Referral Requirements
The Referral Checklist
A complete referral packet lets Liberty's clinical review answer faster. Use this checklist to assemble what the nurse will need, then transmit it through the secure method confirmed on your callback.
1 · Basic Referral Information
Have these ready for the intake call.
- County and discharge destination
- Anticipated discharge or start date
- Requested schedule and nursing level
- Primary diagnosis and requested services
- Equipment and technology in the home
- Physician's name and contact
- Payer, member ID, and authorization status
- Primary contact and preferred language
2 · Supporting Documents
PDFs and images are accepted. Items marked urgent speed the clinical review.
| Document | What It Tells the Review | Priority |
|---|---|---|
| Face sheet | Patient demographics, admission summary, and billing details. | Standard |
| History and physical | The clinical baseline the plan of care is built from. | Urgent |
| Medication list | Current reconciled medications with doses and routes. | Urgent |
| Physician orders | The orders that authorize skilled nursing services. | Urgent |
| Nursing notes | The most recent notes describing current status. | Standard |
| Discharge summary | The hospital summary of the admission and discharge plan. | Standard |
| Plan of care | Existing plan of care, if already written. | Standard |
| Insurance card | Front and back, for benefits verification. | Urgent |
| Authorization documents | Existing authorization or referral documents. | Standard |
| Other supporting records | Anything that clarifies the patient’s needs. | Standard |
Referral Line
Start a referral by phone and confirm the secure transmission method with the care team.
240-376-2550Secure Transmission
Patient documents are transmitted through the secure workflow the care team confirms on the callback. They are never routed through ordinary email notifications.
Callback Request
Prefer to walk the checklist live? Request a referral callback and a nurse will take the details over the phone.
Request a callbackSubmitting a referral does not guarantee acceptance or start of care. Services are provided when authorized, clinically appropriate, within Liberty's licensure and payer approval, and when qualified staffing is available. This checklist is a guide, not a legal or billing document.