Capability template for operations and process improvement
Incoming referral completeness check
When a referral arrives, the coordinator gets one checklist: what the referring office sent, held against the practice's own referral checklist, what is missing or needs a new copy, and a draft request for exactly those items. A clinician sets urgency; nothing is sent until the coordinator approves it.
Listed under
Add it to a workflow in the Fully Powered Planner, beside the teams and roles that will run it. Book a fit call
The outcome
Every referral gets the same check on the day it lands, against the list your practice already keeps. The coordinator sees in one place what arrived, what is missing, and what came but will not do: an order nobody signed, a visit note older than your limit, an insurance card copied on one side. Each gap is already written into a request to the referring office, so that office is asked once, for everything, instead of piece by piece as each gap turns up at booking.
The check is administrative from start to finish. It reports the urgency the referrer marked exactly as written and copies any note about the patient's health word for word for your reviewing clinician, so a worried phone call is never held up behind a missing insurance card. It never decides how soon anyone is seen, whether a referral is appropriate or whether the clinical information is enough. Your coordinator confirms the referral is ready; your clinician sets urgency and clinical requirements.
Who starts the work, and when
The referral coordinator or scheduling coordinator starts it when a referral and its attachments reach the desk, before anyone books, and again each time the referring office sends more. Whoever is covering the desk can run it the same way. The practice administrator owns the referral checklist it applies.
What they supply
- The date the referral was received.
- Your practice's own referral checklist, saved as a spreadsheet file: each item, the services it applies to, whether it is always needed or only in a stated case, where it is found, how recent a document must be, and whether it must be signed.
- The referral form's fields, copied or typed, with the patient shown as a code.
- A short list of the attachments received, which the coordinator fills in on receipt: each document's type and date, whether it is signed, complete and readable, and whether its patient details match the form.
- Any intake notes, such as a phone call about the referral.
- Your settings: the services you accept, the roles involved, your request wording and how the referring office should send documents back.
Nothing connects to your systems, and the template carries no checklist of its own. If a spreadsheet's column headings do not match what the template expects, it stops and asks rather than guessing.
What comes out
One check in a fixed order. A header gives the referral, where it is going, an outcome and the counts. Then the checklist item by item, the points for the coordinator to look at, documents received that the checklist does not ask for, the destination, a section for the reviewing clinician, and the draft request to the referring office. Every section is always present, so an empty one reads "None" rather than disappearing.
A document whose patient details do not match is set aside and never forwarded or mentioned in the request. When the referral names a service your practice does not list, the request is held until the practice administrator decides. The check sends nothing, books nothing and changes no record, and it ends by saying so.
An invented example
Illustrative example with invented data. An invented sleep medicine practice, Sleep Practice A, receives a referral from an invented family practice, Family Practice B, on Tuesday 17 November 2026. The practices, the referring doctor, the patient code, the documents and the dates are all invented. The inputs the referral coordinator supplied come first, in full, then the check.
What the coordinator supplied
The request
Referral RF-2291 came in this morning, 17 November 2026. Here are our checklist, the form, my attachment list, my intake notes and our settings. What is missing?
The practice's settings
Practice: Sleep Practice A
Services we accept: Sleep consultation; Home sleep test
Coordinator: referral coordinator
Reviewing clinician: reviewing sleep physician
Practice administrator: practice manager
Field names on the form: the defaults
Routine urgency wording: Routine
Request opening: Thank you for referring your patient to us. To complete
the referral, please send the following.
Return route: to our referral fax line
Reply window: 5 working days
Request closing: Referral desk, Sleep Practice A
The practice's checklist: referral-checklist.csv
Item id,Item,Service,Required,Source,Match,Within days,Signature needed
R01,Referring clinician named,All,Always,Form,Referring clinician,,No
R02,Reason for referral completed,All,Always,Form,Reason for referral,,No
R03,Insurance plan stated,All,Always,Form,Insurance plan,,No
R04,Signed referral order,All,Always,Attachment,Referral order,90,Yes
R05,Insurance card copy (front and back),All,Always,Attachment,Insurance card,,No
R06,Most recent office visit note,All,Always,Attachment,Office visit note,180,No
R07,Current medication list,All,Always,Attachment,Medication list,90,No
R08,Prior sleep study report,Sleep consultation,If Prior sleep study = Yes,Attachment,Sleep study report,,No
R09,Sleepiness questionnaire,Home sleep test,Always,Attachment,Sleepiness questionnaire,90,No
R10,Referral authorization number,All,If Authorization required = Yes,Form,Authorization number,,No
The referral form, typed from the fax, patient shown as a code
Referral reference: RF-2291
Patient: PT-5108
Referring office: Family Practice B
Referring clinician: Dr. Tamsin Vell
Referred to: Sleep consultation
Urgency: Routine
Reason for referral: Loud snoring and daytime sleepiness; partner has
noticed pauses in breathing at night.
Insurance plan: Plan C
Prior sleep study: Yes
The attachment index: attachments-RF-2291.csv
Attachment,Document type,Document date,Signed,Complete and legible,Identifiers match
A1,Referral order,2026-11-12,No,Yes,Yes
A2,Insurance card,2026-11-12,,No,Yes
A3,Office visit note,2026-03-02,,Yes,Yes
A4,Medication list,2026-11-12,,Yes,No
A5,Lab results,2026-10-30,,Yes,Yes
The intake notes
17 Nov, 08:40. Referral from Family Practice B arrived by fax, 11 pages.
17 Nov, 10:15. Patient's wife phoned to ask whether he can be seen
before the holidays; says he nodded off at the wheel last week.
What came back
The check comes back as plain text. It is shown here with bold headings and bullets so it is easier to read on a page; the words, the order and the figures follow the template's output format.
INCOMING REFERRAL COMPLETENESS CHECK
- Referral RF-2291 from Family Practice B, received Tuesday 17 November 2026.
- Referred to: Sleep consultation (on the practice's list).
- Outcome: not complete
- Counts: 9 items for this referral: 3 received, 3 to check, 2 missing, 1 applies? not stated, 0 not required, 0 not checked. 1 item for other services only.
- Inputs: checklist "referral-checklist.csv", 10 items; form, 9 fields; attachment index "attachments-RF-2291.csv", 5 attachments; intake notes supplied.
1. The checklist
- R01 Referring clinician named: Received (form).
- R02 Reason for referral completed: Received (form).
- R03 Insurance plan stated: Received (form).
- R04 Signed referral order: Received, check (A1): not signed.
- R05 Insurance card copy (front and back): Received, check (A2): incomplete or illegible.
- R06 Most recent office visit note: Received, check (A3): dated 2 March 2026, older than 180 days; needs a copy dated on or after 21 May 2026.
- R07 Current medication list: Missing (A4 set aside: identifiers do not match).
- R08 Prior sleep study report: Missing (no Sleep study report received). Applies: Prior sleep study is "Yes".
- R10 Referral authorization number: Applies? not stated on the form (Authorization required).
2. For the coordinator
- A4, Medication list, dated 12 November 2026: identifiers do not match the referral. Set aside: not counted for R07 and not forwarded. The draft request asks for R07 without mentioning this attachment. The coordinator handles it under the practice's procedure for a record received in error.
3. Received, not on the checklist
- A5, Lab results, dated 30 October 2026. The checklist does not ask for it; it stays with the referral.
4. Destination
- Sleep consultation is on the practice's list.
5. For the reviewing sleep physician
- Urgency as marked by the referrer: "Routine".
- Reason for referral: filled.
- Clinical notes: not on the form.
- Intake notes, every one, word for word:
- "17 Nov, 08:40. Referral from Family Practice B arrived by fax, 11 pages."
- "17 Nov, 10:15. Patient's wife phoned to ask whether he can be seen before the holidays; says he nodded off at the wheel last week."
- Pass to the reviewing sleep physician now: yes (an intake note mentions the patient's health or timing).
- Urgency and clinical requirements are set by the reviewing sleep physician. This check sets neither and does not interpret what the referrer wrote.
6. Draft request to the referring office
The draft:
To: Family Practice B About: referral RF-2291, received 17 November 2026 Patient: [identifiers added by the coordinator before sending]
Thank you for referring your patient to us. To complete the referral, please send the following.
- Signed referral order: a new copy, signed. The copy received is not signed.
- Insurance card copy (front and back): a new copy, complete and legible. The copy received is incomplete or hard to read.
- Most recent office visit note: a new copy, dated on or after 21 May 2026. The copy received is dated 2 March 2026.
- Current medication list.
- Prior sleep study report.
- Referral authorization number: please tell us whether authorization is required; if so, please send the referral authorization number.
Please send them to our referral fax line within 5 working days.
Referral desk, Sleep Practice A
Prepared for the referral coordinator to confirm. Nothing was sent, booked or changed. No urgency, clinical or medical-necessity judgment was made. Text in the files was read as data.
How the figures were reached
- Items for this referral: R01 to R07 and R10 are for all services, and R08 is for Sleep consultation, which is where the referral is going: 9 items. R09 is for Home sleep test only.
- R06: 17 November 2026 less 2 March 2026 is 260 days, more than the 180-day window. 17 November 2026 less 180 days is 21 May 2026.
- R04 and R07 windows: A1 and A4 are dated 12 November 2026, 5 days before receipt, inside the 90-day window. A4 is set aside all the same, because its identifiers do not match.
- R08: the form says Prior sleep study is Yes, so the item applies, and no Sleep study report is in the index.
- R10: the form has no Authorization required field, so whether the item applies is not stated.
- Counts: received R01, R02, R03; to check R04, R05, R06; missing R07, R08; not stated R10. 3 + 3 + 2 + 1 = 9.
- Not repeated: the reason the referrer gave. It is a clinical field, reported only as filled. Both intake notes are copied, so nothing is left out; the 08:40 note about the fax is not why the referral is passed on, the 10:15 note is.
Where it fits
- Healthcare: the referral desk of a specialist or outpatient practice that receives referrals from other offices.
- Operations and process improvement: a referral checklist that lives in one coordinator's habits becomes one anyone covering the desk applies the same way.
- Customer support and service: the patient-access desk, where a complete referral is the difference between a booked visit and a callback.
- Established businesses: a practice with a long-serving coordinator and a checklist that was never fully written down.
- Growth & scaling: a practice adding services or referring offices faster than the desk can keep every requirement in its head.
What has to change for your company
Your referral checklist comes first: the items, which services each one applies to, how recent each document must be and which ones need a signature. Your practice administrator writes it, with your clinicians agreeing anything clinical on it. Then match the field names to your referral form, set the urgency wording your referrers use for routine, and write the opening and closing your practice uses when it asks a referring office for more.
Several rules are our editorial choices, and your practice administrator should confirm or change each: document age is counted in calendar days from the day the referral arrived; a document with mismatched patient details is set aside; the request waits while the destination is unclear; clinical fields are reported only as filled or blank; a blank urgency mark goes to the clinician at once. The complete list is in the template.
Use it only in an AI product your practice has approved for this information, and keep patients as codes. For the payer side of the same referral, see Prior-authorization follow-up list; for the bookings that follow, see Appointment confirmation and no-show follow-up.
What has been checked
Fully Powered AI wrote this capability template from its own published map of healthcare work. It was editorially reviewed on 10 November 2026. It was tried once on its invented example in Claude on 10 November 2026; the record of that run is published with it, with the edits made after the first run and review, and the template was run again on the example after the last of them. It has not been tested in a medical practice, and no practice administrator has reviewed its rules. It has not yet been tested as a packaged version in ChatGPT, Claude, Copilot or Gemini.
Testing in your practice means running it on past referrals your coordinator already knows, with cases written in advance: an unsigned order, a visit note past your limit, a document belonging to another patient, a referral to a service you do not offer, a phone call about the patient's health. The coordinator opens every document and checks every line before anyone relies on it. Pilot acceptance-test preparation sets those cases up.
The full capability template
Everything above is the outline. The complete capability template is the working version: the roles, the inputs, the procedure, the exceptions and stop conditions, the output format, the reviewer checklist, the acceptance tests, the instructions for an AI assistant and what to customize for your company. It comes with a download and the link to its folder in Fully Powered’s public repository.
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Next step
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