Use the agency’s defined referral stages
Agree on the meaning of each status before agents work the queue. Received, information requested, callback scheduled, clinical review pending and accepted are distinct states. The agency determines which stages are appropriate and who can move the record. Do not label a referral accepted because an administrative call was completed.
Ask for the allowed missing information
Work from the agency-approved checklist and access rules. Identify the receiving department, document the request and avoid unnecessary collection of protected information. Questions about care needs, service eligibility or clinical suitability go to the agency’s authorized team.
Coordinate with confirmed availability
A requested appointment is different from a confirmed visit. Use the scheduling process and availability provided by the agency. Record patient and authorized caregiver preferences. When a reschedule or access issue arises, identify the owner and next action instead of implying a visit has been arranged.
Review unanswered handoffs
Assign an owner and an agreed review time for open administrative tasks. Track whether the receiving team acknowledged the request. Use the agency’s clinical escalation process if a concern is raised. Referrals may involve several parties; clear responsibilities are more useful than a queue full of unassigned notes.
Common questions
Can a BPO agent decide whether a patient qualifies for home health?
No. That decision belongs to the appropriately authorized provider and agency process.
What is a useful operational measure?
Measure complete administrative requests and acknowledged handoffs, with open exceptions shown separately from accepted referrals or delivered care.
About this resource
Prepared by GoHealth 360. Operational framework updated October 27, 2026. Adapt the framework to your organization’s approved roles, systems and service requirements.
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