What "fixed" looks like for a practice that loses sent patients.

Watertight, described honestly

• Every arrival is caught and logged the same day — fax, portal, phone, email, walk-in script — into one ledger with a status: arrived, contacted, scheduled, seen, reported. Paper stops being a place patients live.
• Patient contact starts same-day — reached while the referral conversation is still fresh in their mind, when scheduling rates are highest.
• No-answer triggers persistence, not a sticky note — attempts across phone and text until the patient is reached or genuinely declines, with the referrer told if contact fails ("can you nudge them?").
• The loop always closes — the sending office hears "scheduled," then "seen, report sent." Automatically, not when someone remembers. This single habit is why referrers consolidate their sending.
• A monthly number proves it: arrived, contacted within 24h, scheduled, loops closed. An unmeasured ledger drifts back into a pile.

What's deliberately absent: any specific referral-management product name. Watertight is a state — sometimes the build configures what your EHR already half-does, sometimes it adds the missing tracking layer. That's what the first fix's baseline decides, and why we won't quote a full build before measuring.

What engagements look like

Full builds start at $2,500, quoted in writing from your first fix's evidence, scoped to your actual leak. The same tracked-referral measurement runs again after the build — before/after as timestamps, not promises.