Thought Leadership Healthquake™: How To Own Your Front Desk

By Michael N. Brown

Summary: The Front Desk at a Medical Practice can add to the bottom line through improved patient satisfaction and by having staff rigorously follow billing protocols. The Healthquake explains how.

For most physician practices, the front desk is the best chance to make a strong first and last impression on a patient every time they come to see the doctor, nurse, or other provider.

It’s an opportunity to provide superior customer service and ensure that the practice collects every dollar earned. This is important because research shows that as many as 65% of patients cut ties with healthcare providers over a single poor customer service experience. And it all starts at the front desk.

There are thousands of blogs, articles, and PowerPoints focused on the front desk including best practices for checking patients in and out, collecting copays and balances, checking insurance and other demographic information, and how to make sure the office sends out clean claims. Despite all this information, mistakes still happen at the front desk, causing some practices to leave as much as 10% of their revenue on the table.

How can a practice increase the likelihood of creating satisfied patients (who will act as an unpaid referral source) while collecting every dollar? In our experience, it all starts with the mindset and management of the team at the front desk along with a step-by-step process for ensuring appropriate scheduling and collection.

Too many front desk “fixes” skip over the importance of mindset, so let’s start with that.


When patients come to the doctor, they are often sick, scared, nervous, anxious, worried, and more. The front desk’s first job is to make them feel comfortable, which will help the patient relax and build more trust.

If you work at the front desk, the best way to do this is to put yourself in the patient’s shoes and try to see the experience from their point of view. Imagine their anxiety and hope. Feel their worries about money, paperwork, and instructions.

Then, behave in a way that’s appropriate to the situation.

  • Smile – to welcome them
  • Make eye contact – to engage them
  • Address them by name – to let them know they are more than a number
  • Adjust your speed and intensity to match the patient’s speed – so they can follow the conversation comfortably
  • Context and qualify – so they understand why you are asking questions. For example, “In order to make sure your account is current and that everything is up to date, we’ll just have to ask you a few questions. Is that OK?”
  • Check for understanding and ask if they have questions – so they feel cared for and listened to. For example, “Are there any other questions you might have, something that you’d like to know about?”

By following these steps, patient retention will stay high and there will be fewer follow up phone calls and emails that cut into the efficiency of the practice.


If you work at the front desk, you have more than one job. They are equally important. The first is to help the patients feel valued so they will return and refer. The second is to ensure that everything possible is done to maximize collections for services provided. It’s a balancing act.

You must be efficient, thorough, and process-driven when collecting funds and information, scheduling appointments, directing people to the right departments, and explaining instructions. Here’s how to make this run smoothly.

  • Behind the Counter. Work as a team to help each other out so that patients aren’t kept waiting – either on the phone or standing on the other side of the glass. If any member of the team is using a phone, wear a headset and microphone to keep the background noise low. When someone calls, don’t say, “The XYZ Clinic, can you hold?” and then put them on hold. Instead, answer with the name of the practice and wait for a response such as “I’d like to check my appointment” before saying, “Thank you. I’ll be able to check on that in about a minute. Could you hold for a moment?” If it’s going to be 5 minutes, let them know, take their number, and call them back. Be empathetic and imagine how you feel when put on hold when you call the doctor.
  • Appointments. Schedule follow-up appointments before they leave. When verifying appointments remind them to bring their insurance card and ID as well as preparing them for the expected copay, past due, etc.
  • HIPPA. Be careful when speaking about patient information to other staff. If someone might overhear you, go to a quiet place away from patients to discuss anything covered by HIPPA.
  • Billing – Critical Information. Check patients’ demographic information every time – including insurance, date of birth, full name, the relationship code if an adult is present with a child, and verify with a driver’s license. Check for notes in the file. Don’t just ask if anything has changed since their last appointment. Don’t rush. Mistakes at this point significantly increase denials and delays. The goal is clean claims.
  • Billing – Payments. Ask the patient for copays when they check in. Collect additional visit charges before they leave. If they owe money, let them pay by text if they want – those under 40 usually prefer this method and will complete the transaction before they leave. If the patient pays by credit card and the office system is cyber secure, ask if you can store their card number and charge balances to make future payments easier.
  • Billing – Past Due or Setting Up Payment Plans. Have a private space where your biller can speak with a patient. Use approved guidelines for educating the patient and collecting past due accounts or charges for missed appointments.
  • Billing – Measurement and Remediation. To increase efficiency, track important metrics such as copay collection rates, past due balances, denials (and their front desk causes), etc. Work as a team to improve, including goal setting and rewards (which can range from cash to dinner at a nice restaurant). If you outsource your billing, work with your billing company to use metrics to improve efficiency and payments.
  • Optimize Downtime. If there are times when any of the front desk staff aren’t busy, they can increase revenue and efficiency by referring to a list of tasks that usually must be done. Just to name a few, these include:
    • Call patients back to answer questions, etc.
    • Schedule checkups, flu shots, etc.
    • Confirm appointments (if they aren’t done automatically)
  • Train, Refresh, Train. To reduce errors and improve customer service, train all front desk staff, follow up and refresh the training, and train again when changes affect the process (i.e., “No Surprises” Consent forms, Payer policy changes, etc.)

By focusing on patient empathy and checklisting processes, patient satisfaction and revenue should both increase.