Chatty Front Desk Has Frightening Consequences

A physical therapy practice in North Carolina failed to address issues at the front desk, leading to a slew of costly issues. Mary would routinely spend too much time engaging in small talk with patients as they came in and out of the clinic. Mary would get so wrapped up in the conversation that she would frequently forget to collect co-pays when checking-in or schedule follow-up appointments upon check-out. The few minutes of small talk would add up over the course of the day and before Mary knew it, she did not have time for her daily tasks.

Right off the bat, I have to say this is a subject that I get very passionate about.  When I do assessments, I always address the cancellation/no show issue.   I tracked my last 50 client’s responses as to whether they charge for cancels and/or no shows and went from there.  Here is what I found:

Therapists put in years to fulfill the educational courses to become a therapist.  It is an awesome field to be in.  Just one thing about the education, the curriculum does not typically include classes on important administrative issues that are vital to a therapists starting their professional career.  Once they take and pass the exam to become a licensed therapist the search for employment begins. 

During our Administrative Power Center (APC) training sessions with rehab private practice owners and their front desk staff I always ask, “How do you answer the phone?”

Surprisingly, I have never had an entire staff, in one or multiple sites, all say the same thing. ‘Hello, thank you for calling APC Physical Therapy how can I help you?’ ; or ‘APC can I help you?’ ; how about – ‘APC Physical Therapy hold please.’; or ‘Hi, APC Physical Therapy, we are happy you called, this is Diane, how can I help you today?’; or how about, ‘APC Physical Therapy, if you want to schedule an appointment press 1, if you want to speak to a therapist press 2, if you want to discuss your bill press 3…’

Short, long, name, no name or a recording – what do you want every caller to hear every time they call your office? 

I have assessed hundreds of Physical Therapy private practices in my career and I could tell you hundreds of different stories but instead, I am going to tell you about some of the most common stories I hear in just about every practice I have been in. 

The process of taking a new patient, providing services and getting paid sounds so simple.  I mean, why shouldn’t it be?  Why is such a simple concept so complex? It all comes down to understanding the rules and regulations of each insurance carrier, knowing how to comply and implementing operational systems that will support your ultimate goal - getting paid from insurance and patients.   

The front desk is a biller’s biggest asset when it comes to getting paid for all the hard work you put in with your patients. Understanding this relationship and how these two roles work with one another is crucial for a successful practice.  

There are many things a front desk must do before the patient’s information gets to the biller. This includes providing benefit checks, entering patient demographics and managing referrals and authorizations. If any of these essential functions are not done accurately and timely, major problems will arise when it comes time for the biller to submit claims and get paid right the first time.

Benefit Checks

The front desk must check each patient’s insurance benefits before their first visit.  We also HIGHLY recommend that your front desk encourage the patient to check their benefits as well.  This helps to avoid getting conflicting information. If there is an issue, it can be addressed immediately.

There are many easy ways to get this job done fast and correctly.  In most cases you can go through the insurance portal or clearing house but there will be times when you just have to pick up the phone and call.

We have seen many denials that could have been avoided if a benefit check had been done.  For example, some of these denials might include patient’s insurance was terminated, the therapist is not in network with patients carrier and the patient has no out of network benefits.   If treatment begins before these issues are addressed, there is a good chance that the biller will not be able to send a successful claim and get payment for that visit. 

As a consultant I am called in to practices to evaluate the billing function and to answer questions like why are we getting so many denials, why aren’t our payments consistent, how do we know we are charging correctly, are we in compliance and most of all where is my money?  And this is on the heels of investing in and implementing a new billing system. 

We have all read articles on choosing the right system and they all promise that you will get better payments, stay in compliance, and your ability to charge and document will be enhanced, but the truth is, in order to get paid and get paid right the first time you need a competent, well trained staff and processes in place to support your goal – payment for services rendered.