Specialist provider group eradicates referrals leakage, increases revenues

Just by making these people, process and technology changes, our customer was able to reduce referral leakage to less than 2% with a proportionate increase in patient visit volumes and monthly revenues.

Our customer reached out to us when they started getting angry calls from various referral partners. According to our customers’ referring partners, they were not getting patient notes back on time (or ever). Our customer had received complaints from referring partners that they had no idea whether their patients were being seen or not. They were missing out on their own HEDIS reporting measures / timelines.

These complaints were from referring partners that already had a good relationship with our client. In other words, these referring partners had at least bothered to let the management team know their issue. Our customer had no idea how many referring partners had never bothered to complain, slowed down their referrals nor did they know how many referring partners they had lost.

We partnered with our client to understand the issue better. Our initial analytics showed us that:

  1. There was no process around closed loop referral management.
  2. The referral coordinators handled multiple referral sources. These sources were – fax, email, phone calls, 3rd party referral websites. However, there was no consolidation of incoming referrals. Hence, there was no visibility into referring partner volumes.
  3. There was no process around patient satisfaction or referring partner satisfaction engagement.
  4. There was no way to monitor conversion of referrals
  5. Intuition based referring partner relationship management

The solution

We proposed to solve this issue with changes to :

  1. People
  2. Processes
  3. Technology

We have always advocated the importance of closed loop referral management to increase revenues and at the same time, increase referring partner satisfaction. We believe that a high performing referral network not only benefits patients but also adds tremendous value to increase patient volumes. 

We consolidated from the 3 dedicated referral coordinators into one dedicated referral coordinator (outsourced to our patient contact center team).

As a next step, we started using EzMedicalReferral to start logging all incoming referrals from all the different sources. We knew that we would not be able to change the way our client’s referring partners sent referrals. So, instead, we decided to change the way we “manage” referrals. This alone gave us the visibility we needed across all incoming referral channels. This is akin to managing all incoming referrals in a spreadsheet (which is messy).

We put SLAs around incoming referrals.

  • Respond to each referral to within 1-2 hours of receiving the referral.
  • At the end of each day, generate a report to gauge incoming referrals vs referrals tended to.
  • Provide each patient appointment update within 24 hours. This included updating the partner with visit notes as well.
  • Call each referred patient at least and up to 3 times. After this, send the referral back to the referral sender.
  • Give each referred patient an appointment within a maximum of 2 weeks.
  • Each week, send a consolidated referral status update to both the referring partner and the manager.
  • Each month, ask every referring partner “how we are doing”.

Just by making these people, process and technology changes, our customer was able to reduce referral leakage to less than 2% with a proportionate increase in patient visit volumes and monthly revenues.

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