At a Glance
- Miscommunications between the front desk and back office can lead to issues with revenue, patient care, and staff retention
- Addressing this communication gap requires investigating existing processes from all sides
- To be effective, solutions to communication challenges and frustrations must involve all parts of the team
A lack of communication between the healthcare back office (including coders and billers) and front desk (including receptionists and registrars) can lead to an ever-widening gap in many independent practices. This gap often causes frustration and misunderstandings among the team that can trickle down into patient care.
Why should practice managers take the time to acknowledge and address this gap? Doing so improves practice efficiency, employee morale, and patient satisfaction. Keep reading to learn how to improve communication between the healthcare back office and front text, and create a cohesive team focused on productivity and patient satisfaction.
Investigate existing processes to find the root cause
Staff friction and discontent over billing, insurance, or scheduling provide a warning there’s a communication gap between the healthcare front and back office, but don't indicate why. To get to the bottom of the issue, take the following steps:
- Observe and notate the processes that all functions complete.
- Compare what’s happening in practice and what your documented procedures outline in theory.
- Create a visual process flow for what is happening and a separate flow for what the procedures dictate.
- Ask each function to review the process flow of the steps you observed. Invite them to note any missing or erroneous steps.
- Identify functional and communication gaps between the theoretical and lived processes.
- Bring front desk and back office functions together in a meeting to share the gap information. Discuss the identified issues and ask them to suggest ways to improve the process. Asking those employees impacted by the issue to help solve the problem facilitates teamwork and creates a sense of shared ownership over the solution.
Update your policies and procedures to support collaborative workflows
Use the information the team identified to create checklists and protocols. For example, if insurance claims are often rejected due to inaccurate or insufficient data, ensure front office staff know what information the coders and billers need to submit clean claims. Patients and staff alike appreciate this efficiency. It leads to fewer calls, fewer emails, and shorter claim approval time.
Conversely, create a denial management procedure. Encourage coders and billers to inform front-desk staff which denials are most common and how to avoid them.
Create comprehensive job descriptions that include role-specific responsibilities. These documents are critical because they provide a set clear expectations that are easy to reference and help everyone understand how they support the practice.
Schedule daily briefings
Set aside 5-10 minute daily staff briefings before the practice opens to discuss what is currently known about what the day will hold. Consider discussing the following:
- Number of patients on the schedule: Is this volume more or less than usual? What will help the practice stay on track?
- Type of patients: Will any patients require extra time with the physician because they’re particularly ill? If so, how can staff support the patients and the physician?
- Potential challenges: Does the practice anticipate electronic health record (EHR) downtime due to software updates? Does the schedule include several patient add-ons after hospital discharges? If so, how can everyone work together to keep things running smoothly?
- Other considerations: Is a staff member out sick or on vacation? If so, who is available to help? What duties can other team members cover?
- Opportunities for collaboration: How can staff members work together to make the practice as productive as possible? For example:
- Healthcare back office staff can identify patients with outstanding balances or lapsed insurance coverage. They can also assist nurses and medical assistants by providing information about procedures or services that aren’t covered for Medicare patients. This foreknowledge lets the nurse or medical assistant know they need to ask the patient to sign an advanced beneficiary notice. Additionally, back office staff can flag cases that might trigger MIPS quality measures.
- Front office staff can request payment for any outstanding balances and update insurance information upon check-in. They can also ask patients to complete assessments and questionnaires (e.g., asthma assessments, depression screenings, or osteoarthritis pain and function assessments) while they wait to see the physician.
Conduct monthly or quarterly all-staff meetings
These meetings are prime opportunities for process improvement. Practice managers should invite all staff members, including physicians. These meetings can cover:
- The types of denials the back office staff notice and how the front office staff and practitioners can help mitigate risk
- Information the front-desk staff needs from the back office and practitioners to be more efficient
- Billing challenges, clinical inefficiencies, and other problems
Ensure the larger meeting addresses the needs of everyone participating. Structure the meeting so practitioners are involved in the first portion. Based on the agenda and the practice’s staffing needs, consider scheduling a portion of the designated meeting time to encourage office staff to complete administrative work on which they need to catch up. The front desk and back office teams can use that time to solve problems and develop solutions specific to their functions.
Consider cross-training
Provide front desk employees with basic coding and billing training so they understand why demographic information is important. Likewise, require coders and billers to spend a half day shadowing the front-desk staff so they understand some of the challenges and limitations these staff members face daily.
When staff members can view problems from one another’s perspectives — and understand the unique responsibilities of each role — they are more likely to work together in a unified manner.
Lead practice employees to success
Taking time to ensure those at the front desk and healthcare back office work as a cohesive unit creates a stronger practice.
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