This document outlines various office procedures that should be in place, including: - Obtaining complete patient registration and insurance information upfront - Verifying insurance benefits prior to the patient's first visit - Ensuring forms are properly completed at check-in and insurance is scanned - Collecting payment for copays, coinsurance, deductibles and prior balances - Scheduling follow-up appointments within the correct global periods - Having policies for handling past due balances, payments plans, and sending to collections - Establishing protocols for phone calls, faxes, refunds and patient credits

1. Office Procedures you
should have in place

2. Front Office Procedures
Patient Financial Clearance
 Patient makes appointment
 Forms/registration (see folder for sample forms)
 Welcome Letter w/ Office Policies (financial, hardship etc)
 Offer forms on website
 Clean professional copies of forms.
 Start an “originals” binder with sheets in protectors to be copied.
 Insurance information obtained.
 Benefits verified prior to 1st visit with payer.
 Go to the Availity seminar at 10:45
 Referrals and authorizations obtained

3. Check -in procedures
 Sign in Sheets are you HIPPA Compliant?
 Forms returned. 100% Completed.
 Insurance card scanned.
 Every visit!
 Know the different Products example Medicare Advantage plans (see
samples)
 Existing patients: Review balances and verify insurance the day before the
visit. Because they have a card does not mean they have insurance.
 Get a copy of drivers license on first visit.
 Get a second form of ID.
 Patient pays co-pays , co-insurance, deductibles, and prior balances.
 Staff needs to be trained to handle objections and hesitation.
 In house policy on physicians role in finances
Front Office Procedures

4. Check Out
 Collect Superbill if you are not using an EMR
 Make any follow up appointments
 Know global period for your practice when scheduling after
a procedure.
 Example: Global period for a 19120, removal of breast
lesion, is 90 days.
 Do not schedule the patient for a follow up on day 89.
Day 91 and you get PAID!!
Front Office Procedures

5. Front Office Procedures
Helpful Tips and Links
 Attend staff education
 Bad address help
 www.anywho.com
 www.zabsearch.com
 www.Snitch.name
 You can always contact us at 513-843-7632
www.CleanClaimMD.com

6. Policies For You Office
 Make sure your office has an Employee Handbook
 Job Descriptions
 How to handle a patient w/ a past due balance
 Do you continue to see?
 Set up a payment plan?
 When to send patients to a collection agency
 What collection agency?
 Who will send over the information?
 What is the physicians role when sending to collections?

7. Policies For Your Office
 Patient Care and Customer Service
 How many times should the phone ring?
 What is your office protocol for answering the phone?
 What is the process for faxing patients information?
 What information should you be asking for over the
phone prior to giving out balances, appointments etc?
 Date of Birth
 Last 4 of SS#
 Address
 Home phone number

8. Policies For You Office
 Refunds?
 What is your office procedure for patient
credits?
 What is your policy for Insurance
Refunds?

9. Questions?
Office Procedures