Referral Center Action Tip

How Are You Treating Your Professional Referral Sources When They Call?

As I wrote in our Special Report on Referral Management Systems, in order to enhance relationships with your referral sources, you need to make things quick, easy, and over deliver - especially on promises. Here are 4 tips to get you started:

Professional Callers/Referral Partners

No screening.- Don’t screen the referrals when they come in, especially when a professional referral source is giving it to you. Don’t go over the criteria for medical eligibility, or “educate them” if they are sending a patient that doesn’t seem to fit criteria - just take down the information. You never know what you may find when you visit or talk to the patient. If it turns out that they don’t end up meeting criteria, then have your sales rep or liaison visit them personally to let them know why you couldn’t end up taking the patient. This personal touch will enhance your relationship.

Be the easiest to work with - Don’t make them jump through hoops or take up their time filling out an entire referral form when they call you. Just get only the info you need to get the ball rolling, and let your Rep or Liaison get anything else you need. If they know they can call you and 1 minute later it’s off their plate, you will become a preferred provider very quickly.

Do it their way - If they have a particular process that works easiest for THEM (not necessarily for us), use it for that referral partner. It might be a pain, but this how you turn a ‘C’ or ‘B’ account into a top referring ‘A’ account

Make them feel appreciated - Always thank them for the referral when they call in, and make sure your coordinators are asking “Is there anyone else I can help you with today?”. This question will not only net you a few more referrals, but will also enhance the fact that you are there to HELP them, and thus strengthen the relationship.

If you would like a copy of the entire Special Report, email me at

Are You Shooting Yourself In the Foot?

In our industry we put a lot of time and money into our sales and marketing - from your collaterals to having and training your sales reps, we invest tremendously into getting the phone to ring with referrals.

But are you spending enough time and money making sure your referral center is fully trained in how to convert as many of those calls into admissions as possible? It’s no good to have your Sales team work their butts off or have great consumer ad campaigns to keep increasing the amount of referrals coming in if you referral centers aren’t converting those extra calls to admissions. We’ve seen it all across the country, and it is not pretty. From coast to coast, we’ve come in and helped to fix referral centers who were converting only 5-15% of their calls and helped them start converting double, triple and quadruple more calls into visits. Here are just a few of the secrets:

DON’T Over Screen The Consumer Calls: Especially in fall and winter, there is a tendency to dismiss cold/flu consumer calls as not medically eligible for our services, and thus never send someone out or log the call in as a “real” referral. While a consumer may be complaining about how dad is having a tough time with a cold or the flu, the unspoken underlying prospect could be a serious exacerbation of CHF or COPD. The same over screening could be said of other calls, such as slips and falls. Be mindful, ask questions, and make sure there isn’t anything more there before hanging up the phone.

DO Ask for the phone number!: It seems silly and completely obvious, but when we are asked to implement our mystery calls program at agencies around the country, we uncover a great number of aspects lacking - not least of which is them not asking for name and telephone number. Many times it’s a detriment to a consumer call, which then never gets turned into a “real referral” because the referral center is waiting on a call back that never comes. Sometimes it’s as simple as not getting the doctor’s name and number who is calling in the referral, which holds up the CTI process. So always ask for a name a number, no matter the call.

DO Have enough referral people: While even the most top notch referral coordinators can handle 10+ referrals in a day, having this level of constant workload is a recipe for things to fall through the cracks. Whether it’s a CTI, or consents, or potential admissions themselves, things will get missed. If each of your referral coordinators is handling 10+ referrals a day, this is also an excuse for them to over screen or dismiss any calls that aren’t readily apparent as referrals, since they don’t want to add anything “strenuous” (see: needing to do more research and make several extra calls in order) to their workload. So find out what your coordinator’s workload is and figure out how to best distribute it out – and this may include adding one or more coordinators.

For questions, or if you’re interested in our free Special Report On Referral Management Systems, or interested in mystery calls or referral center programs, please feel free to email me at . Have a great day and happy selling!

Is Your Referral Center Being As Effective As Possible?

If you’re like 90% of agencies around the country, you have a good opinion of your intake center. They’re doing a good job, they handle what comes in, what’s the big deal? You know they’re saying the right things, sticking to their scripts, and everything is working well - why mess with it? If you take a closer look at that thinking, it’s actually assuming a lot of things.

As with most things in life, when you assume.... well, you know the saying. So aside from the times you peek your head in to check on the referral coordinators, how often do you listen to what they say to callers? How often are you studying their wording, their tone, their empathy levels? How often are you spending hours in the referral center, checking up on progress and processes? Again, if you’re like 90% of agencies around the country, the answer is hardly ever. “When do I even find the time?” is the most common response.

But taking stock - true stock, a close look, an objective look - will be the key to increasing your referral numbers and maximizing your referral to admissions ratio. For many of our clients, they sign up for our MYSTERY CALLS program, that takes a close and analytical look at every aspect that their coordinators should and could be doing.  It’s quick, easy, they get reports and recordings delivered right to their email inboxes. But what if you have the time to get down in the trenches with your team - what do you need to do?

First, institute your own mystery calls program. Tell your team that periodically they will be getting mystery shopper phone calls to check up on their skills. This does two wonderful things - first, even if you never call, coordinators start to perk up, care more, and act even more professional on every call that comes in. They dont want the next call they take to be a mystery call that they didnt do their best on, right? The other thing it does is cover your bases legally - as long as a company wide email or written memo or new rule is added to your company handbook, you are legally covered to record any and all calls you make to your intake center for training purposes.

Next, create a score sheet that grades your coordinators on empathy, whether they asked for contact info, whether they made the caller do more work or if they made it easy, etc. We have a very lengthy score sheet that analyzes down to the gritty specifics, but you dont need anything that fancy at first.

Third, do at least 3 calls a week - at different times, days, and with different coordinators.

Lastly, after a month of gathering data, you can now begin to see what needs improvement - what your coordinators ARE and ARE NOT doing. If they need training or coaching, please feel free to call us and we can present you with custom solutions. If they are doing everything they are supposed to be doing (asking needs assessment questions, for instance), then keep up with the calls and keep gathering data. It’s vitally important to your bottom line. 

If you would like more information about our mystery calls program, please email .

What REALLY Happens When the Phone Rings?: Here’s How to Find Out

Do you know? When you get your weekly referral report, do you ever wonder what the real story is?

When the reason for no visit or no follow up is “family not ready”, are you SURE that’s really the case? Or is it that your call staff just didn’t manage the call like a referral should be handled? You’ll never be able to help your team unless you know BOTH SIDES OF THE CONVERSATION. You can listen to the call as it occurs, or record it, or have a professional industry call audit calls and provide feedback (like Simione’s Mystery Call Program - email to get a free mystery call to see how it works).

Since listening in can be unnerving for the staff, and recording requires a “this call may be monitored” message, your best bet is using “mystery callers”, where both listening in and recording are used for training purposes only.

The service: Trained Industry professionals will call your agency (or your competition, if you want to see what they do), and inquire about services, acting as a family member or consumer with a question about hospice or home care. You get a full report on each call, and helpful tips for improvement. Plus, and maybe most importantly, you’ll get a real world picture of how calls are handled. For more information on the Simione Mystery Call Program, email me at . I can set you up with a free call to see how it works. 

Okay, Seriously: Where’s The Customer Service? (Part 2: Professional Callers)

Last time we talked about how to have great customer service that will get the community you serve talking about your agency and how easy/great they are to work with. I have witnessed this first hand while doing work at various client sites - we got there and their customer service skills were abysmal. We trained the coordinators, and when we talked to our clients at NAHC or NHPCO 6 months later, found out that referrals have gone up, the referral center was swimming in thank you cards from various member of the community, and it was all because of legendary customer service.

So you’ve got the community buzzing about how great your agency is. What if you could get the doctors and case managers talking about it to? Think that would increase your referrals?

The fact of the matter is this: if you are easy to refer to (your referral process is easy), you are quick to see the patients, and quick to solve any problems that come up, you will be head and shoulders above your competition.

When we surveyed hundreds of case managers about their process for referring to hospice, not one of them said that quality of care was a factor in making a referral. In fact, over 60% said the biggest factor was response time (who can get there the quickest), and the next highest (30+%) was ease of referring (less paper work, one quick call or fax, etc). Nothing else rated above single digits. So the first step is making the process as easy as possible for your referral partners when they call in: just get the bare minimum of information from them over the phone that you need to move the referral process forward.
Dont keep them on the phone for 5+ minutes going over all the little details - if someone else can get the insurance info, or if they can just fax over a face sheet and they’re done - how easy is that? 

If your time from call to admission is longer than 1 day, you need to take a closer look at your processes, or have a referral management specialist from our division help assess where the inefficencies in your process are. One way to lessen the time is to have the referral center have control over scheduling visits, as opposed to going through clinical or some other extra step in the process. There are a number of other ways to lessen the amount of time, but thats one key way.

Next week, we’re going to devote an entire article on problem solving.

Okay, Seriously: Where’s The Customer Service? (Part 1: Community Callers)

With our mystery call program, we do a large number of calls to agencies all across the country, from California to New York and everywhere in between. A mixture of both home care and hospice, and yet there is one consistency with about 75% of the calls I hear: little to no customer service. If we haven’t already seared this into the brains of you guys, our beloved readers: “It’s about THEM, not about US”. While we refer to this motto mostly when it comes to sales reps visiting their accounts, it also should be applied to intake. Maybe more so.

I’m not going to go into a whole lecture on what customer service is, or what makes good customer service - I know you guys already know all of that stuff. But it’s key to remember that companies with reputations nationwide for great customer service earned that reputation when they SOLVED PROBLEMS. Every great company known for customer service, Nordstrom’s, Southwest Airlines, etc. got their legendary customer service status from taking customers who were having a problem, and solved it beyond their expectations. And what better time to do that very thing, than when we get calls from families and patients in crisis. By definition, when a community member calls in to our intake center, they aren’t at their best. People don’t call us up because it’s fun or they need entertainment. Either they or a family member is going through a crisis and they need our help. If we can help them when they call, and help them in a way that makes them go “wow!”, then your agency will start to gain a reputation in the community in much the same way that Nordstrom’s does. So how do we get to “wow!”?

First, empathy. This sounds ridiculous and ridiculously easy, right? I can easily say that 50+% of the calls I hear on a daily basis lack empathy. Intake coordinators either want to know upfront what the insurance information is, or they want to know upfront if someone has diagnosed 6 months or less, or they sound like they are going through a checklist of things THEY need to consider it a “referral” before treating the caller like one. It’s insane, and yet sad at the same time. Do you know what it took for the person on the other end of the line to pick up the phone and call us? It wasn’t an easy decision, likely. And yet we treat them like cattle who need inspection to decide if they are grade A beef. If you catch your intake staff asking “have he/she/you been diagnosed as 6 months or less?”, you need to have a talk with them. Yes, I know it’s information we need - but how many other sources can we get this information from? To ask that question of a family or patient means we are trying to get that information quickly - making it about us, not them. If you catch your intake sounding like they are going through a checklist of items, you need to have a talk with them. They need to remember: there is another person going through some kind of crisis on the other end of that phone. They aren’t just another number for your census.

Over the next few newsletters we’re going to go over how to show empathy, more tips for community callers, and a series of tips on professional callers. 

Branding: The First Words Out of Their Mouths

Make sure your intake coordinators are answering the phone using your full agency name, and not just “hospice” or “home care”. As we all know, our industry provides a commodity, which means that most people (including every type of referral source you can think of) believe that every home care and hospice agency provides quality care. Because they think that in general, every agency is created equal, Branding and getting your agency’s story out into the community is one of the keys of making sure they call your agency first. While we can go over how to effectively get your message and story out to the community on a later date, it absolutely must start with your referral coordinators answering the phone using your full agency’s name. As an example, here is one standard, can’t-go-wrong way we have recommended over the years:

“Thank you for calling ABC Home Health and Hospice, my name is Ted. How can I help you?”

The components of that include: A: thanking the person for calling, B: the full agency name, C: the coordinators name, and D: a pleasant leading question. As you know, the goal of a referral coordinator is to get the other person talking - getting as much information as possible while being pleasant and professional. If you institute this action item today, you will very slowly begin building a genuine branding effort that will be the first step to building your agency’s story in the community. 

As with most things in our industry, don’t be surprised if you get push back from your coordinators. They will say things like “that takes too long to say” or “that doesn’t sound like me”. If you time it (and we have), it takes between 2 and 2.5 seconds. That isn’t long at all - AND it sets the stage properly in a way that very subtly says “we practice good customer service”. Not bad for 2 seconds, right?

If anyone is concerned “that doesn’t sound like me”, frankly most of the callers will either notice in a positive way, or are first time callers and thus wouldn’t even know what the coordinator sounds like in the first place. It’s a win-win.

The Most Important and Overlooked Aspect of Intake

One of the most important and overlooked aspects of being an intake coordinator is being able to do needs assessment when a call comes in. As we spoken about before, empathy is sorely lacking in call centers around the country, and this is especially glaring when it comes to Hospice Agencies. Intake coordinators seem to be going down a checklist or getting the information THEY need, rather than gathering information that the CALLER needs to convey.

Being able to engage a caller in a conversation about their loved one in a way that shows empathy while guiding the conversation to get what we need WHILE understanding what the caller needs is a very difficult skill to master, but it is incredibly important. This is the key to maximizing the conversion of “inquiry” calls into actual referrals and admissions. And we all want more of those, right?

So yes, the call must “get” that we care, and feel like we are there for them, and that they are the only thing in the world we are focusing on. So obviously, don’t have them multitasking. Second, no matter what the caller is saying, the intake coordinator must be in full assessment mode. If you get the piece of information that the caller’s husband is bed bound, thats important. It’s vital to understand that 95% of callers will NOT know what to say or what questions to ask when they call in. So like we’ve mentioned here before, don’t dismiss any call as ‘information only’. This means no assumptions or judgments as well.

Now, to the meat of it. The intake coordinator must be adept at asking good quesitons - qualifying, probing, and confirming questions. Here is a sample sequence:

-Tell me a little bit about whats going on with your mother
-What else is going on?
-How are YOU doing with all of this?
-What about the rest of the family?
-Is there a power of attorney?
-What are your biggest challenges right now?
-What other questions do you have for me?

As you can see, it’s mixing up questions about what we need (POA question), with empathy questions ("how are you doing with all of this?"), with questions about the patient’s or callers needs ("what are your biggest challenges right now?"). Using this information, we would have a much easier time converting this call into a referral. For instance, if the biggest challenge was uncontrollable pain. Your intake coordinator could say:

“Our nurses specialize in keeping reducing pain and keeping it under control. How about we send out a nurse today so we can start getting your mom more comfortable?”.

You see how that works? So make sure your coordinators are asking good questions, listening for needs, and showing empathy. You’ll convert more and more “information” calls into referrals before the week is out. 

“Tell me what’s going on with...”

How Are You Treating Your Professional Referral Sources When They Call?

As I wrote in our Special Report on Referral Management Systems, in order to enhance relationships with your referral sources, you need to make things quick, easy, and over deliver - especially on promises. Here are 4 tips to get you started:

Professional Callers/Referral Partners

No screening.- Don’t screen the referrals when they come in, especially when a professional referral source is giving it to you. Don’t go over the criteria for medical eligibility, or “educate them” if they are sending a patient that doesn’t seem to fit criteria - just take down the information. You never know what you may find when you visit or talk to the patient. If it turns out that they don’t end up meeting criteria, then have your sales rep or liaison visit them personally to let them know why you couldn’t end up taking the patient. This personal touch will enhance your relationship.

Be the easiest to work with - Don’t make them jump through hoops or take up their time filling out an entire referral form when they call you. Just get only the info you need to get the ball rolling, and let your Rep or Liaison get anything else you need. If they know they can call you and 1 minute later it’s off their plate, you will become a preferred provider very quickly.

Do it their way - If they have a particular process that works easiest for THEM (not necessarily for us), use it for that referral partner. It might be a pain, but this how you turn a ‘C’ or ‘B’ account into a top referring ‘A’ account

Make them feel appreciated - Always thank them for the referral when they call in, and make sure your coordinators are asking “Is there anyone else I can help you with today?”. This question will not only net you a few more referrals, but will also enhance the fact that you are there to HELP them, and thus strengthen the relationship.

If you would like a copy of the entire Special Report, email me at

Are You Shooting Yourself In the Foot?

In our industry we put a lot of time and money into our sales and marketing - from your collaterals to having and training your sales reps, we invest tremendously into getting the phone to ring with referrals.

But are you spending enough time and money making sure your referral center is fully trained in how to convert as many of those calls into admissions as possible? It’s no good to have your Sales team work their butts off or have great consumer ad campaigns to keep increasing the amount of referrals coming in if you referral centers aren’t converting those extra calls to admissions. We’ve seen it all across the country, and it is not pretty. From coast to coast, we’ve come in and helped to fix referral centers who were converting only 5-15% of their calls and helped them start converting double, triple and quadruple more calls into visits. Here are just a few of the secrets:

DON’T Over Screen The Consumer Calls: Especially in fall and winter, there is a tendency to dismiss cold/flu consumer calls as not medically eligible for our services, and thus never send someone out or log the call in as a “real” referral. While a consumer may be complaining about how dad is having a tough time with a cold or the flu, the unspoken underlying prospect could be a serious exacerbation of CHF or COPD. The same over screening could be said of other calls, such as slips and falls. Be mindful, ask questions, and make sure there isn’t anything more there before hanging up the phone.

DO Ask for the phone number!: It seems silly and completely obvious, but when we are asked to implement our mystery calls program at agencies around the country, we uncover a great number of aspects lacking - not least of which is them not asking for name and telephone number. Many times it’s a detriment to a consumer call, which then never gets turned into a “real referral” because the referral center is waiting on a call back that never comes. Sometimes it’s as simple as not getting the doctor’s name and number who is calling in the referral, which holds up the CTI process. So always ask for a name a number, no matter the call.

DO Have enough referral people: While even the most top notch referral coordinators can handle 10+ referrals in a day, having this level of constant workload is a recipe for things to fall through the cracks. Whether it’s a CTI, or consents, or potential admissions themselves, things will get missed. If each of your referral coordinators is handling 10+ referrals a day, this is also an excuse for them to over screen or dismiss any calls that aren’t readily apparent as referrals, since they don’t want to add anything “strenuous” (see: needing to do more research and make several extra calls in order) to their workload. So find out what your coordinator’s workload is and figure out how to best distribute it out – and this may include adding one or more coordinators.

For questions, or if you’re interested in our mystery calls or referral center programs, please feel free to email me at . Have a great day and happy selling!

Intake is a Hospital Liaison’s Best Friend

This edition of Referral Center Action Tip will focus on hospital liaisons, how they need to focus on their jobs, and how intake can be their best friend. I know it sounds like a ton of fun, but if we can support them in their mission, referrals can skyrocket - and then we all win. So let’s get to it.

First, hospital liaisons - if their mission and focus is NOT on getting referrals, that needs to change - and fast. Hospital Liaisons are NOT order takers. They are not floor walkers. They are not admissions nurses. They are not to sit in their office waiting for someone to drop by or call them with a referral. They are meant to go out and GET referrals.

As with most things in this industry (intake and sales, especially), it’s up to us to get those referrals, not to wait for them to be given to us. We assume that people know all the great things we do - they don’t. We assume people know what questions to ask or things to say - they don’t. We assume they know criteria for eligibility - they dont. We assume they’ll call back when they say they will, or that they will even remember what agency they even called. As with EVERYTHING - we have to hold onto the ball. It is our responsibility to show people the benefits of our services and get them signed on. If not us, then who? The answer is either a patient goes without care when they needed it, or our competition. I dont like either one of those answers.

So, if your hospital liaisons aren’t trained at how to approach and speak with case managers in order to gain referrals, or trained in any of the specific strategies that have worked for agencies across the country, then that needs to change - ASAP.

Now, to intake. As many of you with hospital liaisons know, the two most frequent calls you get is either from the liaisons themselves with a new referral, or from a physician in the hospital giving you a referral. Many times processes are in place (for instance, a referral form that gets faxed, etc) to help streamline this process, but if you don’t currently have an easy process that streamlines things for referral sources, make one immediately. As we all know, competition is growing - and if your rivals have an easier referral process, they will start to win out. So first and foremost, have an easy to refer system in place for case managers, physicians, etc. in the hospital.

Second, when you get a call from the liaisons about a new referral, offer to help them with things you can do on your end. Whether it’s faxing out a CTI to get it signed, or talking to the physician, or anything else that you can do on your end to make things less time consuming for the liaisons, the better. The more time they have to go out and GET the referrals, the more referrals they will get. If they are bogged down in tasks that intake can help out with, thats inefficient. So help out in ways that you can from your end of the phone.

Third, when a referral source calls in with a referral, immediately call the liaison to give them a heads up. I know you may have lots of info to enter, or other calls you need to make to continue the ball rolling on the referral, but the simple act of calling them first can help the liaison on their end tremendously - and they will be very thankful for it. As with most things, anything you can do to strengthen your alliance goes a long way - intake and liaisons, or intake and sales need to work in harmony. Patients, and revenue, depend on it.

Okay, SERIOUSLY now - Get. Their. Contact Info!

Over the last several months, we’ve seen a skyrocket in the number of agencies using our Mystery Call service to find out how their intake processes are actually working, as opposed to how they think they are working. About 90% of the agencies when they received their first mystery call score sheet and transcript told me some variation of “I had NO idea we were doing this poorly. We’ve got work to do.” On a number of occasions, this led to us doing mystery calls on their competitors to find out how they stacked up. Suffice it to say, many score sheets were just as bad - which, from an outside perspective like ours, is a little sad to see so many agencies not having a good intake process - especially when we’re talking about consumer calls for hospice. Of course, seeing their competitors doing just as poorly was a welcome relief for our clients.

While I could go over every single point that the average agency is either doing completely wrong, or doing inefficiently when it comes to their intake process, the number one constant and most important aspect is this: Get their contact info. You know how “information only” calls end up going nowhere for you? There’s a solution to that. Get. Their. Contact info! If you hold onto the ball, and actually follow up with a caller who “just wanted some information”, more often then not, those “info” calls will start to turn into actual referrals. Imagine how many extra referrals a month that would mean for your company.

As we all know, when we get a call from a family member or patient who need home care or hospice, they are probably not at their best. They are either at the hospital, about to go to the hospital, getting back from the hospital, or have recently found out they have 6 months or less to live. If they call for information, who knows if they will remember to call your agency back? Or call anyone else for help at all? It is our responsibility to not let these “info” calls to slip through the cracks and help these people in our communities.

The first step to doing that? Get their contact info. Follow up with them.

Then you’ll be well on your way. 

How Are You Treating Your Professional Referral Sources When They Call?

As I wrote in our Special Report on Referral Management Systems, in order to enhance relationships with your referral sources, you need to make things quick, easy, and over deliver - especially on promises. Here are 4 tips to get you started:

Professional Callers/Referral Partners

No screening.- Don’t screen the referrals when they come in, especially when a professional referral source is giving it to you. Don’t go over the criteria for medical eligibility, or “educate them” if they are sending a patient that doesn’t seem to fit criteria - just take down the information. You never know what you may find when you visit or talk to the patient. If it turns out that they don’t end up meeting criteria, then have your sales rep or liaison visit them personally to let them know why you couldn’t end up taking the patient. This personal touch will enhance your relationship.

Be the easiest to work with - Don’t make them jump through hoops or take up their time filling out an entire referral form when they call you. Just get only the info you need to get the ball rolling, and let your Rep or Liaison get anything else you need. If they know they can call you and 1 minute later it’s off their plate, you will become a preferred provider very quickly.

Do it their way - If they have a particular process that works easiest for THEM (not necessarily for us), use it for that referral partner. It might be a pain, but this how you turn a ‘C’ or ‘B’ account into a top referring ‘A’ account

Make them feel appreciated - Always thank them for the referral when they call in, and make sure your coordinators are asking “Is there anyone else I can help you with today?”. This question will not only net you a few more referrals, but will also enhance the fact that you are there to HELP them, and thus strengthen the relationship.

If you would like a copy of the entire Special Report, email me at

Okay, Seriously - Where are you putting your ‘pending’ files?

You and I both know that we can’t always schedule a visit with every caller or convince every “info call” that hospice or home care is the right choice. But that doesn’t mean we should relegate those to a “pending” folder on the side of our desk (where they usually pile up and get forgotten!).

Out of sight, out of mind my friends. Yes, it’s true - no matter how much you or your team denies it. Intake/Referral centers are so busy, chaotic, and coordinators are always multi-tasking left and right - it’s only human that things would fall through the cracks. This is why it’s important to:

1. Follow Up with those callers after 2 days - while the need is still evident, and they haven’t mistakenly or inadvertedly called another agency to help them once they’ve made their decision.

2. Keep your “pendings” on the same list as your “actual” patients that will get visits - if you keep them front and center, and give them the same level of importance as your “real” patients, they are much less likely to fall through the cracks

3. Keep them on the list until they’re officially closed, and that means they either admitted, die, or refuse service. No exceptions, for that way holds the key to thrown away referrals!

4. Make sure you are tracking which referral source was involved in getting that call - this is a side issue, but very important to know where your Sales and Marketing is making it’s biggest impact

5. Get permission: always let the person know you’ll be contacting them to see how they are doing - this builds the relationship, and puts this whole “keeping the ball in our court” thing as a positive, reassuring detail the interaction, rather than being “pushy” or any other push back you might get from your coordinators when you implement these tips.

Next time, we’re going to talk further about the importance of holding onto the ball. 

What REALLY Happens When the Phone Rings? Here’s how to Find Out

Do you Know? When you get your weekly referral report, do you wonder what the real story is? When you read that the reason for no visit is “family not ready” are you sure that’s really the case? Or when it says “just looking for information” do you ever wonder how many of those SHOULD have been converted into an actual referral? Do you ever wonder if your coordinators aren’t managing the calls how they should have been handled? As we’ve seen in agencies around the country when we implement the Simione Referral Management System, there are literally thousands of referrals that agencies were throwing away because they weren’t using the right approach with callers. As we’ve seen, if you can increase you conversion rates of info calls to actual referrals you can grow your numbers tremendously.

But, you’ll never be able to help your team unless you know BOTH SIDES OF THE CONVERSATION. There are several ways of going about this, including using our Mystery Call program (a part of our Simione Referral Management System), but another way is for you to start recording your intake’s calls, and listening to them with your coordinators and providing coaching both during work hours, and setting aside time for training as well. Since recording calls and sitting in the referral center can be daunting for many coordinators, Mystery Calls may be your better bet.

The Service: Our Simione Trainers will call your hospice or home care agency (or your competition, if you’d like), and inquire about services. Acting as a family member or consumer with questions, there is a specific list of aspects we look for, and use to score each coordinator objectively. You’ll get a full report, transcript, and helpful tips for improvement. Plus, you’ll have the real story about whats really going on in your referral center, and where referrals might be slipping through the cracks.

The Most Important and Overlooked Aspect of Intake

One of the most important and overlooked aspects of being an intake coordinator is being able to do needs assessment when a call comes in. As we spoken about before, empathy is sorely lacking in call centers around the country, and this is especially glaring when it comes to Hospice Agencies. Intake coordinators seem to be going down a checklist or getting the information THEY need, rather than gathering information that the CALLER needs to convey.

Being able to engage a caller in a conversation about their loved one in a way that shows empathy while guiding the conversation to get what we need WHILE understanding what the caller needs is a very difficult skill to master, but it is incredibly important. This is the key to maximizing the conversion of “inquiry” calls into actual referrals and admissions. And we all want more of those, right?

So yes, the call must “get” that we care, and feel like we are there for them, and that they are the only thing in the world we are focusing on. So obviously, don’t have them multitasking. Second, no matter what the caller is saying, the intake coordinator must be in full assessment mode. If you get the piece of information that the caller’s husband is bed bound, thats important. It’s vital to understand that 95% of callers will NOT know what to say or what questions to ask when they call in. So like we’ve mentioned here before, don’t dismiss any call as ‘information only’. This means no assumptions or judgments as well.

Now, to the meat of it. The intake coordinator must be adept at asking good quesitons - qualifying, probing, and confirming questions. Here is a sample sequence:

-Tell me a little bit about whats going on with your mother
-What else is going on?
-How are YOU doing with all of this?
-What about the rest of the family?
-Is there a power of attorney?
-What are your biggest challenges right now?
-What other questions do you have for me?

As you can see, it’s mixing up questions about what we need (POA question), with empathy questions ("how are you doing with all of this?"), with questions about the patient’s or callers needs ("what are your biggest challenges right now?"). Using this information, we would have a much easier time converting this call into a referral. For instance, if the biggest challenge was uncontrollable pain. Your intake coordinator could say:

“Our nurses specialize in keeping reducing pain and keeping it under control. How about we send out a nurse today so we can start getting your mom more comfortable?”.

You see how that works? So make sure your coordinators are asking good questions, listening for needs, and showing empathy. You’ll convert more and more “information” calls into referrals before the week is out. 

“Tell me what’s going on with...”

Branding Part 2: Increasing The Amount Of Calls You Get

While this column is usually reserved for Actionable Tips that you can implement in your referral center to increase efficiency, this week I wanted to take one step back and talk about how to increase the amount of calls your referral center gets from the community. And if you’re getting the calls that would have normally gone to your competition, that’s a nice bonus. After all, if you couple an increased amount of community calls with a referral center equipped to convert them into referrals, you’ll grow even more unstoppable, right?

So, branding is not solely logos and colors. Every element of outreach, every “conversation” with the potential customer must be taken into consideration because branding happens at every point of contact. 

Consistency of message and image are important to building a strong brand.  Every time you use anything different you are “muddying” the water and making it more difficult for the consumer to latch onto your brand.  For this reason it is vitally important that all elements of your agency use the logo, message, color, look and feel on a consistent basis.  Don’t shoot yourself in the foot by using multiple looks in the market. 

Another element that causes some problems is when there is a name change.  This is a process that requires a long term approach, as you must use the old name with the new for a period of two to three years to make sure that you do not lose customers for the wrong reason.  Even then it is prudent to maintain the listing in the phone book, on the internet, etc. for the old name - just to catch those that didn’t get the new one!

One way to increase overall calls, not lose any calls during transition periods, and to enhance your brand in your territory is by using a vanity number like 1-800-HOMECARE or 1-800-HOSPICE.

This type of smart branding, which many agencies all over the country have already licensed uses the same principle that fueled the tremendous growth of 1800FLOWERS. It has already shown to work extremely well in our industry, and according to the findings of a June 2009 study by Response Marketing Group of Burlington, Vermont, nearly 60% of participants recalled the vanity numbers they had heard after only one exposure to a radio advertisement.  That’s a huge jump over traditional numbers, and the licensees of those vanity numbers can tell you how many more phone calls they are capturing from the fastest growing segment of referrals: consumer callers.

“1-800-HOMECARE has enabled us to compete with the larger agencies in our market. With so much competition, we are able to give our prospective clients a number they never forget. It’s been great for recruitment as well.” said Marty Hoelscher of Superior Home Care in Utah.  By licensing a vanity number and using it consistently in all forms of promotional materials and advertising, an agency can gain brand recognition with less impressions and with greater retention.

Now that as an industry we have gone ‘from good to great,’ the quest is now to go from great to greater!  The consumer is becoming more educated about home care and hospice, the competition is pushing the envelope, and the value of your brand has never been more important.  The sales team has the chore of expanding the brand in the community, what are you doing to support them in this effort?  Your brand is your promise, the sales team and the care delivery teams are building it everyday!

If you want to find out more information about the 1800HOMECARE or 1800HOSPICE vanity numbers, email .

Branding: The First Words Out of Their Mouths

Make sure your intake coordinators are answering the phone using your full agency name, and not just “hospice” or “home care”. As we all know, our industry provides a commodity, which means that most people (including every type of referral source you can think of) believe that every home care and hospice agency provides quality care. Because they think that in general, every agency is created equal, Branding and getting your agency’s story out into the community is one of the keys of making sure they call your agency first. While we can go over how to effectively get your message and story out to the community on a later date, it absolutely must start with your referral coordinators answering the phone using your full agency’s name. As an example, here is one standard, can’t-go-wrong way we have recommended over the years:

“Thank you for calling ABC Home Health and Hospice, my name is Ted. How can I help you?”

The components of that include: A: thanking the person for calling, B: the full agency name, C: the coordinators name, and D: a pleasant leading question. As you know, the goal of a referral coordinator is to get the other person talking - getting as much information as possible while being pleasant and professional. If you institute this action item today, you will very slowly begin building a genuine branding effort that will be the first step to building your agency’s story in the community. 

As with most things in our industry, don’t be surprised if you get push back from your coordinators. They will say things like “that takes too long to say” or “that doesn’t sound like me”. If you time it (and we have), it takes between 2 and 2.5 seconds. That isn’t long at all - AND it sets the stage properly in a way that very subtly says “we practice good customer service”. Not bad for 2 seconds, right?

If anyone is concerned “that doesn’t sound like me”, frankly most of the callers will either notice in a positive way, or are first time callers and thus wouldn’t even know what the coordinator sounds like in the first place. It’s a win-win.

Author’s Note: I reprinted this first article in our “Referral Center Action Tip” this week because I’ve been getting lots of questions on the subject, and promised those I talked to that I would. For all of the readers who have been with this column from the beginning, we will resume our normally scheduled new Tips next issue.

Make Referral Tracking Easy: Adopt a Referral Log

How important is it to track all of your calls, referrals, and where they came from? The word “vital” springs to my mind. It’s like that old saying, if you dont know where you came from, how can you know where you’re going? The same applies here. If you dont know how many calls per day, per week, per month, and per year you’re getting, and how many of those end up being referrals, you won’t be able to determine:

1. If your marketing and advertising campaigns are reaching the community and working (or not working) to generate calls and referrals
2. If your Sales Reps are doing a good job of interacting with their referral sources and getting them to see the benefits of working with your agency
3. If you hospital liaisons are doing a good job of being visible in their hospitals, and helping the case managers, physicians, patients and families see the benefit of working with your agency
4. If your intake/referral coordinators are doing a good job or poor job in converting “info” calls to actual referrals

Among many other data points you should be monitoring. If you can see the rise or fall of these numbers, you will know exactly where your strengths and weaknesses are, can reward those that are doing well, and coach/train/re-train/talk to the people who are causing numbers to fall. Home care and Hospice is an ever changing landscape, from dealing with competition, regulations, changing physicians/case managers/other referral sources...if you just know your census or LOS or overall referral numbers, you are dropping the ball.  Because of the eternally changing landscape, you can’t afford to not monitor each distinct part of the Referral Management process individually, as it could be the difference between firing a perfectly good coordinator, and not firing the one who’s causing your ship to sink.

Okay, so how do you monitor all of that? Well, the first step is having a Referral Log. The main advantage of the log is to be able to scan the day’s activity at a glance, without digging through individual forms, and see exactly what happened that day. It saves you time. So what are some things that should be on the Referral Log?

1. Staff/Time - who took the call, what time it was, and how long it lasted
2. Caller/Referral Source - Who physically made the call, and ultimately who the referral source was. Just because Nurse Penny called doesn’t mean she’s the referral source - it’s going to be the physician Nurse Penny works for. Same thing for patients - it’s most likely going to be their doctor who spoke to them about home care or hospice that instigated the call.
3. Visit Scheduling/Outcome - Did the call result in a visit being scheduled? Did the info call end up being a referral? What’s the outcome? These are important questions with equally important answers.
4. Closed/Follow Up - What is the next step the coordinator needs to take/is the case closed?

These are just a few components to include in your referral log. If you would like a copy of our Referral Log form, please email

Our Referral Sources’ Dirty Little Secret Part 2

Last time we talked about how the data we uncovered from our mystery call program contained many surprises, but the biggest was that even our best ‘A’ accounts, who love us and believe in our agency, would call on a different agency if they received a busy signal or no answer when calling us. It was eye opening. We also discussed that when probed further, the referral sources shared that in the end, their biggest concern was easy, easy, easy. Many times, the whole reason an agency was their “preferred agency” was they made the referral process itself easy. Not that they provided the best care, or anything as wonderfully ideal as all that. Just that they were easy to work with, and easy to refer to.

So here are the key takeways from that eye opening set of data, and some tips to combat it:

1. Make sure you have enough phone lines, and people answering the phone, that a busy signal or answering machine will never happen.

2. Make sure you have longer hours for your referral center on the busiest days, and especially on friday. If you can differentiate your agency from the competition by being “the agency that takes referrals after 5:30pm on fridays”, your sales reps can use this wedge to get patients from sources that have never referred before, and can gain traction with the referral sources that aren’t sending all their patients to you. Again, this goes back to being “easy” and being a problem solver for your referral sources. If a discharge planner gets a patient on friday afternoon - you want them to think “oh, I’ll just call (your agency name here)”. If you are short staffed in the referral center or can’t hire a part time person, simply stagger the hours your coordinators come in on friday. Have a 8-4 shift and a 10-6 shift, or some other combination that works.

3. Make sure that whoever answers the phone - even if it’s the receptionist because all the other coordinators are busy taking a referral - knows how to take a referral. Not only that they know how to take a referral, but they are trained just as your coordinators are in getting only the bare minimum of info (only what you need to get the rest of the information and go out to see the patient). Again, this goes back to making it easy, easy, easy.

4. Make sure that IF you have a situation where so many people call at once that it goes to voicemail, make sure that voicemail is checked the moment someone becomes free and the call is returned IMMEDIATELY. Again, you dont want to lose a referral because someone was tired of waiting for a call back and called someone else.

5. Lastly, and this goes back to making every person in the referral generation continuum as effective as possible, make sure that your referral coordinators and sales reps talk about what the Reps are going out and saying to the referral sources and visa versa. You DO NOT want a situation where the sales rep is telling referral sources that they can call on friday afternoons with a referral and it the patient will be seen by saturday, and then when they do call with a referral, the coordinator says something like “I dont know who told you that, but the earliest we can see them is monday”. This kind of situation happens all the time, and it absolutely KILLS the trust and relationship that the Rep worked so hard to build. Communication - going both ways - is the key to increasing efficiency and maximizing every referral opportunity.

All of this is about integrating the legendary customer service culture into every single person in your agency, and by doing so you will go on to greater and greater success. After years of interim referral center management, referral coordinator training, and referral center assessments and solution building from our division, and all the data we’ve come across, I can tell you that even those these tips are just a small slice of the pie, they can be implemented right away and show you great results. 

Until next time, that ringing phone could be your next great patient.

Our Referral Sources’ Dirty Little Secret

A tough title to live up to, but here goes: one of the things we do for agencies across the country is our mystery call program, which helps them get a fuller picture of exactly what their referral coordinators are telling referral sources, what their referral sources think of the sales reps who visit them, and the entire community’s view of the agency as a whole. After compiling the data for each agency in order to give them a solutions report, I wanted to take it a step further. What data points are consistent across the country? You won’t believe one of the biggest eye opening statistics we uncovered:

Do you know how many “A” accounts - referral sources that self identified as using one specific agency for over 90% of their referrals - turned around to say that if they couldn’t reach their preferred agency on the first try (busy signal/no answer), they would immediately call up another agency? Now, before I reveal that number, I want you to think about that. This is a group of people who love their preferred agency - they believe in the work and the partnership and as such, send AT LEAST 9 out of 10 patients to their preferred agency. Okay, got that in your head? Here’s the number: 77% (yes, seventy seven). More than 3 out of 4 people who have a strong relationship with their preferred agency, would quickly call on someone else if they weren’t take care of immediately. IMAGINE that.

You’ve done a fantastic job branding your agency, providing stellar service to patients in the community, your sales reps are addressing the needs of your referral sources perfectly, solving problems left and right, and BOOM… one busy signal and the patient goes to someone else. How sad is that?

When probed further, the referral sources shared that in the end, their biggest concern was easy, easy, easy. Many times, the whole reason an agency was preferred was they made the referral process itself easy. Not that they provided the best care, or anything as wonderfully ideal as all that. Just that they were easy to work with, and easy to refer to.

There are several lessons to be learned here, and I’m going to get into those lessons and solutions in the next edition of the newsletter.

Until then, that ringing phone could be your next great patient.

Does Your Whole Team Know Who Your Biggest Referral Partners Are?

During an engagement at a client site where we were providing training and interim referral center management services, our call volume started to increase so much that I was called upon to fill in as an intake coordinator. Let me tell you - going from behind the chair coaching to sitting in the chair and on the front lines was a vast and wonderful difference. Without getting into too much detail, the trials, tribulations, and thank you cards from families I helped went a long way to showing me just how difficult, busy, and fulfilling an intake coordinators job really is.

Something else that I learned, and the agency I was helping learned, is that it is vitally important for EVERYONE in the entire organization to know just who the biggest referral partners are. Let me explain:

On one of the days, I got a call from a doctor who, in the span of the 3 days I had filled in, was phoning in his 6th referral. He let me know the matter was urgent - the patient would pass soon and the family would really need the support for the final day, and support afterwards. This was a doctor who was keenly aware of the benefits of hospice, mainly because the hospital liaison on his floor was a superstar and did a great job getting the docs and case managers to see all those benefits.

On this particular day, we had a new liaison filling in on that floor. I called him up to let him know about the referral, and about how urgent everything was. He said okay, and I thought that was that.

What ended up happening was what always happens - the liaison was approached with another referral, and then another one, and got sidetracked and didn’t get in to see the patient until the end of his shift. By that time the patient had passed - and I was on the receiving end of a very upset doctor.

Suffice it to say, the agency lost one of our best referral partners that day, and all because one person - someone filling in and who normally had a different territory, didnt know how important this one referral source was. It could have been a new intake coordinator who treated that doctor poorly, it could have been a nurse who didnt go to admit the patient quickly enough, it could have been anyone or anything that would have caused the situation to break the trust that doctor had in the agency. This is why it is absolutely VITAL that EVERYONE in your organization know your top referral sources, and treat them with the highest level of customer service and attention as they can. While the ideal is to treat every referral source that way - you darn well better treat your best ones that way.

The end of the story is a happy one, actually. The agency helped the family with bereavement and counseling anyway, and after the Vice President and the superstar liaison met with the doctor to apologize, the agency got another shot and is hand in hand with the doctor again. 

Is Your Referral Center Being As Effective As Possible?

If you’re like 90% of agencies around the country, you have a good opinion of your intake center. They’re doing a good job, they handle what comes in, what’s the big deal? You know they’re saying the right things, sticking to their scripts, and everything is working well - why mess with it? If you take a closer look at that thinking, it’s actually assuming a lot of things.

As with most things in life, when you assume.... well, you know the saying. So aside from the times you peek your head in to check on the referral coordinators, how often do you listen to what they say to callers? How often are you studying their wording, their tone, their empathy levels? How often are you spending hours in the referral center, checking up on progress and processes? Again, if you’re like 90% of agencies around the country, the answer is hardly ever. “When do I even find the time?” is the most common response.

But taking stock - true stock, a close look - will be the key to increasing your referral numbers and maximizing your referral to admissions ratio. For many of our clients, they sign up for our MYSTERY CALLS program, that takes a close and analytical look at every aspect that their coordinators should and could be doing.  It’s quick, easy, they get reports and recordings delivered right to their email inboxes. But what if you have the time to get down in the trenches with your team - what do you need to do?

First, institute your own mystery calls program. Tell your team that periodically they will be getting mystery shopper phone calls to check up on their skills. This does two wonderful things - first, even if you never call, coordinators start to perk up, care more, and act even more professional on every call that comes in. They dont want the next call they take to be a mystery call that they didnt do their best on, right? The other thing it does is cover your bases legally - as long as a company wide email or written memo or new rule is added to your company handbook, you are legally covered to record any and all calls you make to your intake center for training purposes.

Next, create a score sheet that grades your coordinators on empathy, whether they asked for contact info, whether they made the caller do more work or if they made it easy, etc. We have a very lengthy score sheet that analyzes down to the gritty specifics, but you dont need anything that fancy at first.

Third, do at least 3 calls a week - at different times, days, and with different coordinators.

Lastly, after a month of gathering data, you can now begin to see what needs improvement - what your coordinators ARE and ARE NOT doing. If they need training or coaching, please feel free to call us and we can present you with custom solutions. If they are doing everything they are supposed to be doing (asking needs assessment questions, for instance), then keep up with the calls and keep gathering data. It’s vitally important to your bottom line. 

If you would like more information about our mystery calls program, please email .

The Most Important and Overlooked Aspect of Intake

One of the most important and overlooked aspects of being an intake coordinator is being able to do needs assessment when a call comes in. As we spoken about before, empathy is sorely lacking in call centers around the country, and this is especially glaring when it comes to Hospice Agencies. Intake coordinators seem to be going down a checklist or getting the information THEY need, rather than gathering information that the CALLER needs to convey.

Being able to engage a caller in a conversation about their loved one in a way that shows empathy while guiding the conversation to get what we need WHILE understanding what the caller needs is a very difficult skill to master, but it is incredibly important. This is the key to maximizing the conversion of “inquiry” calls into actual referrals and admissions. And we all want more of those, right?

So yes, the call must “get” that we care, and feel like we are there for them, and that they are the only thing in the world we are focusing on. So obviously, don’t have them multitasking. Second, no matter what the caller is saying, the intake coordinator must be in full assessment mode. If you get the piece of information that the caller’s husband is bed bound, thats important. It’s vital to understand that 95% of callers will NOT know what to say or what questions to ask when they call in. So like we’ve mentioned here before, don’t dismiss any call as ‘information only’. This means no assumptions or judgments as well.

Now, to the meat of it. The intake coordinator must be adept at asking good quesitons - qualifying, probing, and confirming questions. Here is a sample sequence:

-Tell me a little bit about whats going on with your mother
-What else is going on?
-How are YOU doing with all of this?
-What about the rest of the family?
-Is there a power of attorney?
-What are your biggest challenges right now?
-What other questions do you have for me?

As you can see, it’s mixing up questions about what we need (POA question), with empathy questions ("how are you doing with all of this?"), with questions about the patient’s or callers needs ("what are your biggest challenges right now?"). Using this information, we would have a much easier time converting this call into a referral. For instance, if the biggest challenge was uncontrollable pain. Your intake coordinator could say:

“Our nurses specialize in keeping reducing pain and keeping it under control. How about we send out a nurse today so we can start getting your mom more comfortable?”.

You see how that works? So make sure your coordinators are asking good questions, listening for needs, and showing empathy. You’ll convert more and more “information” calls into referrals before the week is out. 

“Tell me what’s going on with...”

The Most Important Question (Community Edition)

As many of us know, the highest growing segment of referral generation is consumer calls. As we’ve discussed in prior articles and on our facebook, linkedin, and twitter feeds, when a referral source calls in a referral to our agency, the most important question to ask is “Is there anyone else I can help you with today?”. But what about when