Insurance Referrals: Where do They Really Come From and How do you Get Them?

Congratulations! You have successfully completed the insurance credentialing and contracting process and are now an in-network provider with one or more insurance companies. That is a huge achievement in itself, but you haven’t “arrived” just yet. One of the primary benefits of your hard earned in-network status is your ability to accept referrals… So why aren’t you getting any?

The short answer is because your prospective referral sources don’t know you, they don’t know what you do, and they don’t know that you are in network with the same companies they are.

The insurance companies themselves do not actively market your services. In fact, the only thing the companies themselves will do beyond listing you and/or your agency in the provider directory (both on-line and print version, if one exists), is to provide your name and contact information to members calling in looking for services in their geographic area. In other words, your zip code will be the reason your name comes up in a provider search, not the amazing work you do, your reputation or expertise. And let’s be real… how likely is it that a family will choose a provider based exclusively on proximity?!?

So, where do insurance referrals come from and how do you get them to come your way?

A recent visit to my son’s doctor for an annual checkup is a perfect illustration of where your referrals can and should come from. The pediatrician saw a spot on my son’s back and recommended that we consult with a dermatologist. “Who should we see?” I asked. The doctor pulled out a card from his office desk and said “Dr. BlahBlah is excellent. I’d suggest you see her”. And that was that! As a mom, a recommendation/referral from our trusted pediatrician was all I needed. I got on the phone as soon as we got home and set up the appointment.

Translation:  you and your practice need to be the pediatrician’s go-to autism treatment provider when s/he comes across a patient s/he feels could benefit from services like yours.  Citing a national survey, a recent Wall Street Journal article stated that four in 10 medical-office managers flagged referrals from other physicians as the most effective way to attract new patients.

So how do you get those referrals? Think pharmaceutical rep and adapt accordingly. Pediatrician and other referring physicians and providers will only refer clients to you if they know you exist. And, assuming they are the kind of high quality physician we hope, that referral will only come your way if you have managed to impress them that you are worthy of their referrals.

Send carefully worded letters and collateral materials introducing yourself and your practice. Highlight your expertise, your board certification and/or licensure and the things that make you stand out as the best of the best in your field. Make every effort to actually meet with the doctors from whom you hope to get referrals – there is nothing better than a face-to-face meeting and the opportunity to make a good impression.  Keep them updated on new developments in your practice, improvements, accolades, awards and positive feedback you get from clients.

Don’t hold back because you feel like you’re bragging, think of it as a job interview where the goal is to impress and put your best foot forward. Relationships based on mutual trust and professional appreciation are the end game. After all, the best referral in the world won't keep the patients coming back if your people and the services you provide are not of the very highest quality.

Some autism treatment providers have said that organizing open house events to which they invite doctors and other referral sources has been a way to increase referrals. This is a wonderful opportunity to bring them into your world and to share what you do, how you do it and what makes you an expert. The home court advantage can go a long way if you plan well and think carefully how to exploit it!

Your own creativity will certainly yield many more wonderful ideas for how to get the word out that you are here, that you are in-network and that you are ready, willing and able to accept referrals. So go on, get the word out… it won’t happen by itself!