicking the Save All Patient Data button.

*Note:  The only exception to this rule is when adding/editing a payer, you must click on the Save Payer button to save the payer changes. 

Add / Discharge / Delete Employees to Patient Referral

Add New Employees

  1. Click the Referral button from the main menu. The Referral window will open.
  2. Click the Employees tab on the top.
  3. On the employees tab, you add in which employees are assigned to the patient.  The case manager should always be first on the list. You can fill in an employee by name or by code if you know the employee code.
  4. Each time an employee is added, the name goes to the end of the list.  Use the arrow buttons labeled Move Up to move employees to the appropriate place.
  5. There's a maximum of 50 employees allowed on the list. 
Discharge Employee
  1. Check the D/C checkbox for the discharged employee.
  2. Then, complete the Discharge Date as the date employee was discharged.

Delete an Employee
If an employee was added by mistake, click the X box to the left of their name.

Features related to using this screen: 

  • Patients will appear in the My Patient list for POC users if their names are listed here.  
  • You can also run active patient reports by employee using Reports > Patient > 01.06 Selected Patients Detail. 
  • Report 01.11 Employee Involvement is another report linked to the employees listed on the Referral. 


Acuity is the level of difficulty of the visit on a scale of 0 to 9. Each home health agency defines what the acuity levels mean for them. Some of our reports include the patient's Acuity, including Reports > Patient > All Pts with Acuity.

The Acuity level can be documented in the Referral, or POC > Assessment > Pt Contact Info Screen.


Risk identifies patients who must be located and possibly moved in the event of an emergency. JCAHO recommends that all patients be classified as high, medium, or low risk, and that agencies be able to quickly identify all high risk patients.

Key Points on Entering Your Referral

1.  When entering the patient name, there cannot be a slash (/) in the name.  This may cause issues pulling up certain screens within Barnestorm.

2.  Under the Start tab, the County code must be listed.  If not listed, this will affect the CBSA and Wage Index, causing the HIPPS code for the episode to be low.  An empty field will also affect “counts” in reports that include the county code.

3.  Under the Start tab, the Gender and the Date of Birth must be filled in.  Otherwise, it will cause an error in billing screen and cause a delay in the billing of the NOA.

4.  Under the Payers tab, the Program and Payer must be listed.  If not listed, the POC users will not be able to access the patient.  This will also cause an issue with the NOA getting out timely.

5.  Under the Referral Information tab, the Admit Date must reflect the patients start of care date.  If it is not correct it may cause issues with timely billing, as well as entering charges / assessments. 

6.  Under the Payers tab > Extra Billing Info:  The condition code 47 is required for all admissions where the patient was recently transferred/received from another HHA.  If this code is not entered, the NOA will deny, causing your NOA submission to be late.  You will need to notify your billing staff, ASAP, to ensure this code gets appended to the NOA claim prior to submission.

7.  To discharge a patient, this must be documented under the 2 tabs:  The Payers tab, and the Referral Information tab.  Otherwise, the patient will not be “completely” discharged.  To view on how to Discharge a Patient click here.

All fields are important.  We recommend that you fill in all the fields using the information you have for the patient.  These key points are mentioned because if they are not filled in correctly, they may cause issues when you access other parts of the Barnestorm Software.

Click HERE to see "How To Find Out If Patient Is Missing Information From Referral Screen."

Change Status to Active

1.  Pull up the patient from the Select Patient screen.
2.  Click the Referral button from the main menu and c
lick the Referral Information tab.
Change the Patient Status to Active.
Fill in the correct Admit Date.
Choose the appropriate Admit Type, which identifies if this as a new admit, readmit, or pay source change etc.
Click the Save All Patient Data button.

Note: If a patient is marked as RBNA, they will not show up for billing when using Billing > All Other Billing.

Change Status to Not Admitted

After the referral information is entered, if you find out that the referral will not be admitted, then complete these steps:

  1. Pull up the patient from the Select Patient screen.
  2. Click the Referral button from the main menu then select the Payers tab.
  3. Select the payer and check the Discharged box.
  4. Use the calendar drop down box to select a discharge date.
  5. Choose the reason of why the patient was not admitted from the Discharge Reason drop-down box.
  6. Click the Save Payer button. Note that if the patient has a schedule built, a pop up may appear asking if you want to remove the schedules. 
  7. The Referral Information tab will automatically get updated to a discharge reason.  You can change the reason if needed.
  8. The admit types numbered from 70-99 are used to indicate the reason that this referral was never admitted. 
  9. Click the Save All Patient Data button. The referral has now been changed to not admitted.

 *Note: Most accurate date for discharge to use is the date patient refused.  Make sure the patient status and admit type reflects not admitted. 

Change Status to On Hold

If the referral is not admitted by the expected date, or the hospital discharge planner calls and says the patient will not be discharged as expected, or the patient is admitted to the hospital during services, complete these steps:

  1. Pull up the patient from the Select Patient screen.
  2. Click the Referral button from the main menu then click the Referral Information tab.
  3. Change the Patient Status to On Hold - in another facility or On Hold - other.
  4. If the patient has future schedules a pop up will appear asking if you want to remove all future schedules.  Click on Yes or No.
  5. Click the Save All Patient Data button.

Changing Payer and Patient Status to Discharged

We offer two different ways to document a discharge. Below shows both options.

Option A
The following steps will walk you through discharging a payer; and, marking another payer as primary, as needed. 

1.  Pull up the patient from the Select Patient screen.
2.  Click the Referrals button from the main menu and then click the Payers tab.
3.  Select the payer that is being discharged.
4.  Check the Discharged box to the left of the Discharge Date.

From here there are two options to select a discharge date (if discharging the primary payer).
A. Use the calendar drop down box to select a discharge date OR
B. Click the Find Last Visit Date to automatically change the date to the last visit/supply charge. A pop u box will appear letting you know which date was found.  
If the payer is Hospice and the death date if filled in from the Patient Information tab - that date will be used. 

The Patient Status will get updated to Discharged - goals met or if a death date was found it will get updated to Deceased. 

5.  Choose the discharge reason from the DC Reason drop-down box.
6.  Click Save Payer - important step.
7.  If the patient has future schedules under that payer, you will have a chance to delete all future schedules.  A popup will appear, select Yes or No as applicable.
8.  (Optional if patient is staying active) If the patient is only being discharged from the payer, after discharging that payer, select the active payer and click the option to Move to Primary. *Note that the patient status will change back to Active. 
9. To change or verify the patient status click the Referral Information tab.  
10. At the bottom, under Patient Status, select the appropriate discharge reason, as needed.
11. Press Save All Patient Data.    

Referrals > Referral Information tab > Discharge Summary button

If you would like to document discharge information related to condition at discharge, goals summary/outcomes, and discharge information, start with this screen for discharging a patient. This will automatically mark the patient's discharge date and change the patient's status. If the patient has future schedules, it will also give you the option to remove future schedules.

Start at the top with the discharge date. Only add the Death date if the patient expired. Note that there are two dates, one for D/C Date and one for Death. Make sure each date is answered correctly. The D/C Date will update the discharge date on the payer screen and the Death date will update the Death date on the Start screen. Do not answer Death date if the patient did not expire. 

Answer each question that is valid for the discharge. If there are future schedules there will be a checked box towards the bottom of the screen with the number of future schedules. If you leave this box checked it will remove those schedules. This is especially important for employees who use the Care Champ app. This will remove the visits from the app for them. 

There is no need to document the discharge information from the Payers or Referral Information tab. This process will update automatically. 

Remove or delete a chart number

A chart can be removed by pulling the chart number up from Select Patient and going to the Referrals screen.  

1)  Even though you are removing the chart, go to the Payers tab of the referral and discharge the payer for not admitted.  This will clear out EVV schedules as needed.  Be sure to answer Yes to the pop up question on removing schedules.
2)  Click the button "Remove This Chart#" from the left, bottom panel of the Referral.  
You will either receive a message: 
    A) Asking if you are sure you want to deleted.  
    B) Letting you know if there's current data in the chart.  The chart cannot be removed until the data has been reviewed and deleted or corrected, as needed. 

If you received a referral and the patient was not admitted, you may want to consider using the Change Status to Not Admitted article instead of deleting the chart.

When to Create a New Chart Number in Barnestorm

We get a lot of calls asking when a patient should be “discharged” from one chart and admitted to another chart number.  Below are examples of when to switch a chart number.

NOTE:  When in doubt, we recommend you contact the payer on their policies.