Your Front Office How it Drives the Revenue Cycle Presented by Kelley Lipsey February 24, 2016

What is the Revenue Cycle?What is the Revenue Cycle? Starts at the first contact with a patient Continues at Initial Intake/Check-In Develops during entire flow of patient visit Moves through Check-Out Lasts through the billing process Ends with complete resolution of each encounter

The Front Office is where the Revenue Cycle begins Accurate and complete processes are vital to the success of the entire Revenue Cycle

Just How Does the Front Office Drive the Revenue Cycle? 1.Starts at the first contact with a patient 2.Continues at Initial Intake/Check-In 3. Develops during entire flow of patient visit 4.Moves through Check-Out 5. Lasts through the billing process 6. Ends with complete resolution of each encounter

Just How Does the Front Office Drive the Revenue Cycle?  Data Integrity  Financial Impact  Scheduling  Compliance  Positive Patient Experience

DATA INTEGRITYDATA INTEGRITY Garbage In… Garbage Out

DATA INTEGRITYDATA INTEGRITY  Patient Demographic Information Accuracy is VITAL in this area. Common errors include: SPELLING TYPING ERRORS Data must be COMPLETE Emergency Contact Responsible Party/Guarantor “Daytime” or “Primary” Phone # (should also get secondary phone)

DATA INTEGRITYDATA INTEGRITY  Patient Demographic Information  Financial Information Responsible Party/Guarantor Household Size and Income Total Household Income Proof of Income Insurance Information Wrong Policy/Member number Missing/Inaccurate INSURED Information No Copy of Insurance Card (Front AND Back)

FINANCIAL IMPACTFINANCIAL IMPACT Time of Service Payments Collect Copayments BEFORE patient sees provider Collect on existing outstanding balances Daily Balancing Process (checks & balances)

FINANCIAL IMPACTFINANCIAL IMPACT Time of Service Payments Insurance/Eligibility Verify Eligibility Understand patient benefits (out of network?, deductibles, copayment vs coinsurance, medical vs mental health) Frequency of eligibility checks

FINANCIAL IMPACTFINANCIAL IMPACT Time of Service Payments Insurance/Eligibility Sliding Fee Scale Does your front desk staff fully understand your SFS? Is it based on the Federal Poverty Guidelines? Updated Annually Definition of “Household” Do you require proof of income? Policy if patient presents without it Frequency of POI updates Is your cost per encounter covered?

FINANCIAL IMPACTFINANCIAL IMPACT Time of Service Payments Insurance/Eligibility Sliding Fee Scale Written Financial Policy The Patient is ALWAYS ultimately responsible for paying for services Insurance is filed as a courtesy Patient should sign financial policy

SCHEDULING Volume Front desk staff understanding of and compliance with scheduling rules Adjusting for provider “challenges” and directives Getting out of clinic on time Rescheduling cancellations Follow up on No Shows Reschedule Track/flag frequent no show patients

SCHEDULING Volume Patient Flow Managing the Lobby Notification to clinical staff Monitoring wait times Check Out Scheduling follow up visit Scheduling preventive visits (per provider instructions)

SCHEDULING Volume Patient Flow Provider Workflow New vs Established patients Scheduled procedures Injection ONLY/BP Checks “Special” patients

COMPLIANCE HIPAA Signed HIPAA Acknowledgement Consent(s) Signed authorization to release medical information for claims processing Authorization for Assignment of Benefits Signed consent for treatment (if not obtained during initial clinical intake)

POSITIVE PATIENT EXPERIENCEPOSITIVE PATIENT EXPERIENCE Telephone Management & Etiquette Answer the phone! No “eternal” holds SMILE Speak up and BE NICE Be polite and courteous Get management involved, when needed

POSITIVE PATIENT EXPERIENCEPOSITIVE PATIENT EXPERIENCE Telephone Management & Etiquette New Patient Registration Provide information when appointment is made “Come Early” for New Patient Registration What to bring (Insurance card, Picture ID, Medication list, self pay fees, etc.) New patient forms Privacy at front desk Be patient, but efficient

POSITIVE PATIENT EXPERIENCEPOSITIVE PATIENT EXPERIENCE Telephone Management & Etiquette New Patient Registration Managing the Lobby/Wait Time Pay attention to patient wait times Notify patients if provider is running behind Explain priority to “walk ins” Explain policy for late arrivals (at registration AND upon late arrival) Clinical staff “reminders”

POSITIVE PATIENT EXPERIENCEPOSITIVE PATIENT EXPERIENCE Telephone Management & Etiquette New Patient Registration Managing the Lobby/Wait Time Asking for Money It’s OKAY to ask for money Patients should expect it Provide staff with Policy to back them up Few exceptions Ask nursing/triage staff before rescheduling due to non-payment Post time of service payments correctly and timely (do not leave them “unapplied”)

POSITIVE PATIENT EXPERIENCEPOSITIVE PATIENT EXPERIENCE Telephone Management & Etiquette New Patient Registration Managing the Lobby/Wait Time Asking for Money Scheduling Accommodation Provide patient preferences when possible YOU manage the schedule When patient preference not available, provide them with options (YOUR options)

Know What Goes On At Your Front DeskKnow What Goes On At Your Front Desk  Don’t just assume staff is following procedure Monitor front desk activity Watch/Listen Establish and analyze measurement indicators Take corrective action, when necessary Provide adequate/additional education and training Right people, wrong position?

Know What Goes On At Your Front DeskKnow What Goes On At Your Front Desk  Provide your staff with adequate resources Education and training Equipment, etc. Working Close proximity Working and current IT Stable and high speed internet System upgrades Current Microsoft applications

Know What Goes On At Your Front DeskKnow What Goes On At Your Front Desk  Provide Positive Feedback OFTEN This is not just a “receptionist” position This is your FRONT LINE This job is NOT always EASY This job is NOT always PLEASANT This is NOT a minimum wage job! A good Front Desk staff is INVALUABLE Do not underestimate the value of spoken appreciation

QUESTIONS

Kelley LipseyKelley Lipsey