Smart, Seamless, Scalable

Reinventing Behavioral Health Referrals

Significant Business Impact After Integration

40%

Automated intake and smart routing

30%

Real-time availability and self-service

25%

Preference-based matching and updates

35%

Automated tasks and streamlined workflows

50%

Dashboards and EMR integration

A leading US behavioral health organization faced mounting referral management challenges — fragmented data across EMRs, manual provider assignments, and slow bid processes that delayed care initiation. Provider onboarding was cumbersome, transparency was limited, and administrators lacked a unified view to manage high-volume payor referrals efficiently.

We designed and implemented a Salesforce Health Cloud–powered Referral Management System, integrated with Experience Cloud provider portals, to centralize referral intake, automate provider matching, and enable real-time bid tracking. The solution supported A major American behavioral health institution-driven, provider-driven, and hybrid referral approaches, streamlining onboarding, credentialing, and provider availability updates while maintaining bidirectional EMR integration.

Within weeks of go-live, the organization achieved faster referral assignments, improved provider accountability, and higher participant satisfaction — creating a scalable foundation for efficient payor-provider collaboration and data-driven care coordination.

Client Background

2 dashboard US behavioral health services

A leading US behavioral health services organization plays a critical role in supporting payor networks by delivering specialized therapy and behavioral health programs through an extensive provider network.

Handling high-volume payor-referred participants, the organization relies on a mix of internal staff and contracted external providers. Efficient referral management is mission-critical to ensure timely care initiation, adherence to payor SLAs, and improved participant outcomes, while maintaining provider accountability and operational transparency.

A leading US behavioral health services organization plays a critical role in supporting payor networks by delivering specialized therapy and behavioral health programs through an extensive provider network.

Handling high-volume payor-referred participants, the organization relies on a mix of internal staff and contracted external providers. Efficient referral management is mission-critical to ensure timely care initiation, adherence to payor SLAs, and improved participant outcomes, while maintaining provider accountability and operational transparency.

Business Challenge

The organization’s referral management operations were constrained by structural inefficiencies and fragmented workflows that directly affected participant care delivery and provider accountability.

Fragmented Referral Lifecycle

Referral data from payors, EMRs, and direct engagements lacked a unified system, making it difficult to maintain a single source of truth or track participant journeys end-to-end.

Provider Network Bottlenecks

Onboarding and credentialing of external providers were manual and inconsistent, delaying the addition of new providers and resulting in limited real-time visibility into provider availability, service preferences, and compliance with SLAs.

Manual & Error-Prone Assignment Workflows

Participant-to-provider assignments relied heavily on manual decision-making or basic rules, leading to inaccurate matching, unfair allocation perceptions, and slower care initiation.

Inefficient Bidding Process

Providers lacked a structured, criteria-based bidding mechanism. Availability, participant preferences, and service compatibility were not dynamically updated, causing delays in bid evaluations and assignments.

Scattered Participant Data & Limited Transparency

Participant demographics, service history, and feedback were spread across multiple systems, preventing a true 360-degree view. This limited administrators’ ability to personalize assignments or reassign based on real-time service performance.

Disconnected Communication & Accountability

Providers, administrators, and participants operated in silos. Missed updates and delayed feedback loops often resulted in service-level violations, negatively impacting participant satisfaction and payor relationships.

Volume & SLA Pressure

With 90% of referrals coming from a major payor, high-volume participant inflow, and strict SLA commitments exposed operational gaps and made manual processes unsustainable for scale.

Volume & SLA Pressure

With 90% of referrals coming from a major payor, high-volume participant inflow, and strict SLA commitments exposed operational gaps and made manual processes unsustainable for scale.

Solution Overview

Imagine a referral system that works like this

A referral arrives, and within seconds, the right providers—credentialed, available, and best suited for the participant’s needs—are intelligently suggested. Providers update availability in real-time, participants track progress effortlessly, and administrators focus on outcomes rather than chasing paperwork.

This isn’t wishful thinking. It’s what we at GetOnCRM helped design and deliver—partnering, not just implementing—to transform referral management into a seamless, participant-first experience.

One Referral Hub, Many Moving Parts—Finally in Sync

We architected the entire referral journey—intake, qualification, provider matching, bidding, and tracking—inside Salesforce Health Cloud, ensuring every stakeholder works off a single source of truth.

Intelligent Provider Matching—Built for Real-World Complexity

Our consulting team designed a rule-driven engine to move beyond basic filters. Provider credentials, specialties, and live availability now power smart suggestions, supporting hybrid referral approaches without adding operational burden.

Providers Empowered, Not Burdened

Through the Experience Cloud Provider Portal, we enabled providers to manage profiles, update availability, and bid for referrals effortlessly—turning the provider network into a self-optimizing ecosystem.

Participants at the Heart of Every Referral

The system was designed with a participant-first lens—transparent updates, intuitive provider options, and personalized engagement ensure the process feels less like administration and more like care.

Insights that Drive Action, Not Just Reports

We configured custom dashboards and analytics to deliver actionable intelligence. Network optimization, staffing decisions, and performance improvements are now data-backed and real-time.

Built for Scale, Security, and Speed

Our solution integrates seamlessly with EMR systems, automates workflows to reduce manual delays, and ensures strict role-based security—delivering reliability and compliance from day one.

More Than Implementation—A True Partnership

At GetOnCRM, we approached this not as a vendor delivering a platform but as a strategic partner shaping outcomes. Every design choice was driven by consulting insight, balancing immediate operational wins with a scalable, future-ready architecture.

The result? A referral process that feels almost invisible—fast, intelligent, and participant-focused—transforming referral management from an operational challenge into a strategic advantage.

Business Impact

The Salesforce-powered Referral Management System has delivered measurable improvements across referral operations and network performance:

3 dashboard Salesforce-powered Referral

FAQs: Getting the Most Out of Salesforce Sales Cloud

Salesforce Health Cloud centralizes referral intake, automates provider assignments, and enables real-time provider tracking. It eliminates manual processes, reduces delays, and creates a transparent, scalable referral process for behavioral health organizations.
The system handles large referral volumes using intelligent routing, real-time provider availability, and automated SLA tracking. It supports self-service portals, live bidding, and hybrid referral models—making it ideal for organizations managing both internal staff and contracted providers.
Yes. The referral system offers bidirectional EMR integration, ensuring accurate patient data syncing, reducing duplication, and enhancing visibility across clinical and administrative teams.
Provider matching work in this system uses a rule-driven engine based on credentials, availability, specialty, location, and participant preferences. This improves fairness, reduces assignment errors, and boosts satisfaction for both providers and participants.
Yes. Providers use the Salesforce Experience Cloud portal to update profiles, manage availability, and respond to referrals—empowering them to participate in the referral lifecycle efficiently.
Organizations typically see improvements like 40% faster assignments, 35% less admin workload, 30% better provider utilization, and 25% higher participant satisfaction, all while maintaining SLA compliance and referral tracking accuracy.

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