Referral Conversion Rate
Definition, formula, a worked example, and the mistakes that make it wrong. For infusion centers.
What is referral conversion rate?
Formula
Referrals that reach a first completed infusion within the window ÷ referrals received in the same month
What each part means
- Referrals received
- Every new order that arrived in the month, including ones that never got an appointment.
- First completed infusion
- The first visit where the patient came and drug was given.
- Follow-up window
- A fixed period you choose, for example to the end of the second month after the referral arrived. Referrals still open when you report are shown as open, not lost.
- Loss reasons
- Why each lost referral did not start: authorization denied and not resolved, patient declined or cost, could not reach the patient, and so on.
Worked example
A center receives 100 referrals in March. By the end of May, 70 have had a first completed infusion, 20 were lost (10 to unresolved authorization denials, 6 to cost or the patient declining, 4 who could not be reached), and 10 are still open. Conversion so far is 70 ÷ 100 = 70%. Report the month again later, since 10 are not finished.
Run your own numbers: Referral leakage calculatorWhere the numbers come from
- Orders from your infusion software, including orders with no appointment yet
- Completed infusions, to find each order's first one
- Prior authorization requests and outcomes, by payer and drug
- A loss reason recorded by intake staff for every referral that does not start
Mistakes that make it wrong
- Dividing this month's starts by this month's referrals
- Many of this month's first treatments came from last month's referrals. Follow each month of referrals as its own group.
- Not recording why referrals were lost
- A rate without loss reasons tells you there is a leak, not where. Record a reason for every referral that does not start.
- Adding stage losses instead of multiplying them
- Each step can only lose referrals that made it through the steps before it. Losses of 8%, 10%, 12%, and 6% leave 68.5% of referrals, not 64%.
- Counting every lost referral as yours to keep
- Some patients are not candidates, change therapy, or go to a site their plan requires. Count the ones you could have kept.
What good looks like
We do not know of a reliable public benchmark for infusion referral conversion. Follow each month of referrals with the same window for a few quarters, take the usual range as your baseline, and write a threshold that triggers a review.
Common questions
How many referrals are we losing before treatment starts?
Divide referrals that reached a first completed infusion by all referrals received in the same month, and count the rest by loss reason. Keep open referrals separate until the window closes.
What is referral leakage?
The share of referred patients who never reach a first infusion with you. They drop out at intake, benefits checks, prior authorization, or scheduling, and the treatment margin goes with them.
How do I put a dollar value on lost referrals?
Multiply patients lost by treatments per patient a year and margin per treatment. Treat it as a one-year ceiling, since some patients would have stopped, switched, or started late.
Which step usually loses the most referrals?
It varies by center, payer mix, and drug. Record a date for referral received, benefits checked, authorization approved, and first visit, and the gaps show where referrals stall.
Should we appeal every prior authorization denial?
Not necessarily, but decide on purpose. Use your own appeal win rate by payer and the value of a patient for that drug to decide which denials are worth the staff time.
Want referral conversion rate from your own data?
We build the reports that calculate it the same way every month, from the systems you already use.