# Referral Processing: done-for-you AI automation by BufferSol

> A done-for-you referral processing automation is an AI agent that reads incoming referrals from fax, the EHR inbox, Direct messages or the NHS e-Referral Service, pulls out patient and order details, checks them against your acceptance checklist, requests anything missing and contacts the patient to book once a clinician accepts. Triage and acceptance stay with your clinicians. BufferSol builds, connects and configures it, and it is live in 3 to 6 weeks.

- Canonical: https://buffersoltech.com/done-for-you/automations/referral-processing
- Industries: Healthcare (Specialty care & imaging)
- Provider: BufferSol Technologies (New York; serving the US, UK, Ireland, Canada and the EU)
- Timeline: live in 3 to 6 weeks
- Pricing: quoted after a short scoping call

## Every incoming referral read, matched, scheduled and closed out

**Who it is for:** Specialty practices, hospital outpatient services, imaging centers and therapy providers that receive referrals by fax, portal and electronic referral and lose track of some before the patient is ever seen.

### Signs you need it
- Referrals arrive by fax, email, portal and phone, and nobody has one list of them all.
- Staff re-key patient details from faxed pages into the EHR.
- Referrals sit incomplete for days while someone waits for notes or insurance details.
- Referring offices call to ask whether their patient was ever seen.
- You cannot say how many referrals came in last month or how many became visits.

## Business outcomes
- **No lost referrals.** Every referral, whatever channel it came from, lands in one tracked queue with a status and an owner.
- **Sooner first visits.** Missing documents are requested the same day, and patients are contacted to book as soon as a clinician accepts the referral.
- **Closed loops with referrers.** Referring providers hear when the patient is booked and seen, and the consult note goes back to them when it is signed.

## How it works today
1. Referrals land on the fax server, in the EHR inbox, by email or through e-RS, each checked by a different person.
2. A coordinator reads each one, searches for the patient in the EHR and types in demographics, insurance and the reason for referral.
3. If notes, imaging or insurance details are missing, they call or fax the referring office and wait.
4. A clinician reviews the packet for triage; the coordinator then calls the patient, often several times, to book.
5. Status lives in a spreadsheet, and the consult note goes back to the referrer only when someone remembers.

Hidden costs:
- Referrals that are never scheduled are lost patients and lost revenue that no report shows.
- Referring practices send patients elsewhere when they cannot get a straight answer about status.
- Delays in seeing referred patients carry clinical and liability risk.

## How it works done for you
1. The agent watches every referral channel: the fax server (read with document AI), the EHR inbox, Direct messages and the NHS e-Referral Service worklist.
2. It extracts patient details, referring provider, reason for referral and attachments, then matches the patient record using strict rules and a duplicate check.
3. It compares the packet with your acceptance checklist and asks the referring office for missing items by fax, email or portal message.
4. Complete packets go to a clinician's triage queue with a structured summary on top; the clinician decides priority and acceptance.
5. Once accepted, the agent contacts the patient by text, email or phone to book, and follows up on a set schedule if they do not respond.
6. It updates the referrer when the patient is booked and seen, and sends the consult note back once it is signed.
7. Every step, document and message is logged against the referral, so you can report on volume, delays and outcomes.

## What changes for the team
- **Referral coordinator.** Today: Reading faxes, re-keying details, chasing missing notes and calling patients. Done for you: Handling the referrals the agent flags as unclear and building relationships with top referring offices.
- **Triage clinician.** Today: Reading incomplete packets and waiting for the rest to arrive. Done for you: Triaging complete packets with a structured summary at the top.
- **Service manager.** Today: Guessing referral volume and conversion from spreadsheets. Done for you: Seeing referral volume, time to first visit and leakage by referrer every week.

## KPIs we measure
- **Referral to scheduled:** Days from receipt to booked appointment, baselined from the last 90 days of referrals.
- **Referral conversion:** Share of referrals received that become a completed first visit.
- **Incomplete referrals:** Share of referrals that needed a follow-up for missing information, by referring office.
- **Loop closure:** Share of completed visits where the consult note went back to the referrer within your target time.
- **Manual entry time:** Coordinator minutes per referral, from a time sample before launch and the activity log after.

## Industry data
- 34.8%: of 103,737 referral scheduling attempts resulted in documented complete appointments in one large health system (J Gen Intern Med, 2018) ([Journal of General Internal Medicine (PubMed)](https://pubmed.ncbi.nlm.nih.gov/29532299/))
- only half: of the more than 100 million subspecialist referrals requested each year in the US are completed, per an expert panel (reported 2018) ([American Academy of Family Physicians](https://www.aafp.org/about/news/20180130ehrreferrals))
- 21%: of medical groups still rely on manual referral tracking (MGMA Stat poll, Feb. 18, 2025) ([MGMA](https://www.mgma.com/mgma-stat/your-practices-referral-management-may-only-be-as-good-as-the-ehr-youre-using))

## Systems it connects to
Epic, Oracle Health (Cerner), athenahealth, eClinicalWorks, NHS e-Referral Service, EMIS Web, SystmOne, RightFax, Twilio, Microsoft 365

## Guardrails
- Clinicians make every triage, priority and acceptance decision; the agent only prepares, requests and routes.
- HIPAA: a BAA with BufferSol and every sub-processor, minimum-necessary EHR access and encrypted document storage.
- UK: UK GDPR, NHS data security guidance and sign-off from your information governance lead before go-live.
- Patient matching uses strict rules; any uncertain match goes to a person instead of merging records.
- A full audit log of every document read, field written and message sent.

## What teams say about this work
- A study of primary care referrals in a large US health system found that most referral scheduling attempts never led to a documented completed specialist visit, with low scheduling rates a main cause. ([Journal of General Internal Medicine (PubMed)](https://pubmed.ncbi.nlm.nih.gov/29532299/))
- Family physicians describe referrals getting lost through missing information and communication failures, with primary care and specialists each blaming the other for the gap. ([American Academy of Family Physicians](https://www.aafp.org/about/news/20180130ehrreferrals))
- Practice leaders say faxed paper referrals, EHR limits and specialists who insist on their own referral forms keep them stuck with manual tracking. ([MGMA](https://www.mgma.com/mgma-stat/your-practices-referral-management-may-only-be-as-good-as-the-ehr-youre-using))
- In the UK, NHS hospitals were criticized for staying attached to fax machines long after electronic referral became the expected route. ([Digital Health](https://www.digitalhealth.net/2018/07/nhs-hospitals-accused-of-being-stubbornly-attached-to-fax-machines))

## Delivery: live in 3 to 6 weeks
1. Week 1: discovery, access and a baseline of today's numbers.
2. Weeks 2–3: build the agents and connect your systems, with your rules and approvals.
3. Weeks 3–5: test on your real history, then pilot on live work with your team reviewing.
4. Weeks 4–6: staged go-live, training, dashboards and handover.

## Executive Ask questions for this workflow
- How many referrals came in last month, and how many of those patients have been seen?
- Which referring practices send us the most incomplete referrals?
- Which accepted referrals still have no appointment booked after five days?

## Frequently asked questions
### Can it read faxed referrals?
Yes. Most practices still receive many referrals by fax. The agent reads each faxed page with document AI, splits multi-patient batches, pulls out demographics, insurance, reason for referral and attachments, and writes them to the referral record. Low-confidence fields are highlighted for a coordinator to confirm instead of being written blindly, and the original fax image stays attached for reference.

### Who decides whether a referral is accepted or urgent?
Your clinicians do. The agent checks the packet against your administrative checklist, asks for anything missing and puts a structured summary at the top, but triage, priority and acceptance are clinical decisions. The agent never downgrades or declines a referral on its own. If a referral contains red-flag wording that your clinicians define, it alerts the triage clinician right away.

### Does it work with the NHS e-Referral Service?
For UK providers we work with your e-RS worklists and the integration routes your trust or practice has already approved, alongside EMIS Web or SystmOne. We follow UK GDPR and NHS data security guidance, complete a data protection impact assessment with your information governance lead and keep data in approved UK hosting. Your team signs off before anything goes live.

### How long does setup take?
It is live in 3 to 6 weeks. We start by sampling a few weeks of real referrals to build the extraction and checklist rules, then connect fax, EHR and messaging channels. The agent runs in review mode first, with coordinators confirming each record, and moves to normal operation once your team is happy with its accuracy.

### What does it cost?
Price depends on referral volume, the number of channels and specialties, and your EHR integration. We review your current referral process on a short scoping call and then send a fixed written quote. We do not publish prices because scope varies a lot between a single clinic and a multi-site service; the quote follows that call.