Digital patient intake guide for practice managers

HIPAA compliant digital patient intake forms help increase your medical practice margins by reducing manual labor and the need for increased staff. One of the (many) ways to reduce your practice overheads is to use digital patient intake forms. Whether you use them on a tablet (like iPad or Android tablets) or whether you use a kiosk (the Phreesia kind), or on your website – digital intake forms help in these ways:

Let’s revisit the patient intake process article and see how we can make it better. We want to be more efficient and to reduce errors that affect the rest of the organization. Our recommendation is to use a digital patient intake software to achieve all these automatically AND more importantly – accurately.

Here’s how the majority of tasks can be moved to the patient side.

Before the visitAppointment SchedulingAllow patients to self schedule appointment requestsAsk frontdesk to confirm
Appointment reminderSend automated appt reminder SMS and voicemails
During the patient visitPatient check inAsk patients to complete at home (before the visit)
Patient demographics dataAsk patients to complete at home (before the visit)
Verification of patient’s identityAsk patients to complete at home (before the visit)
Patient’s chief complaintAsk patients to complete at home (before the visit)
Patient’s history of present illnessAsk patients to complete at home (before the visit)
Patient’s medical historyAsk patients to complete at home (before the visit)
Patient’s family historyAsk patients to complete at home (before the visit)
Patient’s surgical historyAsk patients to complete at home (before the visit)
Patient’s social historyAsk patients to complete at home (before the visit)
Patient’s allergy listAsk patients to complete at home (before the visit)
Patient’s medication listAsk patients to complete at home (before the visit)
Various HIPAA and consent forms signed by the patientAsk patients to complete at home (before the visit)
Insurance details of the patientInsurance card detailsAsk patients to complete at home (before the visit)
Patient insurance eligibility checks- coinsurance, deductible detailsCheck electronically (before the visit), provide estimated cost of care- include coinsurance and deductibles in calculation(s)
Physician referral informationAsk patients to complete at home (before the visit)
Patient’s care team infoAsk patients to complete at home (before the visit)
Patient’s CCD record from care team physiciansSend automated CCD request faxes to care team before patient visit
Patient’s payment details- Credit card on file programAsk patients to complete at home (before the visit)
Patient reported outcomesAsk patients to complete at home (before the visit)
Patient pharmacy of choiceAsk patients to complete at home (before the visit)
Patient recall appt date/timeAsk patient to choose the same way as this appt
Patient copay / balance duesAsk patient to pay at home or before seeing doctor using credit card on file
After the visitPatient satisfaction surveysSend automated SMS / email
Patient recallsSend automated SMS / email
Patient balance duesSend automated SMS / email. Ask patient to pay using credit card on file
Patient education materialsSend automated SMS / email
Patient statementSend automated SMS / email
Re-appointment of no-show patientsSend automated SMS / email
Re-appointment of cancelled patientsSend automated SMS / email
Stay in touch messages / greetingsSend automated SMS / email

How to leverage digital patient intake

We recommend that you combine all patient intake channels. Take a moment and list all the ways you get patients (and patient appointments). Think through the patient intake process – what you need

  • Minimum patient information you need to be able to create a patient in the EMR
  • Minimum information you need to be able to create an appointment in the EMR

Everything else can be gathered later on – before the patient comes in (pre-visit) and when the patient is at the practice (during visit)

Minimum patient info needed (might vary by EMR)

  • Patient first name
  • Patient address
  • Patient email address or patient opt-out consent
  • Patient preferred language
  • Patient date of birth
  • Patient Gender, race, ethnicity

Minimum patient insurance info needed (might vary by EMR)

  • Relationship to patient
  • Payer Name
  • Policy Type
  • Member ID / member number
  • Insurance effective from

Minimum appointment scheduling info needed (might vary by EMR)

  • Appointment date
  • Appointment time
  • Appointment location
  • Appointment visit type / nature of visit
  • Appointment provider

Minimum information needed before attending the patient

  • Notice of Privacy Practices consent
  • Insurance billing (assignment) consent
  • Consent for digital (E-mail, SMS, app) communication
  • Consent for use of electronic prescription orders
  • Current medications
  • Chief complaint
  • History of present illness
  • Past medical conditions
  • Past surgeries
  • Social history
  • Immunizations
  • Allergies
  • Vitals

Here’s how you should break down the patient intake workflow

How to handle patient intake for new patients

Here’s our suggested way of collecting all patient information while still providing patients with an optimized experience. In the best case scenario as described below, the patient barely has to input any information (other than clinical) and the worst case scenario, they do have to type in all their information (which they would have to provide over a call anyway)

Get patient contact information

Ask for the patient’s first name, phone number as the first step. If the patient abandons the patient intake form, at least your front desk or call center agents can call the patient back. Now that you at least have data to call the patient back, proceed with insurance step

Get patient insurance information

  • Keep in mind that eligibility verification is for a specific provider at a specific location.
  • Ask for patient’s preferred appointment location, preferred appointment visit type / nature of visit, preferred appointment provider.
  • Now you have the provider ID (NPI number) and the other basic info you need.
  • Next step is to get some information on the patient’s insurance. This will vary because some insurances support eligibility requests using specific service type codes. Meanwhile, some providers will give you general health benefit coverage when a member has a specific group number that you can provide. Others will give you eligibility request’s responses if you provide a CPT code. Meanwhile, you can also check for Medicare eligibility by including the HCPCS code
  • Try to find a way to help the patient let you know what their chief complaint is or the reason for the visit is. Remember that you can run eligibility checks based on a combination of information that the patient might have in their hands.
  • If the patient’s insurance does not clear, let the patient know their options – self pay or to rebook after resolving their insurance eligibility issue.

Get patient appointment preferences

  • Ask the patient for their preferred appointment date, preferred appointment time. Patients greatly appreciate this kind of self service and the ability to know up front whether they can book an appointment or not.
  • If the patient’s insurance is valid (i.e. the patient’s eligibility verification goes through), show all available appointment options to the patient and allow them to book their appointment.
  • Each EMR has APIs that allow you to pull appointment slots, appointment availability, appointment types, appointment blockouts, providers, resources etc. Make sure that your patient intake software ties into these APIs and presents the right information (e.g. check – you will have all the required information that you need)
  • Once the patient picks an appointment time/slot, stop at this point and thank the patient for the information. Advise them to expect an SMS / email with confirmation information.

Begin SMS conversation with patient

  • Send the patient an SMS and/or email confirming their appointment details.
  • In this communication, send a link to the patient where they have access to their upcoming appointment at all times.
  • Make sure that this information is protected with verification of DOB. If the patient enters the correct DOB, they can open the appointment confirmation link.
  • Note there that your EMR might already send a patient confirmation SMS automatically.
  • You might want to consider stopping the EMR from sending SMS as your patient intake software would also be sending an SMS with the confirmation and next steps SMS messages. This confuses patients since they get SMS from multiple phone numbers about the same appointment.
  • Make sure that your front desk / call center gets a notification that a new appointment has been requested. This notification could be a desktop alert or it could also be an email or SMS (only limited patient information can be sent via SMS)
  • Your front desk or call center person(s) should verify that the appointment has all the needed information and that you have necessary information in the patient record.

Continue with pre-visit patient registration

  • This is where you need to initiate your intake workflows. Our recommendation is to not ask the patient for every single thing up front. Allow them the ability to “save their work and finish later”.
  • This “save and finish later” ability also allows you to “stay in touch” with patients by reminding them to finish their intake / registration. Whether patients do this or not, that’s not a guarantee – however, what’s guaranteed is that the patient will be reminded of their appointment and will have lesser likelihood of being a no-show (that we all dread, but have gotten used to).
  • Based on the number of days left for their appointment, send them an SMS to finish their patient registration. This should gather clinical information as mentioned above.
  • Gathering these patient clinicals will drastically reduce the amount of time that the techs have to spend on documenting patient clinical information.
  • On top of this, your intake software should ask patients items from your patient health questionnaire. This further contributes to reducing patient wait times and techs + doctors have a more complete picture of the patient’s current medical condition before the patient even steps into the practice.
  • The best part? The patient is usually more committed to showing up for their appointment (reducing no-shows)
  • Send the patients their consent forms as well. Nowadays, most phones are smartphones/touchscreen phones and patients have no issues signing consent forms using a finger drawn signature or to even use their “full name” to e-sign a document (as you might have seen in most digital signature documents that you receive from various other companies.
  • Identity proof? Easy – simply ask the patient to use their phone and take a picture of their driver’s license or other forms of ID proof. These days, OCR software has progressed so much that these software can easily read pictures and present the necessary ID information to the patient to verify. Once patient has verified this information, you can save it in your EMR

Gather and keep patient card on file

  • We have heard many excuses that patients do not always have credit cards, do not want to provide credit cards over the phone etc.
  • Collect the patient credit card information as they check in or before they come to your practice.
  • It is very easy to add a credit card on file – your patients are storing credit cards on amazon, google, various e-commerce websites; they can certainly do the same with your digital intake software as well.
  • We have discovered that when our patient balance collections team calls patients, they actually end up paying using a credit or a debit card – some even pay via ACH payments.
  • Make sure that after the patient registration is done, you ask the patient to leave a credit card on file and ensure that the patient understands that the remainder patient balance is their responsibility PLUS the fact that you will automatically charge their card for the remaining balance post visit.

Pre-visit – send appointment reminders

  • Your intake software should remind patients of their appointments – via email, SMS or phone calls.
  • We recommend connecting with the patient via all modes.
  • You can choose to send an email 5 days before the appointment and ask them to confirm their appointment.
  • You can choose to send an SMS 3 days before the patient’s appointment and ask them to confirm their appointment.
  • You can choose to have an automated phone call made to the patient 1 day before the appointment and ask them to confirm their appointment.
  • At all these points, make it easy for the patient to reschedule their appointment (or cancel it altogether if they choose to do so).
  • If the patient chooses to reschedule their appointment, your intake software can take the same steps as before and ensure that it gets the patient an appointment slot in your EMR
  • If the patient chooses to cancel their appointment, your intake software should mark the patient as “cancelled” and put a reminder in your patient CRM to touch base with (human or automated) at a later time

During visit – Ask patients to verify their information

  • As soon as the patient comes in for their visit and wants to check in, ask them to verify their information.
  • To do so, you can use various modalities – a tablet, a kiosk or the cheapest option.. tell the patient that you are going to send an SMS to their mobile of choice for them to verify their information.
  • This is the time where you should collect their co-pays and also try to add their card on file again. It does work well.
  • You will notice that patients would not always be able to afford their payments and would ask for a payment plan.
  • There are several payment plan options available – patient financing options like Carecredit / prosperhealthcare etc, recurring payments on their credit cards. Make sure that you let the patient know that.
  • Whatever you do, do not go into a passive payment collection mode. Research has shown that you have 70% less chances of collecting payment from patients once they walk out the door. 
  • We have noticed that if you tell the patient that they have a balance due later on, they either cancel their appointment or ask your front desk to “bill them later” (which the front desk gladly agrees to). Do not let this happen to you and your practice.

Make it easy for patients to pay easily

  1. Your patients pay for various services online every day. We guarantee you that they will pay you as well (no matter if you think otherwise).
  2. Allow patients to pre-pay for their co-pay.
  3. Allow patients pay their co-pay while they are present at your practice for their appointment. In any case, you will have to ask patients to verify their informat

How to handle patient intake for inbound calls from patients

  1. Try to make sure that your intake process remains the same as much as possible
  2. When a patient calls in for an appointment, have your front desk or call center agents use the same intake screens / web pages.
  3. Get it to a point where the appointment is created in your EMR and thereafter, let the SMS conversation begin.

How to handle patient intake for inbound calls from referring providers

  1. Again, follow the same steps. However, note that the referring provider office will not always have the patient appointment preferences. You’ll have to give them the best available slots
  2. Make sure that you do capture the referring provider name, practice information, practice fax and contact info (as much as possible) so that you can send them patient appointment updates and also the visit notes after the appointment
  3. When you are processing a referral from a provider, the patient has probably already left the referring provider office. It’s best to modify the first patient SMS to help the patient understand that this appointment was created for them because of the patient’s provider visit and referral. Thereafter, you can continue the conversation with the patient directly.

How to handle patient intake for appointments from zocdoc

  1. First, you need to decide if you’re allowing direct connection between zocdoc and your EMR. If you allow this connection, then Zocdoc’s software creates a patient and the appointment in your EMR directly.
  2. However, you need to check whether zocdoc creates the patient records with all the necessary patient information or not. In our experience, we’ve found that zocdoc doesn’t have all the relevant patient information hence your digital patient intake software needs to finish the job that zocdoc started.
  3. These are going to special cases and your software should be able to send an SMS or email to the patient to continue pre-registration of the patient.
  4. If you haven’t allowed a direct connection between zocdoc and your EMR, then your front desk staff or your call center agent will be notified of the appointment. They will have to call the patient, finalize the patient and appointment details, then start the SMS conversation as above.

How to handle patient intake for Facebook / Google “Book now” appointments

  1. One good thing about these two platforms is that they allow you to send an automated response to the patient.
  2. In this automated response, you can have the patient start they intake process as if they’re cashing in or going to your website to request an appointment 

How to handle patient intake for existing patients

  1. Same channels as above, HOWEVER, the good thing is that you already have all the patient data.
  2. The challenge here is to ensure that all the patient data that is in your EMR is current and up to date
  3. In many cases, the patient’s demographic information and/or the insurance information would’ve changed. You need to verify that.
  4. We’ve found that the best way to handle this situation is to allow the patient to choose whether they’ve been at your practice or not
  5. If they state that they’re an existing patient, then they need to be verified with as many pieces of information as your EMR has. Eg phone number, date of birth, name match, ssn.
  6. Once the patient identifies themselves, you can proceed with the same steps as above. The big difference is that the existing patient will have the ease of verifying their information or correcting their information as needed.

Patient intake kiosks vs website vs tablet vs patient’s mobiles

The functionality remains the same in each modality. Patients can use their mobiles to fill out the requisite information from home / work. Meanwhile, tablets, kiosks can only be used at your practice.

Our recommendation is to lean more towards patients’ mobile phones as there are a few benefits:

  1. You can only purchase limited tablets for your practice (plus they use up storage space)
  2. You can only purchase limited kiosks for your practice (plus they use up floor space).
  3. Neither of these really give patients the privacy that some of the patients prefer (and deserve). Note that even today, immune system related diseases are associated with social stigma.

Kiosks – they are ubiquitous. You use them to check-in for flights at airports, to pay for your groceries, to pay a parking fee at a garage or parking lot, and some states even have them at DMVs or Secretary of State’s offices.

These are the easiest to use (form factor) but offer the least privacy and also use up too much floor space.

Tablets – Most of the patient intake platforms can run on a tablet (iOS, Android – whichever you choose). These are easier to use than mobile devices, offer a little bit more privacy than the kiosks, but some practices have complained that “devices seem to walk away from practice locations”.

Mobile devices – hardest to use because of form factor (smaller screen). However, in this case, you are leveraging the patient’s devices and at the same time giving them maximum privacy. Do keep in mind that if your intake software designs the intake workflow and screens in a way that it is easy to read for even older folks, this truly is a hit. 

Our recommendation is that you should use a combination of both. Mobile and for the patients that do not have a mobile number shared with your practice – use the tablets.

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