Healthcare Referral Management: How Small Healthcare Teams Can Close the Loop on Patient Care

A client comes into your behavioral health practice complaining of constant fatigue and brain fog. You hear them out, ask a few questions, and decide it’s time to loop in their primary care provider (PCP). After the session, you fax over a referral.

From there, you’re left in the dark. Did the other office get the referral? Did the patient book an appointment? There’s no easy way to know.

Large organizations usually have care coordinators to ensure these loops get closed. But in smaller settings, that responsibility typically falls to already overextended clinicians. Breakdowns in tracking and communication at this stage are a key reason why nearly 50% of referrals aren’t completed.

The good news is that digital tools can help close these gaps in a cost- and time-efficient manner.

Understanding Referral Management in Healthcare

Referral management begins with a patient visit to the primary care provider and ends only after the condition or issue is resolved. Healthcare referral management has many phases and can often repeat. The key phases include: 

• Need identification: Deciding what a patient’s need is, usually, during a visit to a primary care provider. Needs may include diagnosis, second opinions, and treatment or ongoing care plans.
  
• Referral: The healthcare professional will gather patient history and supporting documents, and send the referral to the specialist or secondary care provider along with a detailed reason for the referral. 
  
• Verification and intake: At this point, the referral is parsed for completeness and accuracy, and the provider may preauthorize treatment with the patient’s health insurer to keep things running smoothly. 
  
• Scheduling: The patient will be matched with a provider based on the needs of their condition, coverage, practitioner availability and the urgency of the issue. The referring provider will usually help schedule appointments with the patient. 
  
• Tracking: Referring providers often follow up on referrals to make sure the patient attends the appointment and to ensure no drop-off. 
  
• Feedback and reporting: The specialist will often communicate the results of the visit and provide feedback or a report to the primary care provider. This continuity of care helps keep things moving and ensures clear communication.  

There are several ways to trace and manage referrals to ensure consistent, positive patient outcomes. Providers rely on clear and efficient communication to close the loop between primary physicians and specialists.

The Hidden Cost of Failed Referrals

When a referral disappears into the void, patients pay the price. A CRICO Strategies analysis of 23,000 malpractice claims found that communication failures resulted in a staggering 2,000 preventable deaths.

It’s frustrating for providers, too. You’ve made a clinical judgment and recommended next steps, but once that referral is out the door, you lose control of the situation. Did the patient get better? Were they ever even seen? Unless the patient brings it up at a future visit, you may never know.

It’s frustrating. It’s inefficient. And it erodes trust in the broader care system. 65% of patient referrals fall through—gain full visibility today. Track Every Referral with eFax Unite .

Why Referrals Fall Through

Referrals are a routine part of care, especially in complex cases where other providers need to step in. But in practice, these handoffs fall apart for all sorts of reasons:

• No formal process. Many practices don’t have a reliable system in place to track referral status. That leaves teams guessing whether a fax or note actually made it to the next provider.
• Manual communication methods. The manual methods that small practices rely on make things worse. If they send a fax, they have no way of knowing if it was received and processed. The same goes for voicemail reminders — they’re easy to miss and impossible to track.
• Staffing constraints. Even when referrals go through, the receiving practice may not have the capacity to take on the patient. That’s especially true in home health. A 2023 analysis found that only about 35% of referrals were accepted by U.S. agencies.

How Small Healthcare Teams Can Improve Referral Outcomes

Small practices may not have the resources of larger health systems, but there are still actions they can take to dramatically reduce referral breakdowns.

Close the Loop

One of the most effective things you can do is track referrals from start to finish. This can be as simple as logging referrals in a shared spreadsheet and reviewing it once a week. Teams that have the bandwidth may even assign someone to own referral follow-up for the whole practice. 

The goal is to make sure no referral goes out without a plan to check that it was received, scheduled, and completed.

Embrace Tech Tools

If you’re already sending referrals by fax, upgrading to a digital fax platform is a low-effort way to gain better oversight. Traditional fax machines offer zero visibility past the point you hit “send.” But with a digital fax platform like eFax Unite™, you get confirmation that the referral was delivered and viewed. It can even flag referrals that haven’t been acknowledged, nudging you to follow up.

Streamline Intake

On the receiving side, more practices are adopting digital intake tools to shorten response times and keep the referring provider in the loop. These tools are often separate from their core electronic health record (EHR) system, and help teams automatically triage incoming referrals, collect key patient details upfront, and send real-time updates back to the referring provider.

Some also lean on third-party care navigators to personally check in with high-risk patients to make sure they’re staying on track.

Compliance Requirements for Efficiently Managing Healthcare Referrals

Like all aspects of healthcare, there are important regulatory and compliance issues to consider when managing healthcare referrals. 

These include requirements for referral communications under the Health Insurance Portability and Accountability Act (HIPAA). Under this act, Protected Health Information (PHI) must be handled carefully, with due care not to divulge private patient data except with authorization and as part of ongoing treatment and care operations. 

There are also standards for documentation and referral tracking, which include maintaining clear, documented policies and procedures for referrals. Providers must maintain a referral tracking system with appropriate record-keeping. You will also need to maintain effective, secure and accessible communication. 

Proper referral management protects your practice from liability and helps prevent legal, financial or other issues caused by these operations. 

Impact on Patient Care and Experience

Improper referral management can have massive impacts on patients. It can result in patients left untreated, delayed diagnosis or treatment that leads to more difficult recovery, and a worsening of the patient’s condition. 

Not only do issues with referrals often lead to worse patient outcomes, but they can also erode trust, which leaves patients with a loss of trust in their healthcare team. Mismanagement referrals can also strain administrative and support staff in clinics, leading to frustration and fatigue. 

In short, quality healthcare management is crucial for efficient practice operations and effective patient outcomes.

eFax Unite: A Smarter Digital Solution for Referral Visibility

Small practices have more power than they think when it comes to reducing referral drop-offs. Minor tweaks, like a shared spreadsheet or a smart digital fax tool, can go a long way.

eFax Unite makes it easier to follow up, follow through, and ensure the treatments and interventions recommend are carried out.

Request a demo of eFax Unite to learn more. 

eFax Content Team