The Hidden Profit Center:

Written by on June 1, 2017 in Features - No comments

Your Front Desk

Your front desk staff are the first people to greet your patients when they walk through your door and the last people they see when they leave. They have the ability to set your patients at ease before their visit begins and to tie up all loose ends when it is over. They collect a seemingly endless amount of information about the patient, from demographic details to ever-changing insurance information, and are responsible for making sure that everything is up to date. Regardless of this, the front desk staff, and the importance of their job function to both your practice and your patients, is greatly underrated in today’s healthcare environment.

Imagine a scenario where a patient receives a statement from your practice and is being charged the full cost of your services as a self pay, even though the patient presented their insurance card at the time of the visit. Already frustrated, the patient now has to take the time out of their own busy day to call the office and update their insurance information. Hopefully they have no issue getting through to the right person in your office and everything is updated and a new claim is sent immediately. And let’s hope that the original statement was sent in a timely manner and the claim is not approaching the filing limit.  And let’s hope that the patient doesn’t complain to their friends and co-workers about the time and effort they spent on something that should have been handled already. And let’s hope etc., etc. You get the point. It is in your best interest to get all of this right the first time.

There is no debating that the revenue cycle continues to become more cumbersome. What used to take two steps now takes four, and there is generally a pitfall somewhere in the middle. So how can you ensure that your front desk staff aren’t just the people that answer the phones and check patients in, but are also recognized as a profit center to your practice? Easy, the best way to beat cumbersome is with knowledge and expertise.


Long gone are the days of hiring just anybody for the front desk.  Your front desk staff is the gatekeeper to your practice.  They will be the liaison between provider and patient and will likely be the first impression that the patient has of you, the provider.  Job responsibilities at the front desk now range from customer service to collector to scheduler to insurance guru, and sometimes these responsibilities change on a daily basis.


While your front desk staff may not actually do your billing, they should at least have the knowledge of what elements are necessary to file a clean claim.  Demographics, eligibility, preauthorizations, referring providers, co-pays, coinsurance, deductible, etc. They should understand the purpose and importance of each task that they perform and how essential each is to the revenue cycle and your bottom line.


Every time a patient visits you should verify their demographic and insurance information.  Verifying does not mean asking “Has any of your information changed since the last time you were here?”.  Have the patient tell you their address and phone number and ask to see their insurance card.

Once you have the insurance card in hand, check the eligibility.  Just because you are looking at an insurance card does not mean that the coverage is active.  Depending on your technology, eligibility checks can be done through EMRs, your clearinghouse, phone calls or a website search. An eligibility check will provide you with information regarding a patient’s co-pay, coinsurance and/or deductible levels and will set the stage for a discussion with the patient regarding the amount that you will collect from them at that time.

Make sure that you have an eligibility process in place that is efficient for your office even if it means an extra expense. In a chaotic office environment, comprehensive eligibility checks are often one of the first tasks to be skipped because people assume that “billing” will catch any issues that arise. However, by the time the claim reaches billing, it will be too late to collect the proper co-pay from the patient or to discuss coverage.

Better yet, have your registration process available through your website so that it can be done ahead of time.  At a minimum, have forms available on your website so that they can be brought in already completed.  The more efficient you are on the front end, the better the experience for the patient and the more efficient your front desk staff can be.

Also, depending on your specialty, a pre-authorization could be required before you see the patient.  If that’s the case, that should be done PRIOR to the patient presenting for their scheduled appointment.  Pre-authorizations can be very time consuming, and similar to co-pays, you need to have an efficient system for handling them. Spend the time to figure out what works best for the flow in your office.

Additionally, the front desk staff should be able to discuss a patient’s account or have a dedicated contact that can speak to the patient while they are at the provider’s office.  Chances of collecting an outstanding balance are far higher face to face than via the post office. This is key and is the point of failure in most offices. Your practice is a place of business and your front desk needs to treat it as such. There will occasionally be difficult conversations about outstanding balances, co-pay collections, etc. and it is important that your front desk staff is prepared to have these conversations. When they occur, knowledge is your most powerful defense. The better your front desk staff understands why an outstanding balance is what it is, the better chance they have of explaining it in a way that the patient can understand.


In addition to the front desk basics already discussed, there are always nuances that are specific to the state, the MAC, the plan and/or the patient.  As an example, with the Affordable Care Act, there are new plans being added to existing carriers.  Just because you participate with a carrier does not mean that you are automatically enrolled in ALL the plans that are offered.  Have someone on your front desk or billing staff that can stay on top of new plans that your patients have and can keep the rest of your staff updated so that they know what to look out for.

Other potential issues revolve around simple data collection so your staff needs to be diligent and not distracted when checking a patient in. Something as trivial as a date of birth being incorrect or using someone’s nickname vs. the name on their insurance card can automatically eliminate the chances of a clean claim.

Additionally, the more information that is given to the patient via the front desk, the more accepting they will be to your policies and procedures.  If it’s clear that you expect payment at time of service then the patient comes prepared.  If you make sure that the patient understands preventative visits versus medical visits and how that impacts their co-pay then there are no surprises and no resulting disgruntled patients. The reason for the patient’s visit, or chief complaint, drives the type of service that they are going to be billed for. Be clear and be persistent. Everyone on your front desk staff should handle the check-in / check-out process in exactly the same way.


The healthcare industry is quickly changing.  Without continuous training for your staff, they cannot serve you and your patients to their best ability.  Local medical societies are a great resource for staff training.  Your clearinghouse or billing company should offer training opportunities.  Finally, there is no shortage of free webinars available these days.  If you allow your staff just an hour a month for training, the difference in your bottom line will more than make up for the time you set aside for them to train.

Another free training option is to have your billing staff communicate with your front desk regarding errors and denials that originated from the front desk. Discuss ways to avoid the errors and create processes that the front desk can follow while still maintaining their general flow of work.  Most people want to do the best possible job, but if they aren’t given the proper training and feedback then they will not be successful.

Customer Service

Finally, your patients are no longer just “patients”, they are consumers.  As consumers, they shop around, they compare pricing and they choose providers who provide the best overall experience.  Though extremely important, time spent with the physician is just one part of their visit. Your front desk is a key function of that consumer experience and they can make it an exceptional experience or they can cause the patient to leave feeling frustrated and underappreciated. The front desk is a key factor in patient loyalty and it is up to you to build a strong front desk staff and to take the time to provide the support that they need to be successful. An ounce of prevention…

About the Author:
Michelle Durner, CHBME is the President of Applied Medical Systems, Inc. – a Durham, NC-based company which provides revenue cycle management, coding, practice management, and consulting services to start-up practices, hospitals, private practices, and hospital based physician groups across the nation. Michelle is serving as President of the Healthcare Business Management Association (HBMA) for 2017 and is also fulfilling a 3 year term on the Board of Directors.  Michelle served as Chair of the Education Committee from 2014-2016 and has also served on the Finance, Certification and Nomination committees.   To contact Michelle or to learn more about Applied Medical Systems, visit

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