Bridging the Gap Between the Front Desk and Back Office

A lack of communication between front-office staff (i.e., receptionists and registrars) and back-office staff (i.e., coders and billers) leads to an ever-widening gap in many independent, small practices. It’s a gap that often causes frustration and misunderstanding among employees that can unfortunately trickle down into patient care. 

Why should practice managers take the time to acknowledge and address this gap? To ensure long-term viability and sustainability, says Deborah Grider, CCS-P, CDIP, CPC, CPMA, CPC-H, CPC-P, senior healthcare consultant at Karen Zupko & Associates in Indianapolis, Indiana.

Addressing the chasm among staff members improves a practice’s efficiency, revenue patient satisfaction, and more.

Grider provides these five strategies to help managers bridge this gap and create a cohesive team focused on productivity and revenue generation:

Develop Policies and Procedures That Inherently Support Collaborative Workflows

For example, create checklists and protocols so front office staff collect all of the information that coders and billers need to submit claims, says Grider. Patients and staff alike appreciate this efficiency. Also create a denial management policy that requires coders and billers to inform front-office staff of common denials and how to avoid them, she adds. Job descriptions that include role-specific responsibilities are also critical because they set clear expectations and help everyone understand the role they play in supporting overall practice efficiency. 

Schedule Daily Briefings

Set aside 5-10 minutes to create a "game plan" for the day before the practice opens, says Grider. Consider discussing the following:

  • Number of patients on the schedule: Is this volume more or less than usual, and what’s required to stay on track?
  • Type of patients: Will one or more 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 EHR downtime due to upgrades? 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? 
  • Opportunities for collaboration: How can staff members collaborate to make the practice as productive as possible? For example, back-office staff can identify patients with an outstanding balance or whose healthcare coverage has lapsed. Front office staff can collect the balance and update insurance information upon check-in. Back office staff can assist nurses and medical assistants in providing information about procedures or services that aren’t covered for Medicare patients due to medical necessity or other reasons so the nurse or medical assistant can ask the patient to sign an Advanced Beneficiary Notice. Back office staff can flag cases that might trigger MIPS quality measures so front-office staff can 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.  

“This circle of communication and workflow are key,” says Grider. 

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Conduct Monthly Meetings

What types of denials do back-office staff see, and how can the front-office staff help mitigate risk? What information does the front-office staff need from the back-end to be more efficient? These meetings are prime opportunities for process improvement, says Grider. Practice managers should invite all staff members, including physicians. Grider says some practices choose to close the office for an entire day once a month or once per quarter to address billing challenges, clinical inefficiencies, and other problems. The short-term loss of revenue ultimately pays dividends in terms of reduced denials and employee satisfaction, she adds.

Consider Cross-Training

For example, provide basic coding and billing training to front-office staff so they understand why demographic information is so important, says Grider. Likewise, let coders and billers spend a half day shadowing the front-office staff so they understand some of the challenges and limitations these staff members face daily. When staff members can take one another’s perspectives—and understand the unique responsibilities of each role—they may be more likely to work together in a unified manner. 

Engage Staff in Team-Building Activities

For example, consider bowling, miniature golf, or scavenger hunts. “If you do something that’s really fun, it can bond people together,” says Grider. “And once you’re bonded, you’re more willing to work together as a team.” Happy staff members generally translate to happy patients as well, she adds.

To learn how your team to can work together to become patient collection superstars, check out this webinar:
Patient Collections Boot Camp: Part 1 - Preparing Your Technology, Your Staff, and Your Financial Policy

About the Author

Lisa A. Eramo, BA, MA is a freelance writer specializing in health information management, medical coding, and regulatory topics. She began her healthcare career as a...

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