While much emphasis is put on how to handle check-in for patients in your practice, it is sometimes easy to overlook ways to ease this process by clearly defining how pre-admitting the patient is to be properly performed.
Patient pre-admission is an important part of the overall throughput process. Without this vital step, patient check-in can easily become a nightmare for staff and patients.
The Need for a Pre-Admission Policy
An increasing number of physicians and patients find that there is more time spent during an office visit on administrative functions than time spent on actual care delivery. This results in patient dissatisfaction, staff frustration, and decreased productivity for physicians.
While it is true that not all administrative functions can be eliminated during an office visit, there are many things that can be done to shift administrative tasks to times outside the office visit.
Why is this beneficial? Remember that perception is key. Consider the experience of two hypothetical patients in your office.
The Perils of Patient A
Patient A arrives at his appointment on time. He stands at your reception window, where the receptionist is talking on the phone with a caller. He waits for her to end the call, noting that now five minutes has passed since his appointment time.
The front desk receptionist then greets him with an apology for his wait and begins the check-in process. Because no one spoke with Patient A prior to his appointment about his insurance policy, he fumbles around for a moment to find his card.
The receptionist smiles and takes the card to make a copy for Patient A’s file. She notes the amount of his co-pay and respectfully asks how he will be paying it today.
Patient A replies that he thought a bill would be sent to him after the insurance pays its portion. He is unprepared to pay the co-pay, and slightly embarrassed to admit it.
The front desk receptionist then has to call the office manager to discuss the issue, making Patient A stand at the reception counter as other patients line up behind him waiting to be checked in.
When arrangements are made for payment, the receptionist notices that Patient A’s demographic information has not been updated. She hands Patient A the paperwork on a clipboard, and asks that he fill it out and return it to the desk upon completion.
Patient A sits down, uncomfortable with filling out the paperwork because he left his reading glasses at home. He also has trouble remembering some of his medical history, and wishes that the paperwork could have been done at home since his wife remembers dates and procedures he has had more clearly than he does.
By the time he completes the paperwork and returns it to the front desk receptionist, it is an hour beyond his appointment time. Patient A begins to wonder if he will be finished with the doctor’s visit in time to get to his second-shift job.
Pre-Admitted Patient B
Now consider the case of Patient B. Prior to Patient B’s appointment, an employee tasked with the job of pre-admission of patients called Patient B to confirm her appointment.
During that conversation, the staff member reminded Patient B that her insurance policy specifies a certain cop-pay amount, which will be due on the day of her office visit.
With Patient B’s file in hand or onscreen, the staff member notices that Patient B also has an outstanding account balance. Tactfully inquiring about Patient B’s payment intentions, the employee prompts Patient B to also settle her bill on the day of her visit.
She then inquires if Patient B has any questions or concerns. Additionally, she asks how Patient B would like to handle her paperwork, offering to send it in the mail, via email, or directing Patient B to the office website and/or patient portal to download needed paperwork so that it can be completed in the comfort of her home prior to the visit.
Once Patient B expresses her preference, the staff member follows through and then thanks Patient B for her time.
When Patient B arrives for her appointment, she hands the completed paperwork to the receptionist, pays her expected bill for previous services and today’s co-pay, and sits down within moments to wait for the doctor.
Which patient do you think will experience greater satisfaction with the visit? Which patient will have a better perception of your practice? The answer is obvious. It is the patient who was appropriately pre-admitted.
7 Steps to Successful Patient Pre-Admission
To ensure successful and satisfying pre-admission of your patients, it is important to clearly establish a workflow for handling pre-admission responsibilities.
Identify the tasks essential to pre-admission, as well as the staff members responsible for each of those tasks.
Create a standard, written policy for pre-admission procedures, and train your staff in its implementation.
Here are 7 things to consider when crafting your pre-admission policy:
1) Set up appointment reminders.
Make certain that at least two staff members are familiar with the procedure for appointment reminders. Designate one of them as the primary responsible employee for ensuring that appointment reminder calls take place on time, every time.
2) Appropriately handle patient balances.
The appointment reminder is an excellent time to advise patients of any outstanding balances on their account. This avoids any uncomfortable surprises at check-in, and allows a patient to discuss any financial concerns privately with a staff member instead of in a public waiting room at check-in.
3) Handle the paperwork ahead of the appointment.
Gathering all necessary demographic information and medical history prior to appointment time will make the patient more comfortable and provide staff and physicians with information needed to anticipate patient needs and issues.
4) Collect insurance information.
The importance of collecting accurate insurance information when an appointment is made cannot be overstated. To eliminate conflict and denied claims, insurance information should be complete and unequivocal.
5) Verify insurance.
Once you have the insurance information, it is essential to confirm it. Coverages can change. Policies can have riders and addendums that may impact payment of claims. Anticipating any hiccups with insurance coverage is an important part of pre-admission.
6) Advise the patient of any authorization requirements.
It is easy for patients to assume that all procedures are covered by their insurance policy without question. You know that is not the case. Make sure that patients are informed beforehand of any authorization requirements so that potential issues can be addressed before the day of the visit or procedure.
7) Confirm authorization policies are followed.
Do not risk claim denial by seeing patients without the proper authorizations in place. This protects your office from potential financial loss and protects your patient from unnecessary out-of-pocket expense.
Following these 7 pre-admission guidelines will help you keep patient satisfaction high and eliminate unpleasant issues that can arise from a lack of appropriate patient communication prior to a visit or procedure.
If you would welcome additional information about streamlining your pre-admission process, please contact us. We work with practices every day to improve workflows and increase productivity and profitability.