Home Health Referral Process: A Comprehensive Guide

As a home healthcare provider, referrals keep you in business, but in many cases, you need to respond in a timely manner. Errors in paperwork, lost documents, and other factors can keep you from starting a patient’s treatment right away. These delays could impact patient satisfaction and your bottom line. You can minimize delays with a solid home health referral process. 

The Importance of Efficient Referral Process for Timely Patient Care

Effective home health flourishes when agencies have a care referral program in place. 

Your referral system should include a patient referral form filled out by the patient’s primary care physician with a detailed plan of care. These forms allow you to coordinate care services across health networks immediately following hospital discharge. 

Having a process in place also helps you collect the required documentation for insurance approval and payment. When your team knows what information to look for, they can make sure you are submitting complete claim forms, allowing patients to be approved for home health and start treatment quickly. 

Key Stages of the Home Health Referral Process

The home health referral process includes multiple stages. First is the referral and the intake process. You may set up a checklist for your care referral sources, noting home health referral requirements. At intake, you receive the patient's information, including their primary diagnosis and what treatment they need. 

Next, you conduct an initial assessment with the patient or their primary care physician. At this stage, a nurse or another member of your care team reviews the patient's medical history, medical needs, and current living situation. 

After you’re familiar with the patient’s background and needs, verify their insurance coverage and note the information you need to include on claim forms. Finally, you can develop a care plan based on the patient’s needs. This plan should include specific treatments as well as how often you would send a caregiver to the home. You also have to note any specialized care or medical equipment the team would need to provide during home visits. 

Best Practices for Streamlining the Referral Process Workflow

Start making your process more efficient by developing written policies for managing medical referrals. Create a patient referral form or a home health referral form that includes every piece of information you need to collect from your care referral sources. 

Building relationships with your referral partners, such as primary care physicians and hospitals, entails understanding what each of you needs during the referral process. Medicare and other insurance providers often set up strict criteria for patients needing home health or hospice companies. Make sure your referral partners include all critical data on their patient referral form. 

Finally, take advantage of technology that will allow you to communicate with a patient’s entire home health team properly. 

Current State of Interoperability for Post-Acute

Interoperability is a critical component of home health services. It refers to the ability of various information systems, applications, and devices to connect. Using an interoperable system allows you to coordinate care more efficiently because everyone on the care team has access to the most current information, leading to a higher quality of care. 

According to the Care Coordination Playbook presentation at the 2023 Home Care and Hospice Expo hosted by the National Association of Home Care and Hospice, home health referrals and other parts of the industry could benefit from improved technology. Some key insights from the conference include: 

  • There are no interoperability solutions designed for fully-enabled post-acute medical care. 
  • 39% of post-acute care providers have improved interoperability in the past year. 
  • 96% of care referral sources would send more referrals to companies with better patient engagement techniques.
  • 56% of post-acute care agencies are not able to share patient status with their referral sources electronically. 

Using technology to coordinate communication helps reduce complications and allows your home health agency to stay in touch with referral sources regarding patient status. When patient care is effectively coordinated among providers, it can improve patients' quality of life. 

How a Healthcare Workflow Automation Solution Can Be Used for Operational Success

WorldView’s workflow automation solution gives you everything you need to effectively manage the home health process. Our document management system allows your team to store and track healthcare referrals and can even alert you when a form is missing data. 

This solution integrates with electronic medical records, allowing your team to access and share information faster. Learn more about how we can help you improve your workflows and make your referral process more efficient. Schedule a demo today.

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