Simione™ Healthcare Consultants

Building a Referral Process that Delights the Customer

In the world of home care and hospice, the most successful teams have learned to live by “It’s not about us, it’s about them.”  This outward focus on the customer, coupled with high-quality services, is one hallmark for differentiating a modern post-acute care agency from its competition.

Three key strategies for driving such excellence in customer service include:

  • Achieving accuracy and compliance in the referral process

  • Maintaining a sense of urgency and assisting families with barriers to care

  • Executing agency-wide customer service procedures and continually monitoring progress

Accuracy in Referrals

Without the correct information at the time of referral, agencies may be compromising their regulatory compliance.  Key factors include the order for care, a certificate of terminal illness (for hospice), consents and other legal documents.  To ensure quality of care, additional information is helpful such as the patient’s recent history and physical examination, medications, and equipment needs.  It is also important to address the family expectations for care.  From a financial perspective, accuracy pertains to insurance verification/pre-certification, face-to-face requirements, and consent information.

Attention to accuracy also affects business development activities. Agencies should develop a process to evaluate reasons why a patient was ultimately not admitted for care, information about referral sources, how patients/families heard about their organizations, and the impact of each team member’s activities. 

A Sense of Urgency

Since many factors can delay a home care or hospice admission, agencies must define a strategy to maintain a sense of urgency in handling referrals. Urgency means determining what is important to each referral source and delivering on those specific needs, knowing your current response time from referral to first visit, learning how to handle callers to get to the first visit, involving your team in improving that response time, and following up with vigilance on pending admissions. While barriers are preventing timely admission, a patient’s needs are often escalating,in the case of hospice, referrals are often plagued by the stress surrounding the situation.  When families express concerns about readiness or logistics, they need a high level of ease, reassurance and responsiveness from the agency to get their loved one admitted in a timely fashion. Timing is critical to help the patient tap into the important benefits that home care or hospice can offer.

The same holds true for referral partners.  Whether hospital, skilled nursing facility or other provider, they want referrals to be easy and the home care or hospice agency to be highly responsive to their timetables and patients’ needs.Teams need to discuss how they will handle barriers to care in the referral process.  If you can define common barriers to care and develop strategies for each scenario, you will be more effective in facilitating timely admissions.

Customer Service: It’s Everyone’s Job

Common sense says having your team on the same page will help build referrals.  But, they need to have an understanding of all customer groups and how needs may differ from one group to the next. We recommend agencies start by identifying each customer group – referral partners, consumer callers, professional callers and internal customers – discussing each group’s needs, and defining what constitutes ‘great service’ with help from their customers.

When you consider all that your agency has to offer, service may be your greatest differentiator in attracting referrals and securing admissions. In the eyes of callers, the person on the phone IS your entire organization, and their experience IS the product. Referral communication needs to be carefully monitored by team members who can keep their ‘eye on the ball’ and make the referral move forward with ease and expediency.  A great service experience is often determined largely by how the customer felt after the call. 

Evaluating Your Customer Service

Legendary customer service is a culture that requires an unrelenting focus on the patient and family.  Customer service performance should be evaluated from the inside out.  How many people are involved in the process and what are their roles?  Is the process for communicating with customers consistent?  Are you measuring the experience in terms of your conversion rate, productivity and survey ratings?

One valuable area for exploration is in tracking the reasons why a referral does not become an admission.  Agencies should be tracking the reasons why a patient is NTUC (not taken under care).  While reasons range from patient/family refusal to eligibility and choosing another agency, the conversion of referral to admission should be monitored and questioned with a relentless commitment to improvement.

We suggest that teams stay in a place of thinking what the patient or family needs.  They are experiencing stress and fundamental change.  You are there to explain what home care and hospice is all about, what benefits they can bring and focus the family on determining their preferences so that you can respond in a timely fashion to move the referral process forward.

Simione Healthcare Consultants has a team of experts to help you develop a referral process, analyze your metrics, support your staff and improve your conversion rate for greater success in home care and hospice.  For more information, email us at [email protected] or call 844.215.8822.

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