When a patient checks in for a medical appointment he or she should be fully aware of their balance due, any previous balances owed, and an expected balance after their claim is processed by insurance.

How often does it actually happen this smoothly?

 Patients are much more likely to pay if they fully understand their responsibility. While there may be unforeseen circumstances — for example, a preventative screening becomes a diagnostic visit, or emergent care makes it more difficult for a patient to anticipate the cost of service — the expectation for payment should be set from the outset.

Don’t Underestimate the Importance of the Front Desk Staff

Recognize the importance of the front desk staff in the provider’s office.

Every patient should feel welcome, and all staff — not only clinical staff — have a responsibility to take care of your patients. Historically, front desk and triage are very high turnover positions, so it’s difficult to find knowledgeable and experienced staff who will stay long term.

Ensure positive first impressions.

The key to creating a positive first impression is providing proper training and setting up the environment for front desk success. For instance, consider moving the phones to an area out of sight from reception so the check-in staff are not simultaneously answering scheduling calls while taking care of patients face to face.

Be slow to assign blame.

The flip side of being on the front lines is that the front desk staff often receive the blame when things go not according to plan. If the physician is running behind on appointments, or if the lab or consult services are backed up, the front desk staff are made to answer for these errors. There isn’t a perfect solution, but presenting a unified message across your practice is imperative to supporting the front desk staff.

Plan for everyday patient encounters.

Write some basic scripting to help your front desk ask for payment, and to help keep long calls on focus. Help your staff prioritize and even segment work among your team according to their strengths and interests. And remind everyone to smile.  

Set the financial expectation from the very beginning

By the time of appointment check in the patient should have already had three conversations about their bill:

1) When the appointment is initially scheduled, state the expectation that co-pay will be due at the time of service. If there is a fee for canceling the appointment, communicate that information as well.

2) When the appointment reminder call is made, remind the patient of his or her financial responsibility. At this point, take the time to verify insurance eligibility and update demographics or policy information.

3) When the patient arrives at the office for the appointment, ask for payment. And yes, ask the balance due along with any previous balances.

Improve revenue cycle performance starting with the front desk

Your patients need to see the value in their healthcare experience every step of the way. 

Presenting courteous and professional staff, clean and properly lit waiting rooms, and front desk staff who have basic training on explaining the procedure costs, insurance process, and billing will go a long way to instill confidence in your patients. Teach your front desk staff to focus their attention on each patient, and to make eye contact while politely but firmly asking for payment.

The front desk staff typically do not see the end result, so it’s important to tie your staff into the whole revenue cycle process.

Show your front desk staff key metrics like percentage of co-pays collected, authorization denials, and insurance denial rates to give them incentive to ask for money, properly obtain authorizations and enter insurance information so your staff can see the impact they may have on streamlining the revenue cycle and rise to the occasion.

Collecting money from the outset goes a long way to improve the flow.

It also shortens the billing cycle, and the more benchmarks and transparency the front desk staff understands, the more they will work to reduce data errors and increase collections.

Education along with familiarity of processes can help avoid any confusion or delays in payment. 

For instance, if a patient has a bad debt balance, help your front desk staff fine tune how they can approach that conversation so as not to embarrass your patient.  Teach them to look for credit balances or potential misapplied payments so they can identify common errors and know how to correct them gracefully.

The Bottom Line

Working the front desk is often a difficult job, requiring patience and the ability to multitask. It is also a vital role to revenue cycle — asking patients to pay upfront and accurately capturing data to move the claim through the rest of the cycle. If you improve the efficiency and ease of your front desk employees, you will in turn improve the patient experience.