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Published Date: 2025-04-22

CAHPS Cues: Making Specialist Referrals Easier

This month, we’re addressing an area that can significantly impact the patient experience: ease of getting referrals to see a specialist.

This is a key focus of the Consumer Assessment of Healthcare Providers and Systems (CAPHS) survey, where patients evaluate how smoothly they can access specialist care when referred by their doctor. Simplifying the referral process not only improves satisfaction but also enhances overall care coordination.

Improve Getting Needed Care Experience Measure

Your patients may have conditions, symptoms, or a diagnosis that require a referral to a specialist. This may be an especially sensitive time for patients, and a smooth referral process can help ease nerves and create a more positive experience.

Patient Experience Survey Question: Did you have any difficulty getting a referral to see a specialist from your doctor?
Pre-Visit	Call the specialist to ensure they are accepting new patients. Discuss the medical specialty and explain why you are referring them. Offer resources about their condition, the specialty, and the specialist’s credentials to help them to understand the care they are receiving.
During the Office Visit	Authorization Review authorization and referral processes to remove barriers to care. Submit prior authorization requests immediately. Notify patients of referral authorization status and expiration via phone or online portal in a timely manner. Create open access and auto approve referrals, when appropriate. Simplify patient communications and clearly explain when services are not approved. When appropriate, offer suggestions for next steps or alternatives. Provide separate appointment reminder cards, texts, or emails for the specialist appointment.
Post-Visit	Make Sure they Went to the Visit Follow up with patients to see that referrals to specialists are completed and assist with any issues. Ask patients if they have had any delays in receiving services. Understanding Care Include the patient in decision-making regarding tests, referrals, and treatment options. Follow up with the specialist and the patient separately to review notes, test results, and next steps. Survey or ask the patient about their experience and follow up on any negative feedback. Encourage patients and caregivers to view results on the patient portal by sending a text or email when available. Review results with the patient in a simple and clear manner to ensure they understand and can ask any needed questions.