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    Kenneth T. Hertz
    Kenneth T. Hertz, FACMPE

    Registration. It’s complicated, but it really doesn’t need to be so hard. There, I said it. Truth is, the registration process and flow are points of consternation for physicians, clinical staff, front-office staff and, most importantly, patients. Let’s face it — our registration process frustrates many patients. And often, we do everything we can to make it more difficult.

    “Are you still at the same address?” asks the front-desk staffer. 

    Um, what address might that be?, thinks the patient. 

    “Do you have a copay?” asks the receptionist. 

    Darned if I know, thinks the patient.

    “Administrator, why are my exam rooms empty?” asks the frustrated physician. 

    “Well,” the administrator explains, “you insisted that our patients complete all of their paperwork before we bring them back, and, well, Mrs. Jones, came in late, and Mary, our backup, is out sick ….” 

    “Just fix it and get my patients back there, please!” cries the physician.

    Registration is likely the first contact a patient has with a practice. And it can be difficult to change a first impression. Whether it’s an initial phone call to set up a visit or a potential patient walking into the office, this is where the patient forms an opinion of the practice. It has nothing to do with the clinical side of things, but it’s so very important in giving the patient a good experience.

    What are best practices in patient registration? What can we do to improve the experience — make it more effective, more efficient, more pleasant? 

    Truth is, it starts with the people involved, both staff and patients. 

    As a patient, what do I expect from staff?

    Respect. Treat me with respect. Help me with things that I don’t understand. Don’t get impatient with me. Acknowledge me with your eyes. Look at me, please. Even if you’re on the phone. Let me know that you know that I’m here. Acknowledge me. Make me feel important. We all want to feel important.

    I expect that you’ll know I’m here because I’m ill. I don’t feel well. Maybe, just maybe, I need a little extra attention. And thank you for that.

    I expect that you know things: That you know how to read my patient account. That you know the doctor is running two hours late. Let me know that information. Give me an option to wait or to reschedule. My time is valuable, too.

    It’s OK to ask me for payment. When a practice gave me a reminder call two days ago, the message told me I should be prepared to pay. Know my copay. Know how much I owe and why. And when you ask me for payment, be respectful of my privacy — don’t scream it to the entire reception area. Thank you.

    As an administrator, how can you assist your staff in exceeding the patients’ expectations?

    Provide your staff with training. Lots of it. Train them on the computer system. Teach them how to read patient accounts and insurance cards. Provide educational sessions on customer service — how to greet and acknowledge people. Help them learn how to treat patients respectfully. Learn how to listen to what the patient is saying, not for how to answer.

    I had a visit with my endocrinologist recently. Walked into the practice, was welcomed and saw the doctor in a timely manner. But when I went to checkout, it all fell apart. The receptionist asked if I wanted to pay on my balance. “What is it for?” I asked. She couldn’t tell me. And the billing person was out to lunch. Nope, I didn’t pay on my balance. If you didn’t know what it was for, would you?

    Provide ongoing education and training for your receptionists. And recognize them for a job well done. Set goals for front-desk collections. Set goals for accuracy of data input. Set goals for patient satisfaction. Reward staff members when they exceed those goals.

    Registration staffers — phone and front desk — need to understand the important role they play in the patient’s care and the overall flow of the practice. If this part of the process isn’t working, it sets the tone for every other part. Does your registration staff (and, in fact, every other member of your organization) understand and live the values and vision for the practice every day? If not, start there. Unless staff members feel connected to the mission, they will not do their best work, and the patients will not have their best experience.

    What about technology?

    Leverage technology. It’s a tool so use it as such, and leverage what it can do for the patients and your practice. Maximize the use of the patient portal. Use it for email communication, preregistration, appointment scheduling, bill pay and lab reports, as well as allowing for patient access to electronic medical records, educational materials, policies and procedures.

    Make your technology user friendly. Create an intuitive user interface. Create intuitive search and commands. Explore what nonhealthcare organizations are doing to maximize their technology assets and learn from their efforts.

    Consider a patient kiosk in the reception area. If the patient is simply checking in for a follow-up appointment, delegate that function to the kiosk. Use handheld tablets for checking and verifying demographic information, making changes or registering a new patient.

    If your patients are not facile with technology, ensure volunteers or staff members in the reception area are on hand to assist patients in completing their information. 

    The registration process may be complex, but it doesn’t have to be hard.

    Effective (and simple) registration best practices

    1. Train and educate your staff.
    2. Remember, we’re all human beings — patients and staff alike. Treat everyone with respect.
    3. Exceed the patient’s expectations by ensuring the staff understands what those expectations are.
    4. Engage staff members so they live the values and vision every day.
    5. Supply staff members with all the resources they need.
    6. Leverage technology.
    Kenneth T. Hertz

    Written By

    Kenneth T. Hertz, FACMPE

    Kenneth T. Hertz, FACMPE, has held numerous leadership positions in small and large healthcare organizations in primary care, multispecialty care and large integrated systems. 

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