Patient intake is critical for the operational, financial and clinical success of a healthcare organization – be it private practices, hospitals, health systems. Despite the general population being used to digital checkin at airports, healthcare organizations are plagued with manual data entry and patient intake processes.
Learn the various steps in patient intake and how each step affects another department. Understanding the patient intake process (whether it is new patient intake or existing patient intake) will help you with streamlining it.
For each patient, there are about 50 different tasks that need to be performed for patient intake. You are probably aware of the steps subconsciously. Have you ever taken stock of all the steps involved? Easy to do if you use a patient intake software for this.
Various steps involved in patient intake
Let’s break them down into these sections – before the patient visit, during the patient visit to your office, after the patient visit (before the next visit).
The way most of us do things today goes like this:
Before the visit
- A patient calls the office, stays on hold for 5+ mins, then our front desk answers the call.
- The frontdesk asks for the patient’s insurance and if we accept the patient’s insurance, the patient asks for an appointment date/time. Sometimes the patient agrees to pay out of pocket as well.
- The frontdesk gives the patient an appointment date/time, then proceeds to take down the name, phone number, insurance details of the patient. The frontdesk tells the patient to bring a valid photo ID and to carry their insurance card with them.
During the patient visit
- If the patient remembers the appointment, they show up for their appointment.
- The patient is given a printed paper to “sign in”. Then the actual checkin process starts with the patient being handed a stack of papers to fill out in the waiting area.
- The patient starts entering the following details on paper
- Patient demographics data
- Verification of patient’s identity
- Patient’s chief complaint, history of present illness, medical, family, surgical, social histories, allergy list, medication list. The patient typically is not able to provide all the medication names and writes in “layman” terms/language.
- Various HIPAA and consent forms signed by the patient
- Insurance details of the patient (or whether they are a self pay) along with insurance card details
- Physician referral form, if the patient was referred.
- Patient’s payment method and details (for credit card of file program – read our thoughts on patient payments for practice managers)
- Patient reported outcomes . Easy to do if you use our patient intake software for improving the patient intake process.
- The patient takes the next 15-20 mins to fill out these details and hands these to the front desk. Some practices enter all these info into the EMR and some just scan these into the patient record or scan and send these to an outsourced medical BPO company to update their EMRs with this information.
- At the front desk, then we ask the patient for their insurance card, proof of identity. If the patient has remembered to bring these with them, we check the patient in. We then take the insurance card details and type all that information into the EMR. Finally, we scan and PDF the card(s) into the patient record (none of the scanned materials is indexable, searchable, reportable).
- Then the front desk starts collecting copays and prior balance dues (if any). The patient usually has a knee jerk reaction about why there is a prior balance and starts asking billing related questions – which the front desk refers to the billing department. The billing department stops what they are currently doing, dig deeper into this particular patient’s financial records, claims history, EOB (explanation of benefits) and ERA (electronic payment advice) from the payer and tells the patient why they have a balance due.
- At this point, the patient typically states that the practice should “send them a bill” and proceeds to pay just the copay (if at all).
- Overall, this has taken a good 30 mins (or more). Then, the patient starts to wait in the waiting room. They are already delayed because the technicians are backed up “working up” the previous patient(s). Easy to cut this time down if you use our free patient intake software for these steps.
- Then, the patient is taken to a waiting area where they wait for the tech to come in. The tech comes in, takes the papers that the patient has filled out, verifies those information and proceeds to enter all the SAME information into the EMR, from the paper entries. In other words, another 15 mins are spent right there.. Again. The tech spends a little more time trying to nail down the correct medication name(s) because the patient doesn’t recall medications with the formulary names, so the tech has to help them identify the correct ones.
- Finally, the technician gets to check the patient vitals, records the same into the EMR, conducts the pre-tests (if any) and then prepares the patient for the doctor to see the patient.
- The doctor sees the patient, records the diagnosis. The patient might need medication, where the doctor asks the patient for their pharmacy name and the patient struggles to tell them the exact pharmacy name or the exact address. The doctor/tech asks a few more questions to finally get to the correct pharmacy and e-prescribe the medication.
- If the patient requires any extra diagnostic tests or procedures, the doctor asks the tech to perform the same. Now, the tech contacts the billing department to ensure that the patient’s insurance covers the procedure or not. The billing department drops what they are doing at the time being and checks for the eligibility of the patient’s procedure/test. They get back to the tech with the answer. The tech then proceeds to perform those tests.
- The doctor enters the recall appointment date/time or asks the patient to go to the front desk to set up the next appointment date/time. The patient waits to talk to the front desk and gets the next appointment date/time. The patient then leaves the practice.
After the patient visit
- The billing department then submits their claim to the payer within the next few days. A few weeks pass by and either the claim is reimbursed in full or there are some denials due to data entry or eligibility errors. The billing department fixes the issues and finally the insurance company pays up. Since balance billing is not allowed, the remaining patient responsibilities usually are co-insurance / deductible related (which should have been noted during the check in process itself).
- In more cases than not, the patient’s credit card is not kept on file. The front desk or the billing department now tries to get in touch with the patient to collect the dues, or pushes this to the next visit of the patient.
- Some practices do make appointment reminder calls, most don’t.
- The cycle continues.. rinse , repeat. Easy to do if you use our free patient intake software for improving the patient intake process.
Whether you use digital patient intake or you do it manually, the patient intake process starts from the very first phone call the patient makes to your offices. Patient intake is a perfect opportunity to improve patient satisfaction and a better the patient experience. Patient intake ties in directly with patient access as well.
How the patient intake process affects the rest of the healthcare organization
If you understand this aspect, you will be in a better position to excel at your job. Let’s revisit each section from the “patient intake” article. You can use a patient intake software for most of these challenges.
Patient demographics data
While you, as a front desk might not realize this… this is super critical for medical billing. This alone can mean collecting from insurance payers vs not collecting from the claims.
Be VERY, VERY careful about entering demographics data and ALWAYS ensure that you have the absolute latest demographics information from the patient.
Verification of patient’s identity (there’s plenty of patient identity fraud)
You as a front desk or call center person might not realize the impact a patient’s identity fraud might have. But the fines are HUGE and the repercussions are disastrous. .
Patient’s medical, family, social & clinical history, medication list
Know that this is the single item that takes most of a technician’s time. The more time a technician takes to fill out patient’s history, Chief complaint etc, the longer it takes to work up a patient.
This leads to further delays and longer patient wait times. The longer the patient wait times, patient satisfaction reduces dramatically.
As of 2019, CMS has already relaxed the rules around who documents this portion. Try to get this done so it contributes to patients getting in and out the clinic faster.
Patients usually don’t do a great job of remembering the medications they are taking when they are at your office. You can use a patient intake software instead. In addition to this, you can hire a call center team to get the history / intake data if needed.
Various consent forms signed by the patient during patient intake
While we have to deal with documenting patient consents on various items, these can very easily be done by the patient while they are at home as well.
Understand that not having consent forms directly exposes a practice / healthcare organization to higher risk / liabilities.
An even bigger item to think of – when you want medical records from the patient’s regular provider, you need consent forms signed for them to release the medical records to you.
Want to reduce your manual workload of phone calls and want to achieve some parts of your job via SMS and email? You need consent forms for that.
Want to collect patient balance due automatically using the credit card on file? (i.e reduce bad debts). You need to get the patient to consent to allow you to charge the card. Get these signatures done – preferably before the patient even visits the office.
Insurance details of the patient (or whether they are a self pay) along with insurance card details.
This one is crucial and you know that you are supposed to get the insurance details MUCH before the patient comes into the office. Once the patient is in the clinic, you don’t really have a way to send them back because their insurance eligibility was not verified – do you?
Get the patient’s insurance details, preferably a proof of the patient insurance as well, before the patient ever comes in to see your providers. This directly affects your medical billing department from collecting dues from the patient.
If a patient is self pay, you know very well that they need to be given an estimated cost of care and if they can afford your fees, then they can be given a confirmed appointment.
Insurance eligibility and benefits of patient’s insurance plan
Again, you are directly controlling the outcomes that your medical billing can produce. If you are not checking insurance eligibility for the provider that is going to see the patient, you are bound to screw up. You can use our patient intake software for this.
Just because your practice accepts a plan, doesn’t mean that every provider is credentialed with that plan, for that location. Make sure you understand the nuances and make sure that the appointment is made with a provider that is credentialed for that plan.
Just because a patient is “eligible” still does not mean that the member benefits cover the CPT that the provider is going to perform.
Be aware of this. It is always better to have all pertinent insurance details with enough time on your hands to be able to rectify issues (if any).
Physician referral form, if the patient was referred
This is where the medical marketing department is counting on you. The medical marketing department is tasked with generating physician referrals (in addition to digital marketing). They keep knocking on doors of referring providers to get patient referrals.
In exchange, the referring provider expects their patients to get an appointment ASAP, to be kept in the loop about whether the patient kept the appointment or not, to get consult notes within 24 hours of the patient appointment.
Be a good partner to your referring provider partners by keeping them in the loop about everything – they will reward you with more patient referrals. Meanwhile, open up patient access to the maximum, and the referring partner’s patients will reward you with patient reviews. You can use our patient intake software for this.
Patient’s payment method and details (for credit card of file program)
In the past, payers were covering large portions of a patient’s healthcare costs. These days, the trend is for payers to pass on a larger portion of healthcare costs to the patients (members). This trend is not about to change anytime soon.
So, while in the past, you didn’t really have a credit card on file program with your patients, it is critical for you to do so now. You can use our healthcare CRM and patient intake software for this.
Make sure the consent forms are also signed so that the patient consents to being treated only if you are allowed to collect balance dues directly from their credit card (without having to employ a collection agency).
Collecting copays and prior balance dues (if any)
We have heard all kinds of excuses from patients for not being able to pay copays and from front desk staff from not being able to collect copays.
Understand that collecting copays is REQUIRED by most payers as that’s part of “patient cost sharing”. If you do not collect copays, your provider runs the risk of getting into trouble with the federal anti kickback statute, 42 U.S.C. § 1320a-7b. Additionally, none of the payers like that either and eventually your provider will get into trouble for doing so routinely.
Collect copays – each and every time. There’s no 2 ways around this. You can use our patient intake software for this.
Gathering patient reported outcomes
Usually, the technicians do this and the process eats up time. Meanwhile, patients can report their outcomes from the past visit very easily either from home or using a patient intake app as well. You should ensure that the patient does report outcomes from the last visit either electronically or in the office so it would improve clinical workflow efficiencies.
The quicker you are done with a day’s patient load, the faster you can go home 🙂
Hopefully this helps you understand the patient intake process and how you can contribute to the health of your healthcare organization’s clinical, administrative and financial workflows.
Improving the patient intake process
We want to be more efficient and to reduce errors that affect the rest of the organization. Our recommendation is to use a digital patient intake software to achieve all these automatically AND more importantly – accurately.
Here’s how the majority of tasks can be moved to the patient side.
|Before the visit||Appointment Scheduling||Allow patients to self schedule appointment requestsAsk frontdesk to confirm|
|Appointment reminder||Send automated appt reminder SMS and voicemails|
|During the patient visit||Patient check in||Ask patients to complete at home (before the visit)|
|Patient demographics data||Ask patients to complete at home (before the visit)|
|Verification of patient’s identity||Ask patients to complete at home (before the visit)|
|Patient’s chief complaint||Ask patients to complete at home (before the visit)|
|Patient’s history of present illness||Ask patients to complete at home (before the visit)|
|Patient’s medical history||Ask patients to complete at home (before the visit)|
|Patient’s family history||Ask patients to complete at home (before the visit)|
|Patient’s surgical history||Ask patients to complete at home (before the visit)|
|Patient’s social history||Ask patients to complete at home (before the visit)|
|Patient’s allergy list||Ask patients to complete at home (before the visit)|
|Patient’s medication list||Ask patients to complete at home (before the visit)|
|Various HIPAA and consent forms signed by the patient||Ask patients to complete at home (before the visit)|
|Insurance details of the patientInsurance card details||Ask patients to complete at home (before the visit)|
|Patient insurance eligibility checks- coinsurance, deductible details||Check electronically (before the visit), provide estimated cost of care- include coinsurance and deductibles in calculation(s)|
|Physician referral information||Ask patients to complete at home (before the visit)|
|Patient’s care team info||Ask patients to complete at home (before the visit)|
|Patient’s CCD record from care team physicians||Send automated CCD request faxes to care team before patient visit|
|Patient’s payment details- Credit card on file program||Ask patients to complete at home (before the visit)|
|Patient reported outcomes||Ask patients to complete at home (before the visit)|
|Patient pharmacy of choice||Ask patients to complete at home (before the visit)|
|Patient recall appt date/time||Ask patient to choose the same way as this appt|
|Patient copay / balance dues||Ask patient to pay at home or before seeing doctor using credit card on file|
|After the visit||Patient satisfaction surveys||Send automated SMS / email|
|Patient recalls||Send automated SMS / email|
|Patient balance dues||Send automated SMS / email. Ask patient to pay using credit card on file|
|Patient education materials||Send automated SMS / email|
|Patient statement||Send automated SMS / email|
|Re-appointment of no-show patients||Send automated SMS / email|
|Re-appointment of cancelled patients||Send automated SMS / email|
|Stay in touch messages / greetings||Send automated SMS / email|
How to leverage digital patient intake
We recommend that you combine all patient intake channels. Take a moment and list all the ways you get patients (and patient appointments). Think through the patient intake process – what you need
- Minimum patient information you need to be able to create a patient in the EMR
- Minimum information you need to be able to create an appointment in the EMR
Everything else can be gathered later on – before the patient comes in (pre-visit) and when the patient is at the practice (during visit)
Minimum patient info needed (might vary by EMR)
- Patient first name
- Patient address
- Patient email address or patient opt-out consent
- Patient preferred language
- Patient date of birth
- Patient Gender, race, ethnicity
Minimum patient insurance info needed (might vary by EMR)
- Relationship to patient
- Payer Name
- Policy Type
- Member ID / member number
- Insurance effective from
Minimum appointment scheduling info needed (might vary by EMR)
- Appointment date
- Appointment time
- Appointment location
- Appointment visit type / nature of visit
- Appointment provider
Minimum information needed before attending the patient
- Notice of Privacy Practices consent
- Insurance billing (assignment) consent
- Consent for digital (E-mail, SMS, app) communication
- Consent for use of electronic prescription orders
- Current medications
- Chief complaint
- History of present illness
- Past medical conditions
- Past surgeries
- Social history
Here’s how you should break down the patient intake workflow
How to handle patient intake for new patients
Here’s our suggested way of collecting all patient information while still providing patients with an optimized experience. In the best case scenario as described below, the patient barely has to input any information (other than clinical) and the worst case scenario, they do have to type in all their information (which they would have to provide over a call anyway)
Get patient contact information
Ask for the patient’s first name, phone number as the first step. If the patient abandons the patient intake form, at least your front desk or call center agents can call the patient back. Now that you at least have data to call the patient back, proceed with insurance step
Get patient insurance information
- Keep in mind that eligibility verification is for a specific provider at a specific location.
- Ask for patient’s preferred appointment location, preferred appointment visit type / nature of visit, preferred appointment provider.
- Now you have the provider ID (NPI number) and the other basic info you need.
- Next step is to get some information on the patient’s insurance. This will vary because some insurances support eligibility requests using specific service type codes. Meanwhile, some providers will give you general health benefit coverage when a member has a specific group number that you can provide. Others will give you eligibility request’s responses if you provide a CPT code. Meanwhile, you can also check for Medicare eligibility by including the HCPCS code
- Try to find a way to help the patient let you know what their chief complaint is or the reason for the visit is. Remember that you can run eligibility checks based on a combination of information that the patient might have in their hands.
- If the patient’s insurance does not clear, let the patient know their options – self pay or to rebook after resolving their insurance eligibility issue.
Get patient appointment preferences
- Ask the patient for their preferred appointment date, preferred appointment time. Patients greatly appreciate this kind of self service and the ability to know up front whether they can book an appointment or not.
- If the patient’s insurance is valid (i.e. the patient’s eligibility verification goes through), show all available appointment options to the patient and allow them to book their appointment.
- Each EMR has APIs that allow you to pull appointment slots, appointment availability, appointment types, appointment blockouts, providers, resources etc. Make sure that your patient intake software ties into these APIs and presents the right information (e.g. check https://developer.carecloud.com/docs – you will have all the required information that you need)
- Once the patient picks an appointment time/slot, stop at this point and thank the patient for the information. Advise them to expect an SMS / email with confirmation information.
Begin SMS conversation with patient
- Send the patient an SMS and/or email confirming their appointment details.
- In this communication, send a link to the patient where they have access to their upcoming appointment at all times.
- Make sure that this information is protected with verification of DOB. If the patient enters the correct DOB, they can open the appointment confirmation link.
- Note there that your EMR might already send a patient confirmation SMS automatically.
- You might want to consider stopping the EMR from sending SMS as your patient intake software would also be sending an SMS with the confirmation and next steps SMS messages. This confuses patients since they get SMS from multiple phone numbers about the same appointment.
- Make sure that your front desk / call center gets a notification that a new appointment has been requested. This notification could be a desktop alert or it could also be an email or SMS (only limited patient information can be sent via SMS)
- Your front desk or call center person(s) should verify that the appointment has all the needed information and that you have necessary information in the patient record.
Continue with pre-visit patient registration
- This is where you need to initiate your intake workflows. Our recommendation is to not ask the patient for every single thing up front. Allow them the ability to “save their work and finish later”.
- This “save and finish later” ability also allows you to “stay in touch” with patients by reminding them to finish their intake / registration. Whether patients do this or not, that’s not a guarantee – however, what’s guaranteed is that the patient will be reminded of their appointment and will have lesser likelihood of being a no-show (that we all dread, but have gotten used to).
- Based on the number of days left for their appointment, send them an SMS to finish their patient registration. This should gather clinical information as mentioned above.
- Gathering these patient clinicals will drastically reduce the amount of time that the techs have to spend on documenting patient clinical information.
- On top of this, your intake software should ask patients items from your patient health questionnaire. This further contributes to reducing patient wait times and techs + doctors have a more complete picture of the patient’s current medical condition before the patient even steps into the practice.
- The best part? The patient is usually more committed to showing up for their appointment (reducing no-shows)
- Send the patients their consent forms as well. Nowadays, most phones are smartphones/touchscreen phones and patients have no issues signing consent forms using a finger drawn signature or to even use their “full name” to e-sign a document (as you might have seen in most digital signature documents that you receive from various other companies.
- Identity proof? Easy – simply ask the patient to use their phone and take a picture of their driver’s license or other forms of ID proof. These days, OCR software has progressed so much that these software can easily read pictures and present the necessary ID information to the patient to verify. Once patient has verified this information, you can save it in your EMR
Gather and keep patient card on file
- We have heard many excuses that patients do not always have credit cards, do not want to provide credit cards over the phone etc.
- Collect the patient credit card information as they check in or before they come to your practice.
- It is very easy to add a credit card on file – your patients are storing credit cards on amazon, google, various e-commerce websites; they can certainly do the same with your digital intake software as well.
- We have discovered that when our patient balance collections team calls patients, they actually end up paying using a credit or a debit card – some even pay via ACH payments.
- Make sure that after the patient registration is done, you ask the patient to leave a credit card on file and ensure that the patient understands that the remainder patient balance is their responsibility PLUS the fact that you will automatically charge their card for the remaining balance post visit.
Pre-visit – send appointment reminders
- Your intake software should remind patients of their appointments – via email, SMS or phone calls.
- We recommend connecting with the patient via all modes.
- You can choose to send an email 5 days before the appointment and ask them to confirm their appointment.
- You can choose to send an SMS 3 days before the patient’s appointment and ask them to confirm their appointment.
- You can choose to have an automated phone call made to the patient 1 day before the appointment and ask them to confirm their appointment.
- At all these points, make it easy for the patient to reschedule their appointment (or cancel it altogether if they choose to do so).
- If the patient chooses to reschedule their appointment, your intake software can take the same steps as before and ensure that it gets the patient an appointment slot in your EMR
- If the patient chooses to cancel their appointment, your intake software should mark the patient as “cancelled” and put a reminder in your patient CRM to touch base with (human or automated) at a later time
During visit – Ask patients to verify their information
- As soon as the patient comes in for their visit and wants to check in, ask them to verify their information.
- To do so, you can use various modalities – a tablet, a kiosk or the cheapest option.. tell the patient that you are going to send an SMS to their mobile of choice for them to verify their information.
- This is the time where you should collect their co-pays and also try to add their card on file again. It does work well.
- You will notice that patients would not always be able to afford their payments and would ask for a payment plan.
- There are several payment plan options available – patient financing options like Carecredit / prosperhealthcare etc, recurring payments on their credit cards. Make sure that you let the patient know that.
- Whatever you do, do not go into a passive payment collection mode. Research has shown that you have 70% less chances of collecting payment from patients once they walk out the door.
- We have noticed that if you tell the patient that they have a balance due later on, they either cancel their appointment or ask your front desk to “bill them later” (which the front desk gladly agrees to). Do not let this happen to you and your practice.
Make it easy for patients to pay easily
- Your patients pay for various services online every day. We guarantee you that they will pay you as well (no matter if you think otherwise).
- Allow patients to pre-pay for their co-pay.
- Allow patients pay their co-pay while they are present at your practice for their appointment. In any case, you will have to ask patients to verify their informat
How to handle patient intake for inbound calls from patients
- Try to make sure that your intake process remains the same as much as possible
- When a patient calls in for an appointment, have your front desk or call center agents use the same intake screens / web pages.
- Get it to a point where the appointment is created in your EMR and thereafter, let the SMS conversation begin.
How to handle patient intake for inbound calls from referring providers
- Again, follow the same steps. However, note that the referring provider office will not always have the patient appointment preferences. You’ll have to give them the best available slots
- Make sure that you do capture the referring provider name, practice information, practice fax and contact info (as much as possible) so that you can send them patient appointment updates and also the visit notes after the appointment
- When you are processing a referral from a provider, the patient has probably already left the referring provider office. It’s best to modify the first patient SMS to help the patient understand that this appointment was created for them because of the patient’s provider visit and referral. Thereafter, you can continue the conversation with the patient directly.
How to handle patient intake for appointments from zocdoc
- First, you need to decide if you’re allowing direct connection between zocdoc and your EMR. If you allow this connection, then Zocdoc’s software creates a patient and the appointment in your EMR directly.
- However, you need to check whether zocdoc creates the patient records with all the necessary patient information or not. In our experience, we’ve found that zocdoc doesn’t have all the relevant patient information hence your digital patient intake software needs to finish the job that zocdoc started.
- These are going to special cases and your software should be able to send an SMS or email to the patient to continue pre-registration of the patient.
- If you haven’t allowed a direct connection between zocdoc and your EMR, then your front desk staff or your call center agent will be notified of the appointment. They will have to call the patient, finalize the patient and appointment details, then start the SMS conversation as above.
How to handle patient intake for Facebook / Google “Book now” appointments
- One good thing about these two platforms is that they allow you to send an automated response to the patient.
- In this automated response, you can have the patient start they intake process as if they’re cashing in or going to your website to request an appointment
How to handle patient intake for existing patients
- Same channels as above, HOWEVER, the good thing is that you already have all the patient data.
- The challenge here is to ensure that all the patient data that is in your EMR is current and up to date
- In many cases, the patient’s demographic information and/or the insurance information would’ve changed. You need to verify that.
- We’ve found that the best way to handle this situation is to allow the patient to choose whether they’ve been at your practice or not
- If they state that they’re an existing patient, then they need to be verified with as many pieces of information as your EMR has. Eg phone number, date of birth, name match, ssn.
- Once the patient identifies themselves, you can proceed with the same steps as above. The big difference is that the existing patient will have the ease of verifying their information or correcting their information as needed.
Patient intake kiosks vs tablet vs patient’s mobiles
The functionality remains the same in each modality. Patients can use their mobiles to fill out the requisite information from home / work. Meanwhile, tablets, kiosks can only be used at your practice.
Our recommendation is to lean more towards patients’ mobile phones as there are a few benefits:
- You can only purchase limited tablets for your practice (plus they use up storage space)
- You can only purchase limited kiosks for your practice (plus they use up floor space).
- Neither of these really give patients the privacy that some of the patients prefer (and deserve). Note that even today, immune system related diseases are associated with social stigma.
Kiosks – they are ubiquitous. You use them to check-in for flights at airports, to pay for your groceries, to pay a parking fee at a garage or parking lot, and some states even have them at DMVs or Secretary of State’s offices.
These are the easiest to use (form factor) but offer the least privacy and also use up too much floor space.
Tablets – Most of the patient intake platforms can run on a tablet (iOS, Android – whichever you choose). These are easier to use than mobile devices, offer a little bit more privacy than the kiosks, but some practices have complained that “devices seem to walk away from practice locations”.
Mobile devices – hardest to use because of form factor (smaller screen). However, in this case, you are leveraging the patient’s devices and at the same time giving them maximum privacy. Do keep in mind that if your intake software designs the intake workflow and screens in a way that it is easy to read for even older folks, this truly is a hit.
Our recommendation is that you should use a combination of both. Mobile and for the patients that do not have a mobile number shared with your practice – use the tablets.
Patient payments for medical practices – doesn’t get enough attention!!
Nowadays, patients are responsible for a larger portion of their healthcare costs. Traditionally, doctor offices have either written payment dues off as bad debt or have simply let those patient balances due slide to avoid damaging relationships with patients. Most practices that we talk to, or work with, do not have a credit card on file program before we start working with them.
Medical practices need to collect every dollar they’ve earned. Here are a few things you need to get started.
Front desk collections of patient payments
Arguably, the biggest bang for the buck is to ensure that your front desk is respectfully aggressive with collecting account balances from patients. You need to stop allowing your front desk to “mail the bill” to the patient as many patients ask them to do. In our experience, most patients do NOT pay unless you are asking them to pay. My medical call center team also did patient balance collections and had reported similar results.
You need to hold your frontdesk staff 100% accountable for collecting copays and past due balances. Organizationally, you could even have a monthly competitor and maintain a leaderboard to reward top collectors.
Patient payments plans
Patients are willing to pay, however, many times they are unable to pay. Medical practices need to have well defined payment plans set up. Front desk and payment collection agents in your call center should be made well aware of these payment plans.
In our call center, we did not allow payment plans for more than 6 months – however, this is a decision that each medical practice needs to make for themselves. In my experience , patient payment plans of more than 6 months do not seem to do well as patients change their credit or debit cards.
Patients also have options like Carecredit, ProsperHealthcare, LendingClub patient solutions etc. to get financed.
Set payment expectations and cost of care before patient’s visit
During your patient intake process, your patient intake software should be able to give you a cost of care estimate. Ensure that you run an insurance eligibility check for the upcoming appointment before you call the patient and when your front desk or call center agent is speaking with the patient about their upcoming appointment, make sure you let the patient know what their current balance is and what their upcoming appointment cost might be. This truly does help collect more from patients.
Yes, there will be cases where patients will cancel appointments if they learn about a past balance due. Think about it this way – would those patients have paid at all? You are better off cancelling the appointment if that patient was not going to pay in the first place!
Explain options to patients
Most front desk and call center staff do not take the time to explain the complicated terms to patients. Patients do not have a clear understanding of copayment, coinsurance, deductibles, out of pocket maximums etc – at least not as much as you and your practice staff do.
Take the time to explain these differences to patients (in other words, spend some time in educating them). The more you educate the patients, the better your chances are of collecting patient balances, ensuring patients are well aware of their visit costs, and preparing for the payment in full (PIF) – whether it is on the date of service or over a few months, on a payment plan.
Send patient payment reminders
One thing we have noticed with our patient debt collections agents is that when they call the patient with a reminder about their balance due, patients do actually end up paying. Payments from patients thus far have been primarily via credit card, debit card and on very few occasions, using ACH / check.
Sending a payment reminder SMS and an automated way for a patient to see their balance due goes a long way towards collecting patient balance due. If you cannot send a HIPAA secure link with the patient statement in the SMS, then it is better to not even send the payment reminder SMS. In our experience, patients always ask for an explanation of why the balance is due before they actually agree to paying in full, part etc.
Balancing payment collection with greeting patients
This is where most front desk staff struggle the most. They are tasked with providing the best patient experience possible – smiles, warm greetings, building a relationship with the patient to make them comfortable etc. It is hard for them to balance their patient greeting with asking for payments.
While the patient balances for regular visits are not very high, the balances for surgical procedures can tend to add up to amounts of significance. This is where the surgical coordinators can be of the biggest help.
As an example – in our ophthalmology group customer’s practice, the surgical density is quite good. For this practice, our doctors recommend a procedure to the patient and then the patient is taken to a separate surgery scheduling waiting area. The surgery scheduler / coordinator is actually in the best position to collect patients’ payment responsibilities.
Just like with the call center staff (or front desk), surgery coordinators should take the time to explain to the surgery candidates / patients that their doctor is recommending a surgery, what the next steps w.r.t clearances are, who is responsible for each step, then finally explain the total costs and break it down into patient’s insurance coverage vs deductible vs the patient portion of deductible that has / has not been met and what the patient would be responsible for. At that time, the scheduler should ask the patient for the patient’s responsibility portion to be paid upfront – BEFORE the surgery is scheduled.
Sure, some patients would cancel their surgeries if they are told what their payment responsibilities are – but these are also the same patients that would never pay their balances anyway. Unless your practice is OK with collecting only the insurance portion (hey, something is better than nothing), this is the route we recommend taking.
Set up credit card on file program for patient payments
This is, by far, the best method we have seen thus far. With a patient intake software along with our call center asks every patient to set up credit cards on file before they come in for their visit. Since many of our patients are of the Medicare/Medicaid payer mix, they do not, typically, have much of a balance to pay – however, for the commercial insurers, there’s almost always a patient payment balance.
Our front desk staff are instructed to ensure that payments are made with credit or debit cards with an explanation like “we try not to have cash in our practice locations”. This allows our practices to have a credit card on file. The front desk staff are also instructed to explain to the patients that under a mutually agreed upon balance (e.g. $200), we would be allowed to charge their credit card for the patient obligations.
Athena has a wonderful study + recommendation that you can read here.
Patient payments using a bill pay software
Our patient bill pay software is a simple tie in using Stripe. Whether patients are sent a payment link via a payment reminder SMS or directed to it from the customer website, the patient can simply enter their name, card number and pay. They get an email receipt of their payment that they can use for proof of payment. Meanwhile, they also have the option to select post dated and recurring payments as well.
In addition to the patients being able to use this software to pay their payment responsibilities, our call center staff also uses the same portal to make payments for the patients when they are speaking with the patients about their balances due.
Each day, at the end of the day, Stripe automatically deposits the monies collected to our customers’ bank accounts and each day, the transactions are downloaded and tallied against the balances due by our medical billing team. These payments are then posted against the patient’s account daily to ensure that the patient account always reflects the correct account balance.
How to save 25 mins per patient visit
Take stock of where do you really spend (waste) time? Add it up
- Scanning and uploading Driver’s license, Insurance card to EMR.
- Scanning and uploading Consent form e-signatures to EMR.
- Copays and past dues.
- Noting Chief complaint, HPI, history, medications, allergies – all, in EMR.
- Medication reconciliation
- Follow up appt for patient
So, how do you actually save 25 minutes per patient visit?
SIMPLE ! Have your contact center wrap up patient intake before patient comes for their appointment. What can you get done before the patient visit?
- Driver’s license, Insurance card pictures.
- Consent form e-signatures.
- Chief complaint, HPI, history, medications, allergies – all.
- Medication reconciliation.
- COVID questionnaire.
Follow up appt – after patient leaves, call and give them appt.
THAT’S IT! WE’VE SEEN HUGE PRODUCTIVITY AND PERFORMANCE GAINS. TRY IT OUT.
Take a look at how we do it with EzHCRM and you will see that most of the “work up of a patient” is really taken care of, by the patient themselves 🙂
We would have the patient enter their own emergency and care team contacts as well.
On top of it, patients save us time by uploading their insurance docs.
Next, we ask patients for problems, allergies, medical history, Social history, Consent forms and signatures as well
Free patient intake forms
Here are some sample patient intake forms – feel free to edit them and customize them for your specialty. Most of these are part of our digital patient intake software as well.
Free Patient Intake Form Template
In general, if you can, try to get the patient to answer most of these questions (demographics, insurance, clinical history and chief complaint).
In any case, your patient will need to give you all this data while in your waiting room. Try to have the patient fill these out in the comfort of their homes (as these do take a good 15-20 mins to fill out). This way, when the patient comes in, they are fully prepared with the correct information.
Unfortunately, unless you use digital patient intake forms, you do have to type all this information into your EMR or scan and upload the PDF into the patient chart.
The clinical, family, social histories and the chief complaint information truly cuts down on the time it takes techs to work up a patient. It’s the same information that is captured and transferred over whether the patient types it in or if the tech asks the patient those questions and enters the information into the EMR.
Here’s a free patient intake form template that gathers the following information (RTF format , doc format and PDF format).
- Patient demographics data
- Patient’s social & clinical history, medication list.
- Insurance details of the patient (or whether they are a self pay) along with insurance card details
Free Patient privacy notices consent forms
Feel free to use these privacy practices notice that we all have to use at our front desk.
Free Patient Health Insurance Billing Consent Form Template
Feel free to use these Health Insurance Billing Consent notice that we all have to use at our front desks.
Free Patient Consent Form For Electronic Communications Template
Feel free to use these Patient Consent Form For Electronic Communications notice that we all have to use at our front desk.
Free Patient Consent For Use of Electronic Prescription Information Template
Feel free to use these Free Patient Consent For Use of Electronic Prescription Information notice that we all have to use at our front desk.