For each patient, there are about 50 different tasks that need to be performed for patient intake. You are probably aware of the steps subconsciously. Have you ever taken stock of all the steps involved?
Various steps involved in patient intake
Let’s break them down into these sections – before the patient visit, during the patient visit to your office, after the patient visit (before the next visit).
The way most of us do things today goes like this:
Before the visit..
- A patient calls the office, stays on hold for 5+ mins, then our front desk answers the call.
- The frontdesk asks for the patient’s insurance and if we accept the patient’s insurance, the patient asks for an appointment date/time. Sometimes the patient agrees to pay out of pocket as well.
- The frontdesk gives the patient an appointment date/time, then proceeds to take down the name, phone number, insurance details of the patient. The frontdesk tells the patient to bring a valid photo ID and to carry their insurance card with them.
During the patient visit:
- If the patient remembers the appointment, they show up for their appointment.
- The patient is given a printed paper to “sign in”. Then the actual checkin process starts with the patient being handed a stack of papers to fill out in the waiting area.
- The patient starts entering the following details on paper
- Patient demographics data
- Verification of patient’s identity
- Patient’s chief complaint, history of present illness, medical, family, surgical, social histories, allergy list, medication list. The patient typically is not able to provide all the medication names and writes in “layman” terms/language.
- Various HIPAA and consent forms signed by the patient (click here for free patient intake forms)
- Insurance details of the patient (or whether they are a self pay) along with insurance card details
- Physician referral form, if the patient was referred.
- Patient’s payment method and details (for credit card of file program – read our thoughts on patient payments for practice managers)
- Patient reported outcomes
- The patient takes the next 15-20 mins to fill out these details and hands these to the front desk. Some practices enter all these info into the EMR and some just scan these into the patient record or scan and send these to an outsourced medical BPO company to update their EMRs with this information.
- At the front desk, then we ask the patient for their insurance card, proof of identity. If the patient has remembered to bring these with them, we check the patient in. We then take the insurance card details and type all that information into the EMR. Finally, we scan and PDF the card(s) into the patient record (none of the scanned materials is indexable, searchable, reportable).
- Then the front desk starts collecting copays and prior balance dues (if any). The patient usually has a knee jerk reaction about why there is a prior balance and starts asking billing related questions – which the front desk refers to the billing department. The billing department stops what they are currently doing, dig deeper into this particular patient’s financial records, claims history, EOB (explanation of benefits) and ERA (electronic payment advice) from the payer and tells the patient why they have a balance due.
- At this point, the patient typically states that the practice should “send them a bill” and proceeds to pay just the copay (if at all).
- Overall, this has taken a good 30 mins (or more). Then, the patient starts to wait in the waiting room. They are already delayed because the technicians are backed up “working up” the previous patient(s).
- Then, the patient is taken to a waiting area where they wait for the tech to come in. The tech comes in, takes the papers that the patient has filled out, verifies those information and proceeds to enter all the SAME information into the EMR, from the paper entries. In other words, another 15 mins are spent right there.. Again. The tech spends a little more time trying to nail down the correct medication name(s) because the patient doesn’t recall medications with the formulary names, so the tech has to help them identify the correct ones.
- Finally, the technician gets to check the patient vitals, records the same into the EMR, conducts the pre-tests (if any) and then prepares the patient for the doctor to see the patient.
- The doctor sees the patient, records the diagnosis. The patient might need medication, where the doctor asks the patient for their pharmacy name and the patient struggles to tell them the exact pharmacy name or the exact address. The doctor/tech asks a few more questions to finally get to the correct pharmacy and e-prescribe the medication.
- If the patient requires any extra diagnostic tests or procedures, the doctor asks the tech to perform the same. Now, the tech contacts the billing department to ensure that the patient’s insurance covers the procedure or not. The billing department drops what they are doing at the time being and checks for the eligibility of the patient’s procedure/test. They get back to the tech with the answer. The tech then proceeds to perform those tests.
- The doctor enters the recall appointment date/time or asks the patient to go to the front desk to set up the next appointment date/time. The patient waits to talk to the front desk and gets the next appointment date/time. The patient then leaves the practice.
After the patient visit
- The billing department then submits their claim to the payer within the next few days. A few weeks pass by and either the claim is reimbursed in full or there are some denials due to data entry or eligibility errors. The billing department fixes the issues and finally the insurance company pays up. Since balance billing is not allowed, the remaining patient responsibilities usually are co-insurance / deductible related (which should have been noted during the check in process itself).
- In more cases than not, the patient’s credit card is not kept on file. The front desk or the billing department now tries to get in touch with the patient to collect the dues, or pushes this to the next visit of the patient.
- Some practices do make appointment reminder calls, most don’t.
- The cycle continues.. rinse , repeat.
Patient intake is critical for the operational, financial and clinical success of a healthcare organization – be it private practices, hospitals, health systems. Despite the general population being used to digital checkin at airports, healthcare organizations are plagued with manual data entry and patient intake processes.
Whether you use digital patient intake or you do it manually, the patient intake process starts from the very first phone call the patient makes to your offices. Patient intake is a perfect opportunity to improve patient satisfaction and a better the patient experience. Patient intake ties in directly with patient access as well.
Let’s look at how the patient intake process affects the rest of the healthcare organization next.