Intake Specialist
Confidential
GrowEdgeX · Workflow Standards
Intake
Specialist
Workflow standards, responsibilities, and performance expectations for the central coordination role in home health admissions.
Click anywhere to advance
Presenting to
MW
Mike Wheelwright
Owner · Advanced Home Health and Hospice
Verified Partner
Trusted Since 2020 · growedgex.com
Role Overview
What Does an Intake Specialist Do?
Central Coordination Hub
Serves as the primary point of coordination between referral sources, clients, caregivers, clinicians, physicians, and internal teams — ensuring nothing falls through the cracks.
End-to-End Referral Management
Manages every referral from receipt through admission — including intake, eligibility verification, clinician assignment, documentation transfer, and client communication.
Regulatory & Payer Compliance
Ensures all processes adhere to regulatory requirements, payer-specific admission standards, and agency policies — protecting the organization from compliance risk.
Proactive Escalation
Identifies and escalates barriers immediately — clinician unavailability, authorization delays, insurance issues, or any threat to timely and safe admission of the client.
Process Overview
Intake Workflow
01
Referral Intake
⏱ 2 min
Accept referral, verify source, enter patient into system and assign case ID
02
Eligibility & Insurance
⏱ Under 5 min
Clinical eligibility, benefits verification, authorization management
03
Prior Authorization
⏱ Varies by payer
Timeline depends on in-network vs. out-of-network status and insurance plan — auth turnaround varies by payer
04
Patient Care Coordinator
Varies patient to patient
Enter system, assign case ID, acknowledge receipt, set priority level
05
Client Communication
Follow-Up
Intro call, appointment confirmation, post-SOC monitoring
06
Prioritization & Escalation
P1/P2/P3
Urgent → Time-Sensitive → Routine with immediate escalation
Core Performance Expectations
KPIs & Standards
≤2min
Referral acknowledgement time from receipt
≤5min
Eligibility & insurance verification completion
100%
HIPAA-compliant documentation transfer — no exceptions
Escalation Framework
When to Escalate Immediately
Clinical & Admission Triggers
No Clinician AvailableNo qualified clinician available for required admission
SOC Deadline at RiskStart of Care deadlines cannot be met without intervention
Client Condition DeterioratesClinical status changes requiring urgent care response
Compliance / Safety ConcernAny safety or safeguarding issue is identified
Payer & Access Triggers
Authorization DeniedInsurance authorization denied or significantly delayed
Physician Orders DelayedPhysician orders not received within required timeframes
Client Unreachable × 3Three documented outreach attempts with no response
Continuity of Care ThreatAny issue threatening timely admission or care transition
Business Proposal
Flexible support options built to scale with census
Intake remains the starting service. Choose the model that best fits your current workload, then expand only when volume supports it.
OPTION A · FLEXIBLE HOURLY
OPTION B · DEDICATED COORDINATOR
Rate
$10.50 / hour
$1,750 / month
Best fit
Variable weekly workload and a lean starting model.
One dedicated resource assigned to your agency.
Primary focus
Support can be directed to the operational area with the highest need each week.
Intake, client onboarding, care coordination, initial scheduling, caregiver coordination / coverage and related tasks.
Lower census utilization
Hours can be adjusted based on weekly workload, keeping support lean while census is lower.
Available capacity can support recruitment, caregiver onboarding, credentialing, scheduling, and follow-ups.
As census grows
Increase hours only when the workload requires more support.
The coordinator becomes more intake-focused. GrowEdgeX reviews the need before adding another resource.
✦
No long-term contracts — start, scale, or pause based on your census
✦
HIPAA-compliant from day one — no setup risk
✦
GrowEdgeX manages quality — you stay focused on patient care
GrowEdgeX
Thank
You.
Questions?
You.
Questions?
Why Clients
Choose Us
Choose Us
We're committed to timely, compliant, and client-centered admissions — every step of the way.
✦ Referral to Eligibility in Under 5 Minutes
Fast, accurate verification so no patient falls through the cracks.
Fast, accurate verification so no patient falls through the cracks.
✦ 100% HIPAA-Compliant Documentation
Every handoff secured, tracked, and audit-ready — no exceptions.
Every handoff secured, tracked, and audit-ready — no exceptions.
✦ Certified, Licensed & Patient-Centered
Quality of care and the patient experience are at the heart of everything we do.
Quality of care and the patient experience are at the heart of everything we do.
✦ 24/7 Care Coordination
✦ In-Network & Out-of-Network
✦ HIPAA Secure
ISO 27001
ISO 9001
HIPAA Compliant
GrowEdgeX · Intake Process
Patient Care
Coordinator
A detailed walkthrough of the patient care coordinator workflow — from first referral receipt through Start of Care scheduling and clinical handoff.
Click anywhere to advance
Presenting to
MW
Mike Wheelwright
Owner · Advanced Home Health and Hospice
Verified Partner
Trusted Since 2020 · growedgex.com
Stage 01 · Target: 2 Minutes
Referral Sources & Intake Actions
Referral Sources
Hospitals & discharge planners
Physician offices
Skilled Nursing Facilities (SNFs)
Case managers & community providers
Fax, secure portal, telephone, EHR
Intake Actions
Enter referral into system
Assign referral / case ID number
Acknowledge receipt to referral source
Establish referral priority level
Request any missing documentation
Required Information
Client demographics & contacts
Referring physician details
Primary diagnosis & skilled care needs
Insurance & payer information
Physician orders + requested SOC date
Receive
Referral
→
Enter
System
→
Assign
Case ID
→
Acknowledge
Source
→
Set
Priority
→
Proceed to
Eligibility
Stage 02 · Target: 30 Minutes
Eligibility, Insurance & Authorization
Eligibility Checklist
Homebound StatusClient qualifies for home health services
Skilled Care NeedNursing and/or therapy requirements confirmed
Active Coverage VerifiedBenefits, deductibles, copayments confirmed
Service Area & CapacityAgency can safely provide required care
Authorization SubmittedTracked through completion
Escalation Triggers
Coverage UnverifiableImmediately notify leadership
Authorization Denied / DelayedEscalate with full timeline impact
Outside Service AreaRefer or transfer to appropriate agency
Payer Blocks AdmissionEscalate to leadership immediately
SOC Deadline at RiskImmediate coordination required
Stage 03 · Target: 25 Min Post-Clearance
Clinician Assignment & SOC Scheduling
RN
Registered Nurse
PT
Physical Therapist
OT
Occupational Therapist
SLP
Speech-Language Pathologist
MSW
Medical Social Worker
HHA
Home Health Aide
Assignment Match Criteria
Required discipline & clinical expertise
Geographic coverage area
Availability & workload balance
Client-specific clinical needs
Language & cultural considerations
SOC scheduled within payer timeframes
Stage 06
Referral Prioritization Framework
Priority 1
Urgent
Same-day hospital discharges
High-risk clients
Post-surgical admissions
Cardiac-related conditions
Complex wound care cases
Safety & safeguarding concerns
Priority 2
Time-Sensitive
Pending insurance authorizations
Next-day admissions
Expiring referrals
Delayed physician orders
Time-sensitive payer requirements
Priority 3
Routine
Standard home health referrals
Routine follow-up activities
Non-urgent documentation requests
Best PracticeMaintain full visibility of active referrals. Complete tasks to a logical stopping point before transitioning.
GrowEdgeX
Thank
You.
Questions?
You.
Questions?
Patient Care Coordinator Process
Patient Care
Coordinator
Coordinator
GrowEdgeX ensures every referral is processed with speed, precision, and full compliance — delivering exceptional outcomes for your clients and your organization.
✦ Regulatory Compliant
✦ Client-Centered
✦ HIPAA Secure
✦ Trusted Since 2020
ISO 27001
ISO 9001
HIPAA Compliant
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