Ensuring a Successful Provider Referral Network: A Heart of CareSync Story

Posted by Kaerrie Hall

Jun 14, 2018 12:30:40 PM

CareSync supports the success of your provider referral networkYou expect there to be benefits for your patients when you choose care coordination services from CareSync. But how does the CareSync approach to Medicare’s Chronic Care Management program support you as well? Here’s just one example!

Often, what our Health Assistants do for our members carries over into what their experience is with the specialists their healthcare provider refers them to. Our commitment to coordinating care among all the patient's healthcare providers can give you invaluable insight into how well your provider referral network is taking care of them.  

Physical Therapy Becomes a Pain

In one example, a Health Assistant received a call from a member who was extremely frustrated with a provider referral for physical therapy to treat his chronic lower back pain. He felt the physical therapist his doctor had referred him to wasn’t effective, and now he was being asked to schedule more appointments for therapy.

When he asked the physical therapist to explain what the plan would be so he could feel confident in continuing with treatments, he was disappointed that he didn’t get an answer beyond, “It’s a process.”

The member said he refused to continue to pay for appointments if they weren’t going to be effective, and especially if no one was going to explain what to expect.

A Provider Referral That Needs Rethinking

Your provider referral network needs to take care of patients the way you wouldThe Health Assistant contacted the physical therapist’s office and shared the member’s concerns. She explained he just needed some reassurance that the physical therapy was the right course of action, and that he wanted a little more detail into how the treatments might go over the series of appointments.

She was met with the same vague response the member had received so she contacted our client, the referring physician, to explain the situation.

Guilt By Association?

The member’s primary care doctor knew how easily a patient’s poor opinion of a referral can create negative feelings about the prescribing physician. He expressed gratitude to the Health Assistant for letting him know what had transpired, and for being proactive in trying to fix it before contacting him.

Together, they identified a different physical therapist in the patient’s neighborhood and the doctor asked the Health Assistant to coordinate the patient’s care with the new member of the provider's referral network. She told the member's primary care doctor she would get back to him if there were any issues.

A New Provider Referral Leads to Patient Satisfaction

CareSync can help your provider referral network flourishThe Health Assistant quickly scheduled a physical therapy appointment for the member. She made sure the new physical therapist had the imaging and visit notes from the past physical therapy visits. And she contacted the physical therapy group to explain the member’s expectations, and how he was looking for a more focused and detailed plan of action so they could be ready.

The member expressed how appreciative he was that his CareSync Health Assistant took action and was able to resolve the situation so he could get the treatments he needed.

Building Relationships With Your Provider Referral Network

CareSync builds relationships with your patients, with you, and with your staff. But we also build relationships with your referral network, go above and beyond to create patient satisfaction, and leverage our care coordination services to close the feedback loop so you have more information about your patient and the performance of your provider referral network.

It’s one more reason CareSync is the Leader In Chronic Care Management™.

To learn more, call us at 800-501-2984.

For more information about Medicare Chronic Care Management, care coordination, MACRA, MIPS, and other CMS requirements that impact reimbursement and healthcare, download this free CCM white paper by CareSync.

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