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An effective referral management process improves patient care, and making life easier for patients is always our first goal. Sometimes, though, what is good for the patient is good for the bottom line, and in the case of referral management, it is very good.

Take a look at open orders, which are a big part of the revenue opportunity of an effective referral management process. When a patient visits her primary care physician, receives a referral to see a specialist, and then leaves without the appointment scheduled, there is a process problem. Patients get busy, they do not prioritize their health, they get lost in the shuffle of life, and that open order sits in the system, not making the organization any money. This is a huge gap in the referral management process. That order is revenue sitting on the table, and it starts to add up. Just ask our clients that had upwards of $2 million of unscheduled orders sitting in the system.

We fix this issue the usual way. We take a step back and look at the entire referral management process from start to finish, from the first point of contact with the primary care physician and go from there. Is it possible to create a process that schedules the specialist appointments in the PCP office itself? Is it possible to make sure no patient leaves without his next appointment already scheduled? Can we automate that process to make it easy for staff?

As much as we want that to happen, sometimes we cannot overhaul the process completely. In that case, we look to the contact center. We look for a way for an organization’s contact center to reach out to those patients who need care, to get their appointments scheduled, and then send them reminders to ensure they show up.

Creating new processes, whether at the doctor’s office or through the contact center, is not easy. It requires cooperation across the board and with all levels of the organization. But as other health systems can attest, the results from a fully functional referral management process will be well worth the effort.

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