How to Improve the Patient Registration Process to Increase Efficiency and Reduce Revenue Loss

by | Mar 15, 2023 | Ambulatory Practices, Patient Registration, RCM Processes

The patient registration process is any healthcare practice’s first impression. Getting it right has ripple effects on operations, patient experience, and revenue cycle. This brief exchange sets the tone for the entire care encounter and billing process to follow. Therefore, it is worthwhile to evaluate opportunities to optimize your patient registration procedures to improve patient loyalty, staff burnout, and time-to-collect patient payments. Below are the best practices we suggest implementing to improve patient registration operations.  

Value Front-Desk Staff  

Front desk employees have a major impact on your practice’s bottom line. Staff members who feel recognized and rewarded are more likely to be effective, efficient, and to stick around. Unfortunately, at many practices, front desk staff members have the most demanding, lowest compensated roles. This leads to staff dissatisfaction, burnout, and turnover. In fact, a Medical Group Management Association (MGMA) poll found that the turnover rate for front office staff is 20%, significantly higher than any other aspect of a typical physician practice’s staff.  

Depending on the size of a practice, the front desk team is often a bit rushed, juggling a line of people to check-in, keeping track of provider availability on the backend, answering phones, and ensuring they have up-to-date patient information.  

The more you can eliminate the rushed, overwhelmed feeling that leads to burnout, the more positive patient interactions will be and the less mistakes your front desk will make—that translates to higher patient satisfaction and more revenue collected on the back end.  

When evaluating your patient registration process, start by checking in with your front office team to discuss what is working and what could be improved. They are aware of the patient registration process bottle necks.  

Empower your Registration Desk with Processes 

In addition to seeking process feedback from your front office staff, running a tight patient-registration ship is a proven way to reduce front desk staff burnout. Beyond reducing burnout and turnover, it also impacts your revenue cycle.  

We suggest creating clear scripts and standard operating procedures to empower your team to work efficiently and maximize the likelihood of clean claims (that means more revenue, sooner). Below are a couple key scripts/processes to employ: 

Scheduling Process

Make sure your patient scheduling process streamlines the patient check-in process. Collect as much information about a patient as possible during the scheduling process. For example, prompt patients to confirm their appointment time and location, address, and their insurance information before they even set foot in the clinic. This reduces patient wait times and improves chart accuracy. (Pro tip: Put a special process in place around January 1 [when most insurance plans change] to collect new insurance information during the patient scheduling process).  

Check-In Script

When a patient arrives at check-in, the front-desk staff should be equipped with a streamlined list of questions to run through that maximizes the likelihood that data collected is complete and correct. It is important to remember that not all questions are created equal, which is why a set script is so impactful. The way questions are phrased matters. For example, asking a patient if they have new insurance places pressure on patients to recall when their last visit was and whether their insurance has changed since then. Instead, it is more effective to directly ask, “Is your insurance still X?” or “Is your address still X.” This takes the pressure off patients to remember what has changed since their last visit and instead puts your front office staff in a position to confirm current data.  

Flag Common Registration-Related Denials

Your check-in script should cover all topics that lead to common registration-related denials. According to the Healthcare Financial Management Association (HFMA), up to 90% of denials are avoidable. A substantial portion of those denials occur at the beginning of the revenue cycle (such as making errors and omissions during registration such as entering the wrong address, occupation, insurance status, or coverage details). We suggest educating your front office staff on the most common cause of denials and equipping them with process to help avoid them.  

The most common registration related denials include:  

  • Expenses incurred after coverage terminated 
  • Expenses incurred during a lapse in coverage 
  • Claim denied as patient cannot be identified as our insured 
  • Claim/service not covered by this payer 
  • Secondary payment cannot be considered without the identity of the primary payer 

Source: AAPC 

Educate your staff on the budgetary impact of denied claims

The fiscal effects of denied claims include delayed revenue, lost revenue, and increased cost to collect. Most practices won’t know if a claim was denied until 2 weeks to a month after the claim was submitted. If there is an issue with the claim, the front desk must spend additional time calling the patient and updating demographic and insurance information. The cost of this additional time spent adds up (and at some busy practices, simply doesn’t happen—over 60% of denied claims are never resubmitted).  

The average cost to file a claim is around $6.00. If a claim needs to be resubmitted or reworked, that costs $25 per claim, on average, for physician practices and $181 per claim for hospitals. For many smaller practices, and even some larger ones, pursuing denied claims becomes too costly to be worthwhile. For example, if it costs $25 every time a claim is touched, for a regular family practice physician billing $100 for an office visit, it doesn’t take very many touches to make appealing or reworking a denied claim worthwhile. That highlights how important it is for the first claim to go out clean with complete and accurate patient registration information, provider documentation, and coding. When you consider the cost of cleaning up incorrect claims downstream, the value of investing in front desk staff and processes upstream is well worth it.  

Collect Patient Payments

Giving your front desk team tools to collect patient payments can have an enormous impact on your bottom line as studies from Medical Economics find that collection rates for insured patients can be as low as 50-70% after a patient walks out of the door of your practice. We suggest setting up alerts to show a patient’s outstanding balance (a standard feature in most practice management software) to ask patients whether they would like to take care of their co-pay at time of service. It is best to coach your staff to ask specific questions such as, “I see you have a balance of $100 today, would you like to pay with cash or with credit card?” rather than asking an open-ended question like “Are you able to pay today?” Take time to put a patient payment collection process in place, considering requirements of the No Surprises Act. A few essentials we suggest including in the process are:  

  • Verify insurance 
  • Estimate patient responsibility  
  • Collect as much of that as possible before or just after medical services are provided  
  • Establish effective program to collect amounts patients cannot pay after service 

Dialing in this front-end process (and following up with patient-friendly digital patient payment tools after the visit) can help reduce patient collection delays.  


The Bottom Line: Valued Front-Office Staff with Effective Patient Registration Processes Drive Revenue Improvement  

Employ the above patient registration best practices at your organization to improve patient and staff satisfaction and downstream revenue. Empowering your staff with precise processes means your revenue will come in quicker, you will spend less resources following up on denied claims and unpaid bills, and you are much closer to collecting the most possible with the least number of touches and expenses. Overall, it is much simpler (and less costly) to streamline and standardize your patient registration process on the front end rather than spending resources addressing complex denied claims after the fact.  


About the Author

Theresa Shurley, Senior RCM Consultant

Theresa Shurley has more than 16 years of experience in healthcare revenue cycle management. Today, she serves as a Senior RCM Consultant at Resolv connecting healthcare organizations with effective RCM solutions. Prior to her current role, Theresa has worked in various operational leadership roles supporting Resolv clients. Theresa brings a unique perspective to her work because she has stood in our customer’s shoes working on the front lines as a front office manager and in several roles supporting front office staff and healthcare finance leaders.