Making your practice’s first impression a positive one
Debra C Cascardo

Don’t overlook the importance of a friendly, efficient check-in and check-out system. Checking patients in and out of their appointments in a friendly and efficient way is a complex process that leaves a deep impression - for better or worse - of your medical practice. Because first impressions are often lasting ones, leaving this process up to chance is not a risk you want to take. This column will review the key steps you and your staff should take to ensure that all patients get courteous and efficient service from the moment they walk in the door until they pay for their services.

When patients enter your office, are they seeing the image of your practice you want to convey? If not, educate your staff about the specific image you want to convey and provide the standards to support it. By establishing high standards, you eliminate mixed messages patients might get if they see another patient getting more personal attention or courteous, discrete service. While all office staff has a role to pay in achieving high standards, the office receptionist is the first contact a patient makes when he walks through the door. Her efforts to maintain those standards need to be supported by the rest of the office team.
Best foot forward

A clean, well-organised front desk and reception area will go a long way toward creating a positive impression and making patients feel comfortable. Desks and work areas visible to patients should be neat and organised. Establish rules about eating and drinking in the reception area. Ensure that confidential phone calls to insurance companies by your billing personnel be made outside of earshot of the waiting room.

The front desk should be configured to help the receptionist efficiently perform her duties. For example, have a copy machine available to copy insurance cards, driver’s licenses, and referral or pre-authorisation information. Some practices let receptionists lose valuable time by requiring them to walk to the back office to perform these simple tasks. Also, consider using “cheat sheets” to assist staff in answering questions about insurance co-pays, hospital/lab phone numbers or directions to your office. The station responsible for collecting payments should have a cash drawer and credit card machine available. A good receptionist has a demanding position that requires she courteously deal with difficult patients, scheduling delays and other problems. Making small improvements in the working conditions lets her know her skills are valued. For instance, consider providing a telephone headset that allows her to handle calls and appointment changes without getting a crick in the neck.

Getting Ready for the Day
Staff should arrive at the office before the first scheduled appointment. This is a good time to hold an informal staff meeting to discuss the upcoming day’s appointments, open slots, potential problems, special meetings, as well as reviewing the previous night’s hospital admissions and emergency calls. Charts should have been pulled or created for new patients the night before or prior to the day’s first appointment. A list of the scheduled patients and appointment times should be prepared and ready for the receptionist as each patient arrives. All staff should be at their desks 15 minutes before the first scheduled appointment. The front desk staff should be ready to turn their undivided attention to the first patient as he or she opens the door.

Greeting and preparing patients
A friendly, attentive receptionist can reduce the anxiety of a doctor’s appointment. Does your receptionist make eye contact when speaking with patients? Does she listen and respond rather than spout rote phrases? Standard scripts can e helpful in ensuring that office policies are followed, but they must be flexible to accommodate individual situations. Assuming a list of the day’s patients has been prepared, the receptionist should know who is expected and be able to greet each patient by name. For new patients, an appropriate greeting could be: “Hello, you must be Mrs. Smith. I’m Debra; we spoke on the phone. It’s a pleasure to meet you. The doctor will be with you in a few minutes. Please make yourself comfortable in the reception area.” Greeting the patient personally is preferable to a sign that says, “Sign in Please. “ To assure confidentiality, patients should be signed in on a list that’s kept next to the receptionist instead of on the counter.

Patients requiring special assistance should be escorted to a seat in the reception area and then to the examination room. New patients should be pre-qualified during the appointment scheduling and reminder calls. Before the patient arrives at the office, you should know what type of insurance coverage he has; whether you are a participating provider in that plan, and if your practice provides the services needed. All such information should be in the patient’s chart and verified upon arrival.

For established patients, the receptionist should verify the patient’s address, employer and insurance plan. It is better to ask the patient to provide this information to assure they don’t assume that “everything is the same.”

Check-in is the best time to update a patient’s account. This is also the last opportunity for specialists to obtain the patient’s referral and/or authorisation form. Whether a practice collects co-payments and deductibles at check-in and check-out depends on the practice’s philosophy and type of services offered. For all practices, however, it is important that the patient be aware that payments for which the patient is responsible are expected at the time of the visit.

The Last Impression
Checking out also provides an important impression for patients. Naturally, you want them to leave your office with a favourable impression of the practice. If a follow-up appointment or referral letter is needed, handle it immediately. If the patient will be sent to the hospital or lab for tests, provide directions and a phone number as well as the appropriate form. If necessary, make the appointment for the patient.

The receptionist should know the co-payment, deductible and other fees due for the visit and politely request that payment. Here’s a courteous way to phrase that request: “Mrs. Smith, your co-payment for today’s visit is $20 — $10 for the visit and $10 for the strep test. Will you be paying by cash, check or credit card today?” If the patient has forgotten her checkbook, provide a stamped, self-addressed envelope so that the check can be mailed as soon as she arrives home. By not expecting appropriate payment for your services, you are implying to the patient that your knowledge, skill and care are not worth the fee you are charging. Before the patient leaves, ask if there is anything else you can do. Conclude the visit by thanking the patient and, if appropriate, relaying your concern for his or her well-being. (“Thank you. I hope you’ll be feeling better soon.”) Because the check-in and check-out process have so many components, you will need to modify your procedures from time to time. Regularly schedule discussions at your staff meeting about how to handle a difficult patient; resolve scheduling problems, adapt to changes in insurance information; physician delays, and the like. As new problems arise, the entire staff can work on providing a solution.

(Source: www.medscape.com)