AAOS Bulletin - February, 2006

First impressions count

What does your front-office staff say about you?

By Kathleen Misovic

When new patients enter your office, the first thing they notice isn’t your up-to-date machinery and equipment, your framed diplomas and licenses, or even your communication skills. They form their first impression of your practice from the way they are treated by your front-office staff.

“The front-office staff is the face of your practice, and you need to show patients an attractive face,” said Steven Fisher, MBA, manager of practice management affairs at the AAOS. “If your front-office staff is rude and/or rushed, that conveys a negative image of your practice.”

“Patients, referring physicians, insurance carriers…everyone comes through the front office, either by phone or in person,” said Jim Gdula, business manager with the Central Texas Spine Institute in Austin, Texas. “The front-office staff really sets the tone for the entire practice.”

Choose an experienced staff

Your front-office staff may consist of receptionists, phone operators, cashiers and/or patient accountants and an office manager. In smaller offices, the office manager may assume one or more of these roles. No matter what their roles are, it’s crucial that all members of your staff provide patients with accurate, noncontradictory information.

“I would be most concerned about front-office staff giving out incorrect or misleading information,” said Gdula, “such as misleading patients about insurance networks or whether the doctor accepts certain plans.”

Attention to detail is crucial for front-office staff because it must be adept at various tasks, from collecting all the necessary patient demographic information to understanding insurance billing. The front-office staff is instrumental in informing patients about their rights, such as the confidentiality of their health information under the Health Insurance Portability and Accountability Act, and their responsibilities, such as when payment is expected. The staff should also be trained to collect insurance-related and other billing information from patients in a way that ensures the claims are not returned to the office unpaid. “They may have to go over the patient information forms with the patient to accomplish this,” Fisher said.

Because good communication is crucial in interacting with patients, consider hiring bilingual front-office staff if your practice serves patients who speak a language other than English, he added. Relying on the patients’ family members to translate is risky because patients may not be comfortable in sharing their medical problems in the presence of their family. Also, family members may not understand medical terminology, which could result in miscommunication.

A little etiquette goes a long way

Next to knowledge, good etiquette is an important skill for front-office staff to possess. Don’t assume this is a trait your office staff automatically has. “Most offices train people on the tasks they need to complete, but not how to treat people,” Fisher said.

Each day your front-office staff should know which patients are expected and how these patients prefer to be addressed, said Fisher, who worked as an office manager for a 30-physician orthopaedic practice in Chicago for seven years, and spent 10 years as a practice management consultant. If any of the patients are new, the staff should ask how they would like to be addressed.

Consider enrolling your front-office workers in classes to learn phone etiquette and have them practice their tone and delivery.

“Many people don’t have a clue about how they come across on the phone,” Fisher said. “I advise people to put a smile on their face when answering the phone. The smile will come out in their voices.”

Also consider enrolling your staff in a class that teaches how to interact professionally with the public. This training will be invaluable in helping your staff deal with difficult people and defuse touchy situations by not acting defensively.

“A lot of the time they will be dealing with anxious patients or stressed insurance personnel,” Gdula said. “They have to learn to take into account the situation on the other side of the reception desk.”

“Many times difficult patients may just be worried about their medical condition and not feeling well,” Fisher said. “And if they’re in an orthopaedist’s office, chances are they’re in pain.”

Multitasking mania

Perhaps the most difficult task for front-office staff to learn is how to serve the needs of the patients, the insurers and the medical staff all at once.

“I think the amount of multitasking is the biggest challenge,” Gdula said. “Front-office staff has to deal with patients who are not only in the office but on the phone. Although the telephone is the lifeline that controls much of the day in the front office, your staff can’t use the phone as an excuse to ignore patients in the office, the doctor that has a question, or the coworker who has a problem.”

Diplomatic multitasking is possible, Fisher says, as long as your front-office staff is trained to do so in a professional way.

“Advise your staff members that if they must answer the phone, they should first excuse themselves to the person waiting at the desk. Have them say, ‘I’m sorry, I’m the only person at the desk right now’ and do so in a friendly tone, not indifferently,” he advised.

Having a front-office staff who can effectively meet the needs of everyone who enters your office will not only be helpful to your patients and their insurers, it will also help you in the long run.

“If patients feel your office staff has been helpful and have gone out of the way to accommodate them, they are more likely to forgive you for any shortcomings,” Gdula said.


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