Aiming at the problems in the actual two-way referral process of medical alliance platform，such as untimely referral arrangement and unsatisfactory patients，a two-way referral intelligent decision method based on random forest was designed. In this method，five main factors affecting referral were selected and an intelligent referral scoring model was established，including the number of beds，bed utilization rate，disease cure rate，treatment cost and distance. Then，big data and random forest methods are used to analyze the main factors and measure the suitability of the hospital to be referred to in the form of scores. The practical results show that predictions based on these five main factors can list a variety of referral plans，provide a basis for accurate decision-making on referral arrangements，and improve the efficiency of referrals.