In my management consulting work with optometrists, I notice that it is quite common to furnish the patient with a receipt for services and products rendered that is not very impressive. Most optometric practices use office management software that provides a full accounting of fees, payments and amounts billed to insurance plans. These software programs can print a very nice financial summary for the patient, but in many cases, the entering of the fees, diagnosis and procedure codes, co-pays, and transferring of some fees to insurance plans is so time consuming that the office staff gives the patient a hand-written receipt at the end of a visit and returns for the actual accounting work later. My own practice has struggled with this process as well.
As challenging and time-consuming as the process may be, I think practice owners and managers must work toward entering all the fees, payments and credits at the time of service with the patient still in the office. It is important for the staff to hand the patient a printed financial walkout statement from the office software system. Let’s explore the factors involved.
The patient experience
The financial walkout statement and receipt is an important document for the patient and it should reflect the high quality your office stands for. This document represents the services provided and the products that were purchased. It shows the amounts the patient paid out-of-pocket and the amounts billed to insurance that are still pending. The document shows the name of the doctor, diagnosis information, tests performed, next exam date and other important information about the practice, such as the website address. The walkout statement may be the only document the patient keeps after an eye exam and it can serve as a public relations piece.
The entire transaction at an office visit can be fairly expensive and patients will study the receipt, show it to others and keep it in their personal records. A copy of the walkout statement may be used by the patient for many purposes, such as submitting out-of-network insurance claims, filing for flex-spending plans, and submitting to optical vendors for rebates.
I recommend you review the financial walkout documents that are currently being issued by your staff. In many cases, you may find they are handwritten copies of fee slips or superbills that have amounts scratched out, are rewritten multiple times and it may be the second or third copy of no-carbon required paper, which has very poor quality. This is not the image you want your patients to have of your practice.
It is simply good business practice to enter all sales into the office software system with the patient still present in the office. Here is why:
Recording the information on a paper form and then entering it into a workstation is double-entry and inefficient.
It is very likely that staff will forget to come back and enter some fees properly, which results in not getting paid for services and products.
The office software system typically has default fees and checks math, so entering and transferring fees to insurance reduces errors. It is best to find and correct any errors with the patient still present.
Entering fees and payments into the software system and printing the receipt for the patients reduces the chance of employee theft and embezzlement.
Watch the wait time
I find that there is usually a good reason why staff members perform tasks a certain way. If you want to change the procedure, it is important to find out why they did things the old way. In the case of printing walkout statements, it may be quite time consuming for staff to enter all the information the software requires. And the staff may also be answering phones and greeting other patients.
Be aware that patients who are checking out may have already been in your office for over an hour. They may be tired and blurry. They may be running late for another appointment or work. At this point in their visit, they may really want to leave your office! An employee who is methodically entering a huge amount of data can be very annoying! Your staff may have sensed that, which led them to handing the patient a handwritten receipt. Don’t make the situation worse by requiring staff to perform a very inefficient task that creates a poor image for the whole practice.
Every office software system is different, but spend some time observing your staff in action as they enter patient data. See what you can do to speed up their process. Ask other ODs who use the same system how they handle the walkout receipt. Ask customer service at the software vendor what they recommend and ask if they can improve the process in a future update.
Here are some things to look at:
Try to make the drop-down lists of products and services shorter. Or change the list so frequently used items are at the top.
See if there is some data that could be entered later, but still allow the critical fees and payments to be entered now in order to print the receipt.
Have the scribe start the fee slip in the exam room, enter some services and fees, and put the fee slip on hold so the front desk staff can retrieve it and add to it.
Have opticians enter the optical products directly into the fee slip as the items are sold in optical. Add workstations if needed.
You may need to hire more staff at the front desk so a person doing checkout is not pulled away to handle other tasks.
Best wishes for continued success,
Neil B. Gailmard, OD, MBA, FAAO
Editor, Optometric Management Tip of the Week
Dr. Gailmard's new book, Practice Management in Optometry: A Blueprint for Success Based on the Optometric Management Tip of the Week, is now available on Amazon.