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I've reviewed the front desk procedures in many optometric practices and I want to share a very common shortfall: taking much too long with the check-in process. There are many factors in play as we analyze why this process can take too long, but I urge you to examine your check-in procedure. This includes every step from the time the patient says hello to the time a technician brings him into the clinical area.
Read on to consider the reasons why check-in can take too long and what you can do about it.
Far reaching problems
A long check-in process causes a series of negatives for your practice from both a customer service and a sales standpoint.
Long history forms
- The doctor runs late for appointments and it may get worse as the day goes on.
- Patients resent not being seen on time.
- Patients dislike completing long forms and some have difficulty understanding the questions.
- Doctors and staff members have to rush with patients and may not give the best care and offer all vision care options.
- Patient education suffers.
- Record keeping suffers.
- Patients want to leave the office before they have time to complete their frame selection.
This is the big offender in the process for most doctors. It starts with an approach that looks first at the doctor's wants and needs and does not consider the patient's. Many doctors don't even realize that is what they are doing, but highly successful practices look at everything they do from the patient's point of view first. If you have a long detailed history form for patients to complete, consider a new approach.
- I realize you'd like every patient to print your form online and bring it to your office completed (or complete and submit it electronically), but we have to accept that many patients won't do it. Even for those who will complete online, it is not pleasant.
- Consider having a basic short form that covers some demographics and some easy ocular history and use a longer form if and when it is needed or ask the extra stuff verbally. Not every patient needs a complete review of systems and a past family and social history. Not every visit must be billed with an E/M code. Even the history of present illness should be taken verbally by the pretesting technician and maybe the doctor as well, so why have that section on the patient questionnaire at all?
- Do we need the history form (or any intake form) for established patients? I do not in my practice. We just update the previous record verbally as we take the case history. We have a very simple history form for new patients only. We check the postal and email addresses as the patient checks out. We are very fast to start most of our appointments.
Verifying the patient's insurance benefits, whether they are vision or medical, can slow down the process a great deal. Some companies still rely on telephone representatives for this information and the hold times are terrible. But even online verification and printing the benefits page wastes valuable time. I truly do not understand any practice that does not obtain this information over the phone and verify the benefits well in advance of the visit. If the patient does not know or does not want to look up the information, we politely tell them that if we can't verify the coverage in advance, we will have to charge them for the services. We get the information.
Entering demographic data
Review your front desk procedures so the patient is not made to wait. It could be that the staff is stuck in some bad habits, like completing a long demographic page before calling the technician. Why not input just the name and address to open the record and then complete the rest of the data while the patient is being examined. If there are obstacles, resolve them. Perhaps the history form should be two part NCR paper.
No technician available
Of course, problems happen occasionally in every office, but if you find that you are usually not able to start a visit because there is no technician available; I think you may be understaffed. In that case, hiring another tech could make you more profitable. A slightly different problem is when the technician is available but she feels she must read every word and review every test in the entire multi-year patient record. I train my staff to get the basics and call the patient. You can review it while you talk and test.
No room available
Is there a bottle neck because you have only one pretest room with many instruments and it is busy for a long time? If so, consider breaking up the instruments into multiple smaller rooms. Or equip a second pretest room with duplicate instruments (assuming you have a lot of patient volume). Solve the patient flow problems.
If you can overcome your check-in delay, you'll see an increase in patient satisfaction and loyalty and an increase in revenue.
Best wishes for continued success,
Neil B. Gailmard, OD, MBA, FAAO
Editor, Optometric Management Tip of the Week
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Dr. Gailmard offers consulting services to eye care professionals through Prima Eye Group; information is available at www.primaeyegroup.com.
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