Working as a front office associate in a medical office or hospital setting can be one of the most stressful and high demanding positions in the business of healthcare. These individuals are expected to perform many tasks throughout the day as well as provide excellent patient customer service and be masters of multitasking. We depend on our front office associates to complete their duties correctly because if not our revenue cycle will be impacted negatively.
So the question is what does the front office associate do every day? What a great question, since I find a lot of revenue cycle leaders and operators don’t truly know. When we as leaders truly understand what they do and why they are so important in our organizations, we can then actually streamline and improve the processes and systems used to capture information.
So here is a day in a life of a front office associate. Please note it may not be the same for every front office associate but will be close. The background helps us understand how busy these individuals are in the office. This will be for a very busy practice, 4 MDs, and 2 NPs as well as ancillary services schedules, lab, nurse visits, X-ray. We will say that all the providers are in the office as well as full ancillary service schedules. Provider schedules are full with 35 patients each, Lab schedule with 50 patients, Nurse schedule with 15 patients, and X-ray schedule outside of patients already being seen will be 5. This will give us a total of 280 unique patients checking into the practice throughout the day. For this example, we will have two individuals on the front desk checking in the patients and performing all the duties of the front office functions.
They will start the day, by opening the practice, setting up everything to get ready for the patients to arrive. When the patient arrives at the office, they will either sign in or stand at the window or desk to be check in to see the provider. The associate will verify the patient’s information by printing off documents for the patient to review or will show them the information on a privacy screen; they should NEVER check demographic verbally. While the patient is verifying the demographics, the front office associate will scan the patient's ID and insurance cards and check the insurance is correct in the system. Once this is completed, the associate will verify to see if the patient is eligible for benefits, if the patient does not qualify for insurance, then the front office associate must have a discussion with the patient. After all this information is completed the front office associate will proceed to collect the payment for the visit. They will do this asking for either the copay or balances or both depending on the patient and will provide a receipt to the patient. At this point, if the patient has questions about their balance the front office will give the patient explanation or refer the patient to the billing office. They will do these steps for all 280 patients who check into the office. At this point you may say, this is easy and they should be able to do this accurately. I would say yes, but let’s add the reminder of the tasks these individuals must do throughout the day. They will answer the phone, taking messages, direct calls, as well as schedule appointments. On any given day they will have anywhere between 10-30 calls an hour, which means an average of 160 calls a day. The individual will also, scan documents, provide support for the nurse or provider, obtain referrals, some offices will call insurance companies for pre-certifications for outside test. Communicate with other offices and make appointments for their patients. They will do all of this while they are checking in patients throughout the day. Sometimes, these individuals will be additional tasks not stated above for specials situations. On top of all the tasks, they must also have excellent customer service, to smile, make eye contact, defuse irate patients and do all this will out showing stress or frustration every day.
Now that we talked about a day in a life of a front office associate let talk about the importance of these individuals to your revenue cycle. If at any point during the checking-in process, collecting monies, and verification is done incorrectly, your overall revenue will be impacted. So for example; let us say your front office associate decided they will not collect balances – this will affect your patient overall account receivable. Because as you know, it is easier to get balances from the patient in person than through statements and calls, the result is the revenue is negatively impacted. Another example, what if our associate doesn’t see the value in verifying insurances. What does that mean, it means that you will see patients who, at the time of service, will not have the correct insurance, resulting in denials. As every revenue cycle leader knows denials are always revenue impacting. So you see where I am going here if any aspect of tasks assigned to our associates are not completed or completed incorrectly it will negatively affect the revenue cycle. This is the reason why we need our associates to understand their role in the practice is paramount.
So if we say our front office associates are a critical part of the revenue cycle, what can we do to make sure they are valued and know they are an essential part of the process, we can provide our associates the best process and tools to do their job functions. In most cases, revenue cycle and operations leaders don’t take the time to help the associate understand their functions or give them the proper tools. Our leaders will hire associates, give them little to no training and expect the associate to perform. So what should you as leaders do, you must value the job function and ensure that the proper tools and process are in place. By providing these simple operational items, it will allow us to gain real synergies in the front office operations. So let’s talk about these tools, streamlining the front office tasks and front office training.
Streamlining the front office process and tasks can be difficult regardless of the size of your practice but can be more difficult in a smaller office. I will say the more technology you have in play will reduce the number of tasks the front office associates has to perform as well as increase revenue. We will talk about technology in another segment. Let us begin, how do you start to streamline your front office operations and process, you must start with an evaluation. Yes, I know you are saying right now, I do not have time to do an evaluation, but I will say back to you if you don’t know what is going on in your practice you can’t streamline the processes. Once the evaluation of the front office is completed, the assessment of your practice management software is to be done. Remember your technology will make or break your revenue cycle in the short and long run, so yes your software must be assessed. The biggest reason you want to evaluate the software is that the majority of the time the practice does not take the time on the front end to optimize their software. Instead, they just do the least amount necessary to get the software up and running, and will say they will optimize later, later doesn’t come, which means that revenue cycle will be impacted.
Once the evaluation process has been completed, now it is time to streamline the processes. Streamlining the check-in process will help to reduce the amount of time the patient is waiting, increased productivity, and reduce errors. Every practice and hospital system are unique and the same, so streamlining the process may be universal in some areas and with others will be very specific to your circumstance. So do not be fooled into thinking that one size fits all, this where most revenue cycle leaders will get in trouble. For the most part, the processes will be the same, but you must be open to tweaking the process for your own circumstance when needed.
The second area to bring value to the front office associate is training. So often front office associates are hired and not given proper training, resulting in denials and loss of revenue. Adequate training should be done before the front office associate starts and the training should be simple and relatively straight forward. Training is not limited to just when the associate starts, but it should be continuous. It can be easily done by providing a step by step guide for all your front office associates to refer when they need additional guidance. The “how to” guide will ensure they do the task or process correctly as well as know what is expected of them in their positions. At this point, you may be saying, this is not realistic, but I assure you it is realistic and can be done. But again, you as leaders must take the time to build the training and guideline for your associates. We as revenue cycle leaders and operational leaders need to understand that our front office associate is under a great deal of pressure to perform and we MUST provide them with the tools to perform these functions. If we don’t provide the associate the tools, then we are setting our associates up to fail and our revenue to be negatively impacted. So it is important for you to take the time evaluate, optimize, streamline, and train your front office processes to ensure that your revenue cycle is not affected. This is not an overnight process. In some cases, depending on the size of your practice or organization it could take weeks or months to evaluate, create, and educate your associates. When you do, you WILL see positive results only if you do take the time. When there are positive results, there is an increase in net revenue. When there is an increase in net revenue everyone is happy!
If you need assistance in evaluating, optimizing, streamlining or training of your front office process, please give us a call at Revitalize Healthcare Solutions, I will be happy to assist you.
Cissy Mangrum, MBA, CMPE, CPC
Revitalize Healthcare Solutions
Email: Cissy.Mangrum@cmhealthconsulting.net
Cell: 615-397-50422
Disclaimer – my thoughts are my own and are not associated with any company or system.
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