To Improve Revenue Cycle, First Assess Front Office Processes
In medical practices of all sizes, the front office staff is, in effect, the clinic’s frontline. Their accuracy and efficiency in handling patient scheduling, pre-registration, check-in and check-out, benefits verification and preparing for appointments plays a huge role in the success of your medical practice.
At the same time, medical front office professionals experience high rates of job burnout and turnover. In 2019, the National Institutes of Health reported study results from 740 primary care clinic staff: 53% of staff reported burnout and 41% had left their positions 2 to 3 years later.
All these factors directly affect the smooth and efficient operation of your medical practice. However, Clinic-ology has found that medical practices that establish best practices for front office operations can see fast improvements. But before changes can be implemented, an assessment of current practices is essential.
Clinic-ology has developed a Healthcare & Practice Management Assessment to discover where your front office staff struggles most and where they’re currently excelling. Then, we provide a framework for change. We’ve found that implementing tried-and-true best practices in your front office and amplifying existing areas of strength, can help you retain your staff, improve patient care and boost revenue flow.
How a Front Office Assessment Works:
Clinic-ology uses a Likert Scale Style Assessment, which allows for degrees of opinion and even no opinion at all. Using this format over a simple yes/no assessment results in quantitative data that can be analyzed with greater accuracy and relative ease.
We break down front office tasks into the five major areas and then drill down into each step of the process through a series of statements that are answered on a scale of 1 to 5, ranging from Strongly Disagree to Strongly Agree.
1. Patient Scheduling
Patients should be scheduled in a manner that provides the staff with all the necessary patient information. For new patients, this is crucial. For returning patients, information should be verified at the time the appointment is scheduled.
Here is a sample of the statements Clinic-ology asks front office staff to self-evaluate:
Templates and/or scheduling defaults are used for scheduling patients in our practice management software.
During scheduling, established patient’s contact information is always confirmed for accuracy and updated for changes.
There are standard operating procedures (SOPs) written for our scheduling processes.
2. Pre-registration & Benefits Verification
Once patients are scheduled, the revenue cycle moves to registration and eligibility verifications. Here, front office staff records patient data, including demographics and insurance information. Since eligibility issues are a top reason for claim denials, capturing all necessary patient information is crucial. Also, it’s important to remember that Payers are increasingly asking providers to contact their offices prior to a patient visit to ensure that services are reimbursable.
3. Preparing for Appointments (Referrals & Pre-authorization Management)
Properly managing pre-authorization and referrals means that your front office verifies that the medical services for an upcoming appointment are covered by the patient’s health insurance plan.
The American Medical Association recommends that “prior authorization should utilize a standardized, automated process to minimize the burden placed upon both physicians and health plans.”
To learn the best ways to standardize this process, and based on current best practices, the Clinic-ology assessment includes evaluation of the following:
Any procedure appointments that require pre-authorization are reviewed for receipt of authorization at least 24 hours prior to the appointment.
Any missing information that creates a need to reschedule is handled promptly by a designated team member.
4. Patient Registration/Check-in
Despite all the data available today, most medical practices are not routinely tracking some key metrics that help assess the performance of their operations. Clinic-ology’s patient registration assessment relies on best practices and the results can be used to improve the patient experience and your financial results alike.
5. Patient Check-out
Check-out is the last stop for the in-person patient process and is where deductibles and self-payments are verified and follow-up appointments are scheduled. And just as important, it’s an opportunity to provide a positive end to the patient’s experience at your clinic. So, a smooth check-out process has a two-fold value.
Clinic-ology works with your front office team to assess the patient check-out process by having them evaluate each step, including:
Co-pays and deductibles are always known at the time of check-out.
Payments are posted to the patient’s account at the time of collection.
Incoming phone calls rarely distract the front desk team from checking out patients.
Clinic-ology knows that an in-depth evaluation of front office processes against best practices is a vital first step for any medical practice. Capturing and assessing current practices and processes can show exactly where, how and why they may fall short and what the effect is on your medical practice. In addition, it provides a window into ways to improve not only revenue cycles but patient experience, as well.
Ready to learn more about how Clinic-ology can help you optimize your practice operations? Schedule your free consultation call with us today using our Quick Schedule Link here.