The patient intake process is essential but also one of the most frustrating aspects of the patient visit. It is essential for the practice to obtain the necessary demographic, insurance, and clinical information. It is frustrating for the patient who has to repeat, repeat, and repeat! And as a new patient to be told to come in 15 — 30 minutes early to complete the documentation only to wait another 30 minutes to be seen!
The practice needs to look at the information needed, the tasks required, and the time frame within which to complete each step. For any visit the issues of HIPAA, "meaningful use," verification, authorization, and consent occur for each visit whether new or established.
It is a great time to review your process. Address the following questions for both new and established visits:
• What information is needed for new (packet) and established (updated) patients
• What tasks need to be done in the process?
• Who should do them?
• Why – yes, this is the baseline question
• When do these need to be done?
For the new patient, the patient portal or other secure internet option can be a real time saver! As a patient, I get very frustrated when I have to complete eight forms many of which have the same information in different sequence or format! Review your forms to eliminate duplication and to obtain ONLY necessary information. In addition to completing the forms, the new patient needs to receive the practice financial policy, assignment of benefits form, HIPAA, documents (offer copies at least), and if necessary, consent forms.
For the established patient, what needs to be updated with each visit? This can include what is your house number and what are the last four digits of your phone number. We don't give out complete information and we ask limited specifics from the patient. It is not wise to provide full information with a waiting room full of patients.
There are five basic steps for the front desk at intake time:
1. Greet the patient by name and give your name;
2. Obtain or update all demographic and insurance information. In some cases you may ask to complete a clinical information update related to the reason for the visit, especially for established patients;
3. Obtain the co-payment, deductible, and past due balance if any exists;
4. Update the data in the system;
5. Notify the clinic staff that the patient has arrived and is ready to be seen
A couple of great tools to help you in your analysis are available. The first is a flow chart, ask your team to complete sticky note for each task they do and stick them to a piece of brown paper on the wall. Once all input is received, review for the what, when, and where questions noted above and rearrange. Staff involvement will go a long way in revising the process.
The second tool is to ask why up to five times. Simply ask why do you do something and you will get answers like its my job, why is it your job — I was told to do it, etc. Or ask why do you do it that way. The answer will be we've always done it that way, second why have you always done it that way – that's the way Peggy taught it to Jane who taught me, why did they teach it this way – because that worked with the software, why do you still do it that way since we changed software last year, and finally you get to the bottom which is things could change!
The bottom line is first impression for the patient is key. Make that first visit effective. And make each subsequent visit as painless and friendly as possible.