It’s been another long day. The last patient is still waiting to be seen and tired staff is ready to go home. Everyone knows they need to clock-out on time, so they are doing what they can to get the office ready to close. Why do days seem to get longer, but revenue is down?
There’s a good chance your patient scheduling needs a second look. Long days with extended wait times, labor overruns, and uneven revenue can be symptoms of schedule mismanagement. Thankfully, employing a few simple strategies to optimize time management and revenue can help put your practice back on the right track.
Establish set times in your schedule for new patient visits, sick visits, follow-up exams, emergency visits, and so on, and stick to your template. For example, some practices choose to schedule new patients for a 30-minute exam on the hour in the mornings. The remaining 10- or 15-minute timeslots are filled with sick visits and follow-up exams, with one or two same-day emergency visits available right before lunch.
The afternoon’s template might switch out the new patient exams for yearly visits with lab work, but otherwise generally follows the morning template. Varying visit types account for time differences, and creating same-day emergency or sick appointments allow some leeway to help the office get back on track if they are running behind.
Many patients dread the new patient visit because of the sheer volume of tedious form-filling involved, which contributes to time in the waiting room and causes frustration for patients. A study published by the US National Library of Medicine and National Institutes of Health found that new patients wait on average 41 minutes to see their healthcare provider. A way to circumvent the in-office wait time, as well as obtain more accurate and complete patient information, is to forward registration packets or electronic forms to patients to complete at home.
Completed packets accelerate patient processing and are more likely to be checked for omissions by front desk staff. For many practices, inaccurate patient demographics is a significant source of claim rejections and denials. Increasing demographic accuracy with preregistration packets can drastically reduce labor to correct claims and keep cash flowing.
An often-overlooked reason for working more and getting paid less is a change in your payer mix. It may be that you are seeing more patients from payers with lower reimbursement than you did a year or two ago. Depending on your wait times for new patient appointments, you may want to consider assigning a certain number of slots for different payer categories.
For example, workers’ comp insurance historically not only takes longer to pay but pays less. Limiting the amount of new workers’ comp patient appointment slots will make sure that patients with higher-paying commercial insurance aren’t waiting so long for a new patient appointment that they decide to go elsewhere.
It’s essential to continually remind staff how important it is to keep waiting times low and move patients. If a patient has a 9 AM appointment, ideally, that patient should be in an exam room no later than 9:05 AM. That may require asking all patients to arrive 15 minutes early for their appointment so they can be processed and roomed on time. It also means that patients should not be seen on a first-come, first-served basis. If patients arrive an hour before their scheduled time, think twice before moving them into an exam room.
Patients that come on time should not be delayed simply because someone with an appointment after theirs arrived before them. Patients who arrive early are aware they are early. Slot them into an earlier time slot if possible and make that change on the schedule to avoid backing-up the rest of your morning or afternoon.
It’s not easy to do, but sometimes it is necessary to tell a patient they need to reschedule because their appointment window has passed. If you adopt this policy, or start charging for no-shows, it is critical to tell patients about the policy when they make their appointment. Many practices include late and no-show rules and consequences in new patient packets to make sure everyone is on the same page.
Explain to patients that you are a busy practice and the empty appointment slot could have gone to a patient that needed it – many can appreciate that line of reasoning, and they will be more careful about appointments in the future.
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