Check-in and Front Desk

The front desk is the patient’s first point of face-to-face contact with the practice and sets the tone for the visit. Every patient must be acknowledged and greeted upon arrival at the front desk. The patient service coordinator (PSC) should have the proper training, time and space to greet patients, share and receive information confidentially, and be comfortable and proactive in setting expectations and offering help when delays, scheduling issues, or unscheduled walk-in requests occur.

Check-in prompts regulatory and financial workflows and can impact compliance and revenue.

The PSC should have training and working knowledge in workflow and systems for check-in (and checkout). Ambulatory Administrator Onboarding orients new hires, including front desk staff, managers and other staff who require cross-training, to the front desk role, including:

• Practice workflow
• Insurance plans and products
• Payer authorization and referral requirements
• Compliance standards
• Phone etiquette
• Customer service
• Systems training, including Epic

At Check-In

• Ensure the required signage, brochures, and items (e.g., masks, tissues, waste basket, hand sanitizer) are posted and/or available.

• Acknowledge and greet every patient upon arrival at the front desk.

• Use the Epic check-in button to go through each check-in step and run all checks in Cadence.
  • First, identify the patient correctly via the two patient identifiers consistently used in the practice.
  • Ask for a photo ID in accordance with hospital policy (or, alternatively, two forms of non-photo ID, one of which should be government-issued).
    • You may not refuse care due to a lack of ID.
    • Remind a patient who has no ID to bring appropriate ID to all future visits.
    • If a patient has no ID, you must still verify that patient’s identity by asking for at least one of the following identifiers not provided in the identification step above: date of birth, date of last visit, Social Security number (if in the record), or mother’s maiden name (if in the record).
    • See the procedure for face-to-face check-in for a printable sheet with more details.
  • Verify the patient’s:
    • Demographics
    • Insurance coverage
    • Infection control precautions
    • Primary care professional (PCP)
    • Special needs flag
    • Medicare Secondary Payer Questionnaire (MSPQ) is completed, if applicable
    • Pre-appointment labs, questionnaires, and blood work.

• Provide the patient with all applicable forms from the list below and review each form with the patient before the patient signs them:
  • Assignment of Benefits
  • Referral or Prior Authorization
  • Primary Care Waiver
  • Inactive Insurance or Non-contracted, Self-pay
  • HIPAA Notice of Privacy
  • Mass HIway Consent (new English, Spanish, and Portuguese versions live in Epic on 8/22/21; ensure patients can view a printed copy before signing)
  • Health Care Proxy

• Offer to enroll the patient in Patient Gateway if the patient has not already enrolled or declined enrollment.

• Check appointment notes.

• Inform the patient of wait time, if applicable.

• Ask the patient to use the express phone to verify guarantor or make registration changes, if applicable.

• Collect co-payment.

At Checkout

• Complete wrap-up and follow-up sections in Epic.

• Complete Cadence checkout function.

• Print the After-Visit Summary.

• Schedule follow-up appointment(s), if applicable.

At End of Day

• Use the DAR to perform end-of-day reconciliation. Review appointments remaining in the “scheduled” status and assign a status (e.g., No Show). Each practice should have a process in place to follow up with patients who did not show, identify barriers to attend scheduled appointments, and reschedule patients as needed.