With the implementation of the Affordable Care Act the face of healthcare has changed. As expected, private medical practices have become inundated with new patients requesting to be seen. In theory, any increase in patient volume is good, however, in reality physicians are being asked to provide more for less.

With year over year declines in reimbursements and the increase in overhead required to provide quality care, physicians and their practice administrators have begun diverting more time and resources to optimize front office operations.

Front Office Efficiency

Prior to any shift in front office policy or practices, it is necessary to first create a sound strategy prior to introducing the idea to your staff. A more efficient and educated front office team will look at the following:

• Collect more patient co-pay charges
• Have less patient no-shows
• Create more satisfied patients
• Help relieve the administrative burden on medical staff
• Better educate and engage with patients prior to consults or treatments
• Provide an overall better patient-customer experience

Numbers Don’t Lie

In order to craft a more efficient front office policy, you must first have full visibility into your front office metrics. Begin by understanding the importance of these metrics:

1. Patient No-Show Rates – When patients miss their scheduled appointments, it affects more than their health – it affects your bottom line. Knowing this figure will allow you to understand where your front office staff is failing. A study by the Robert Wood Johnson University Medical Group, in New Jersey, found the following:
   • 77% of patients who received a reminder call showed up for their appointment
   • 82% of patients contacted by an automated appointment reminder system showed up for their appointment
   • 86% of patients contacted by a live staff member showed up for their appointment
2. Co-Pay Collection Rates – With the patient now responsible for a larger percentage of health care costs, many providers do not want to cause friction. Front office staff and providers do not want to upset their patients by asking for co-payments at the time of service or refusing service, however, by not doing this you could be losing thousands of dollars. For example, consider this simple equation; if your average co-pay per patient is $25 and each provider sees approximately 25 patients a day that is $625 per day per provider. Furthermore, depending on the total number of work days, your co-payment volume could account for $125,000 per provider per year.
3. Telephonic Analytics – The number of rings or amount of time until your staff answers your phones and how they greet your patients are very important. The impression formed about your practice will depend on your staff’s telephone personality and how they answer incoming calls. To foster a more positive impression, answer all calls by the end of the first ring to within the third ring. You need to understand these analytics to ensure that your staff is providing timely, top level customer service. The following are several metrics that can be sourced by using voice over IP (VoIP):
   • average call times
   • ring counts
   • in-bound and out-bound call analytics
   • HIPPA-compliant recorded calls
4. Patient Wait Times – Nothing is more frustrating than having to wait to be seen by the doctor. Patient check-in data should be readily available depending on your EHR or practice management software. The following statistics came from a survey of 5,003 US patients discussing patient wait times:
   • 80% of patients would be less frustrated if they knew how long the wait would be
   • 70% of patients said a personal apology from the doctor would minimize frustration
   • 41% of patients are willing to see another physician if it would reduce their wait times
   • 22% of patients indicated that they would pay an additional fee to be seen more quickly
5. Scheduling Utilization Rates – Taking the reins of your scheduling process and learning how to optimize your capacity calendar can both preserve your operating margins while improving patient care. Providers have a finite amount of time that they are available to see and interact with patients. With the increase in administrative tasks required for reimbursement, it is important that schedules are optimized better. There are multiple types of scheduling methods that may work for your practice:
   • clustering
   • wave scheduling
   • double-booking
   • stream scheduling
   • practice-based scheduling

Better Visibility Leads to More Accountability

With a firm strategy in place, it is time to train key staff members on your new policies. Begin this process by explaining to your front office team that the current way they handle patient interaction needs to be optimized. Explain that you understand working in a medical practice is not easy, however you are still a business, and businesses need to operate efficiently and profitably with customer service as one of the top priorities. Explain that in today’s competitive healthcare marketplace, patients are playing more of an active role in their healthcare decisions.

By nature, staff that know that their work is being evaluated on a consistent basis should, by default, strive to achieve and beat your realistic expectations. Front office audits of key performance indicators and staff efficiency should be occur monthly to ensure that the promise equals the delivery. After numerous failed coaching attempts, staff members who are not improving should be moved to a less patient-facing department or let go.

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