Snapshot
-
Client Industry: Healthcare / Hospital System
-
Engagement Type: Medical Referral Call Center Mystery Shopping
-
Location: New York
-
Program Scope: Physician referral accuracy, patient service evaluation, benchmark validation
The Challenge
A New York hospital needed to verify whether its referral call center was meeting internal benchmarks for physician referrals and patient service. Leadership wanted to ensure that call center agents:
-
Referred doctors in the correct order shown on the hospital’s website
-
Distributed referrals fairly among participating physicians
-
Provided accurate, courteous, and professional patient guidance
This was not just an operational review — it was essential for proving objectivity and fairness to member physicians. The hospital needed clear visibility into whether its referral process truly worked as designed.
To get that visibility, they needed a structured physician referral mystery shopping program that measured both accuracy and patient service quality.
The Objective
The hospital partnered with Confero to:
-
Evaluate referral accuracy against the hospital’s published doctor order
-
Assess patient service benchmarks, including greeting, helpfulness, and courtesy
-
Validate whether all physicians were receiving referrals equitably
-
Provide trustworthy data to present to doctors, demonstrating process fairness
-
Identify opportunities to elevate call center standards and patient experience
The goal was to ensure consistent, fair, and patient-friendly referrals that strengthened trust across the provider network.
Why Physician Referral Mystery Shopping Matters
Hospitals rely on call centers to guide patients to appropriate physicians. When referral accuracy slips, consequences follow:
-
Doctors receive unequal patient volume
-
Benchmarks become unreliable
-
Patient frustration increases
-
Trust in the system erodes
A structured evaluation reveals whether staff follow the referral sequence, communicate clearly, and provide the supportive patient experience hospitals expect.
The Approach
1. Condition-Based Medical Scenarios
Before contacting the referral center, mystery shoppers were fully prepared with:
-
A specific medical condition
-
Associated symptoms
-
Insurance details
-
A realistic home address within the correct service area
These details allowed each evaluation to mirror a true patient referral call.
2. Evaluating Patient Service Behaviors
During the calls, shoppers assessed whether agents met patient service standards, including:
-
Professional greeting
-
Helpfulness and clarity
-
Courtesy and empathy
-
Effective closing
This ensured the department’s service quality matched the hospital’s goals for patient experience.
3. Verifying Referral Accuracy
Shoppers reported the names of the physicians they were referred to during the call. This enabled Confero to analyze:
-
Whether referrals followed the established order
-
If participating physicians received equal distribution
-
Any patterns of deviation that required training or process updates
This insight proved essential to leadership and to physicians seeking assurance of fairness.
The Results
Clear Validation & Actionable Insights
The program provided the hospital with reliable, unbiased data showing:
-
Whether call center staff adhered to the correct physician referral sequence
-
Whether all physicians received referrals equitably
-
How individual agents performed on key patient service indicators
-
Opportunities to strengthen consistency in communication and support
The findings elevated departmental standards and gave the hospital confidence in the fairness of its referral process.
Key Takeaway Box
Targeted medical telephone mystery shopping uncovered whether referral agents followed correct doctor order, delivered quality patient service, and distributed referrals equitably.
Looking Forward
Hospitals and healthcare systems use mystery shopping to protect fairness, strengthen patient trust, and validate internal benchmarks. Confero supports medical clients with:
-
Referral accuracy evaluations
-
Call center patient service assessments
-
Appointment scheduling journey testing
-
Digital access and physician directory usability reviews
Want to evaluate your own patient referral experience?
Contact Confero to explore a targeted medical mystery shop for your organization.
