Referrals, Prior Authorizations & Requests
Workplace product
Referral / prior authorization communication
Course goals advanced
- 2. Professional Workplace Writing
- 4. Documentation-Style Writing and Professional Responsibility
- 5. Summarizing and Paraphrasing
Essential Question
How do I communicate a request so that another person has the information needed to act on it?
Teaching & Learning Concepts
The communication principles, workplace expectations, and healthcare context behind this topic.
- Purpose and audience — a referral is read by someone with no knowledge of this patient
- Required information: what the receiver must have before they can act
- Concise requests — a request buried in narrative gets actioned last
- Supporting information versus padding
- Follow-up: a request with no tracking is a request that disappears
- Documentation of communication — record that the request was made, when, and to whom
Grammar Focus
A small set of high-value grammar skills, tied directly to this topic's communication task.
Paragraph organization
- The topic sentence states the paragraph's point, usually first
- Supporting details back it up, and each one earns its place
- Logical order: the reader should never have to re-read to follow you
- Transitions connect the sentences so the paragraph reads as one thought
Healthcare Vocabulary
This topic's spelling and usage words. Earlier lists spiral forward — turn them on to review.
Word Bank — List 8
Flip each card for the meaning and an example.
Formative Practice
Guided activities and short exercises. None of this is graded — it is here so you can find out what you know before it counts.
What is missing from this request?
Read the referral request as the specialist's office would receive it. Check every required element that is not there.
The request as written
Hi — we'd like to refer a patient to your office for the knee problem we discussed. She's been having trouble for a while now and our provider thinks she should be seen. Please let us know when you can fit her in. Thanks!
Order the request
Arrange these into the order a busy reader can act on fastest.
Practice only — nothing here is graded or recorded.
State the requested timeframe and give your contact details.
Provide insurance and authorization information.
Give the reason for the referral, specifically.
State the request and who it concerns: referral for [patient name, DOB] to orthopedics.
Supply the relevant history: duration, findings, and what has already been tried.
Topic sentences and transitions
Paragraph organization — the grammar that makes a request readable.
Practice only — nothing here is graded or recorded.
Build a referral request
Write each part. The completeness check looks for the elements the receiving office cannot act without.
Scenario
Ms. Wen Chen, date of birth 4 March 1968, has had right knee pain for four months. It worsens on stairs and after standing for long periods. She has tried over-the-counter ibuprofen with partial relief. An X-ray taken last week showed changes consistent with osteoarthritis. Dr. Amara Reyes is referring her to orthopedics. Her insurance is Meridian Health, member number MH-4471902, and prior authorization has been obtained, reference PA-88213. Dr. Reyes would like her seen within four weeks. Your office number is 555-0134.
One sentence: what you are asking for, for whom, and why. This is your topic sentence.
Duration, findings, and what has already been tried. Enough to triage, nothing more.
Carrier, member number, and authorization reference if obtained.
When you would like the patient seen, and how to reach you.
Completeness check
Fill in the sections above and this will tell you what a reader would still be missing.
This checks for missing elements only. It does not judge your writing — use the Communication Check for that.
Words to spell — List 8
Flip each card for the meaning and an example.
Cumulative Workplace Product
Combine this topic's grammar, vocabulary, and communication skills into something you would actually produce at work.
Referral / prior authorization communication
Produce a complete referral or prior authorization request from the case above. The receiving office should need to ask you nothing. Organize it in paragraphs with clear topic sentences.
Submit through Brightspace. This page is for drafting and self-checking.
Revision & Reflection
Review your work against the Communication Check, then name one thing to improve next time.
Communication Check
Check your own writing against all five. Not graded — saved in this browser only.
Think about
- Read it as the specialist's scheduler. Could you book this patient without calling back?
- Does each paragraph have one point, stated in its first sentence?
- Is there anything here the receiving office does not need?
Before You Leave
- Identified every missing element in the incomplete referral
- Put the request into the order a busy reader can act on
- Completed the topic sentence and transition drill
- Built the referral and ran the completeness check