A Postpartum Referral Needs a Destination and a Follow-Up Plan

The referral is one step in ongoing care

A postpartum patient leaves with recommendations to see a therapist, a pelvic health PT, or a primary care clinician. The chart lists the referrals, but no one knows whether the patient can schedule them.

ACOG describes postpartum care as an ongoing process. Its guidance recommends contact with an obstetric care provider within the first three weeks and a comprehensive visit no later than twelve weeks after birth, with ongoing care tailored to the patient’s needs. [1]

A practice can apply that approach operationally by making referrals easier to complete and deciding who will follow unresolved concerns. The clinician determines the timing appropriate to the patient.

Give the patient enough information to act

A referral should identify the reason for the next service and provide a usable destination when possible. Check whether the receiving practice offers the relevant care and accepts referrals for that patient population.

An office that provides physical therapy generally may not offer pelvic health appointments. A mental health directory listing may not tell the patient whether the clinician is taking new patients. Before giving a patient a name, verify the information the practice can reasonably check.

Explain what records will be sent and whom the patient should contact if scheduling fails.

Track the handoff

Choose an owner for checking whether the referral reached the receiving office and whether an appointment was arranged. Distinguish a referral sent from a referral completed.

For example, if a patient reports that the recommended office cannot see them, the workflow should bring that information back to the clinical team. Reprinting the same referral does not resolve the access problem.

Record barriers that affect the plan, such as inability to reach the office or a coverage question. The clinical team can then decide the next step instead of assuming follow-up occurred.

Keep the payment explanation tied to the service

A postpartum referral can lead to a different specialty, benefit, and participating provider. Help the patient understand that those coverage questions require their own verification.

Clinical recommendations and payment rules serve different purposes. A recommended service may still face a payer restriction, and a covered benefit may still lack an available appointment. Document the issue rather than describing the entire situation as handled.

At Sunshyn, we want practice workflows that make care easier to reach. A referral is useful when the patient knows where to go, the receiving practice knows why they are coming, and the referring team has a plan if the handoff does not happen.

Source: [1] ACOG: Optimizing Postpartum Care

Sunshyn practice resources

For help with billing workflows in your maternal health practice, see Sunshyn's maternal health billing support.

For a structured review of documentation and practice requirements, explore the Documentation & Compliance learning pathway in the Sunshyn Learning Center.