Patient check-in is a simple process, or at least it should be. But in reality, patient check-in is one of the most problematic areas in the ophthalmology practice as reported by both patients and the practice staff. What happens during the patient check-in process that can result in either a calm and well-orchestrated patient flow that ends the clinic day on time or one that is totally out of control and running late all day.
How is the patient check-in process at your practice? Here are several factors which may be the source(s) of breakdown in the patient processes at check-in:
The reception desk staff is not prepared for the day before it begins:
The number of staff assigned at check-in is inadequate for the number of patients arriving. This results in patients standing in line to check-in and usually creates delays in patient charts reaching the clinical staff.
The check-in staff are not fully trained and subsequently slow to register patients and more likely to make mistakes. Check-in staff should average 4-6 minutes to process a patient which meets the industry standard of 12 patients per hour per staff member.
There is a lack of cross-trained staff to allow back-up for all check-in staff positions.
The reception desk is responsible for handling all incoming phone calls:
The check-in desk is noisy, hectic and the phones are continuously ringing while the staff is trying to check-in patients who are waiting in line. This creates a negative patient perception, poor customer service and increased patient waiting time.
There are errors with demographics, pre-certifications, referrals, outstanding patient balances, and co-pays:
Demographics may or may not be checked on every patient visit. A demographic sheet is not used for patients to document changes. There is no written policy for processing a signed demographic sheet.
Errors are made when entering demographics into the computer creating insurance denials. Insurance cards and driver’s license for new patients and patients with new insurance plans are not consistently scanned into the computer.
Information on referrals, insurances (primary and secondary), pre-authorizations and/or eligibility is not reviewed and/or documented in the chart prior to the patient’s arrival. The clinic staff has no way to know why the patient is in clinic and what treatment and/or tests are authorized.
Proper signatures for treatment and payments are not consistently obtained prior to a service being rendered.
Outstanding patient balances and co-pays are not consistently collected at check-in.
Here are just a few recommendations that we have implemented at ophthalmology practices all over the United States with outstanding results:
- Ensure a proper number of FTE staff to cover the check-in desk at all times; do not allow more than one staff member per position to take vacation at the same time.
- Ensure there is always cross-trained staff to allow back-up for all check-in positions.
- In a high volume ophthalmology practice, there should be an assigned full-time manager for the check-in area who should be held accountable for meeting all departmental expectations.
- Consider creating a Call Center to handle ALL calls coming into the practice and any satellite locations. This will create a central area for phone control that is consistent and accurate and allow the check-in staff to place 100% of their attention on the patient check-in process.
- Ensure verbal and visual verification of patient demographics. Ensure all insurance cards are reviewed on every visit. Register effective and termination dates on all insurance plans.
- Ensure a thorough review of the patient’s account including vision benefits versus medical benefits, outstanding patient balances and co-pays.
- Train check-in staff to collect time-of-service and past due patient balances while the patient is on-site to reduce the time and money spent working patient accounts receivable.
- Ensure minimum of one (1) verification FTE per every 100-125 patients scheduled per day.
- Ensure your verification system is working flawlessly and is consistently monitored on an ongoing basis. Ensure your pre-verification list guidelines are enforced: verify three days in advance and consistently reconfirm “pre-admit unverified report” within twenty-four hours of date of service.
- Ensure all return appointments are made at check-out.
No matter the size or location of your practice, the check-in process is an extremely important part of patient acquisition. The check-in area is the patient’s “first impression” to your business and your practice culture. Every practice should routinely perform an assessment on their check-in processes and let your staff know if they are making the grade!