Download - Best Practices the Front Office
• Click to edit Master text styles• Second level• Third level• Fourth level• Fifth level
Best Practices:The Front Office
Removing the Roadblocks to Efficiency
Kathie Huttegger, MBA,, CMPEAdministrator
St. Louis Pediatric Associates, Inc.
• Click to edit Master text styles• Second level• Third level• Fourth level• Fifth level
Best Practices:The Front Office
• Define Reality
• Identify the bottlenecks
• Increase efficiency
• Click to edit Master text styles• Second level• Third level• Fourth level• Fifth level
The Right Questions– What is a “best practice?”
– What are the functions of the “front office?”
– Definitions of some key principles
• Click to edit Master text styles• Second level• Third level• Fourth level• Fifth level
Defining Reality
• Max DuPree – Leadership Is An Art
• “The first responsibility of a leader is to define reality. . .”
• Click to edit Master text styles• Second level• Third level• Fourth level• Fifth level
Wrong Jungle
• Click to edit Master text styles• Second level• Third level• Fourth level• Fifth level
Defining Reality - Differences• Primary Care versus Specialist• Single Specialty versus Multi-specialty• Number of sites• Ancillary service offerings• Use of midlevels• Cost or accrual based accounting• Physician compensation• Payor mix• Many other variables (triage, billing, etc.)
• Click to edit Master text styles• Second level• Third level• Fourth level• Fifth level
Defining Reality - Similarities• Provide medical services• Face increasing costs• Struggle with reduction in payment• Patients• Staff• Physicians
• Click to edit Master text styles• Second level• Third level• Fourth level• Fifth level
MGMA Best PerformersIn Three Critical Areas
• Profitability and operating costs
• Productivity, capacity and staffing
• Accounts receivables and collections
See “Key Indicators” Handout – Expanded Quantifiers of Better Performing Practices
• Click to edit Master text styles• Second level• Third level• Fourth level• Fifth level
What are the functions of the front office?
• Click to edit Master text styles• Second level• Third level• Fourth level• Fifth level
Front Office Multi-Functional
• Click to edit Master text styles• Second level• Third level• Fourth level• Fifth level
Director of First Impressions
• Click to edit Master text styles• Second level• Third level• Fourth level• Fifth level
Can Help or Impede Patient Flow
• Click to edit Master text styles• Second level• Third level• Fourth level• Fifth level
Touches Revenue Cycle at Multiple Intervals
• Click to edit Master text styles• Second level• Third level• Fourth level• Fifth level
Removing Roadblocks to Efficiency
• Throughput = Money coming in (profit)
• Operating Expense = money going out to make throughput
• Inventory = Money stuck inside
• Click to edit Master text styles• Second level• Third level• Fourth level• Fifth level
Bottleneck• A resource whose capacity is equal
to or less than the demand placed upon it.
• The flow through the bottleneck must equal the demand from the market.
• Capacity of a process is the capacity of its slowest resource
• Click to edit Master text styles• Second level• Third level• Fourth level• Fifth level
Bottlenecks or Roadblocks• Crowded reception area
• Irritable patients
• Financial underperformance
• Burnt out staff
• Click to edit Master text styles• Second level• Third level• Fourth level• Fifth level
Causes of Bottlenecks• Too much paperwork• Poorly planned processes• Inefficient office design• Miscommunication between staff• Poor scheduling
• Click to edit Master text styles• Second level• Third level• Fourth level• Fifth level
Productivity• Accomplishing something in terms of
goals• Meaningless if you don’t know the
goals
• Click to edit Master text styles• Second level• Third level• Fourth level• Fifth level
The Goal• Reduce operational expense
• Reduce inventory
• Increase throughput– More important to increase volume– Expand hours with providers with no
increase in fixed costs– Incorporate efficiencies to increase
patient volume
• Click to edit Master text styles• Second level• Third level• Fourth level• Fifth level
What is Our Goal?• The Right Number of Staff• In the Right Place• With the Right Skills• At the Right Cost• With the Right Behavior• With the Right Rewards• With the Right Outcomes• No More – No Less
Deborah L. Walker 2003
• Click to edit Master text styles• Second level• Third level• Fourth level• Fifth level
The Goal Defined by Jim Collins
• Get the wrong people off the bus
• Get the right people on the bus
• Get the right people in the right seat on the bus
In “Good to Great” the bus doesn’t leave
until . . .
• Click to edit Master text styles• Second level• Third level• Fourth level• Fifth level
“Count what is countable,
measure what is measurable,
and what is not measurable,
make measureable”
Galileo Galilei (1564-1642)
• Click to edit Master text styles• Second level• Third level• Fourth level• Fifth level
“You cannot manage what you
cannot measure and
what gets measured gets done!”
Bill Hewlett
• Click to edit Master text styles• Second level• Third level• Fourth level• Fifth level
• Click to edit Master text styles• Second level• Third level• Fourth level• Fifth level
Dynamic Relationship of Staffing Levels With
Accounting Functions
• Click to edit Master text styles• Second level• Third level• Fourth level• Fifth level
Physician Time• Data suggests that
most critical resource in a medical group is physician time • Profit is a function of
productivity and the cost of the resources that enable productivity
• Click to edit Master text styles• Second level• Third level• Fourth level• Fifth level
Waiting Room Time
“Yes, I have an
appointment. Should I also have made a
reservation?”
• Click to edit Master text styles• Second level• Third level• Fourth level• Fifth level
Standard Production Measures• Telephone calls w/messaging 180-200
• Appointment scheduling 75 – 125
• Check-In with registration Verification and copay collection 75 – 100
• Check-Out with schedule of return appointment and charge entry70 - 90
• Click to edit Master text styles• Second level• Third level• Fourth level• Fifth level
The Peasant and The King
• Click to edit Master text styles• Second level• Third level• Fourth level• Fifth level
Management’s job is not to see
the company as it is . . .
But as it can become.
John W. Teets
• Click to edit Master text styles• Second level• Third level• Fourth level• Fifth level
RE-ENGINEERING THE FRONT OFFICE
• R eliable• E fficient• S ervice• P atient-Focused• E nergy• C ustomization• T rust
• Click to edit Master text styles• Second level• Third level• Fourth level• Fifth levelPut the Cookies on the Lower
Shelf
• Click to edit Master text styles• Second level• Third level• Fourth level• Fifth level
S N A P• Smile
• Name
• Ask “May I help you?”
• Parting comment
• Click to edit Master text styles• Second level• Third level• Fourth level• Fifth level
The Five Whys
• Click to edit Master text styles• Second level• Third level• Fourth level• Fifth level
Best Practices:The Front Office
• Define Reality
• Identify the bottlenecks
• Increase efficiency
• Click to edit Master text styles• Second level• Third level• Fourth level• Fifth level
You are NOT Alone . . .• Books
– The Total Service Medical Practice by Vicky Bradford, PhD– Mastering Patient Flow by Elizabeth Woodcock, MBA, FACMPE– Good to Great by Jim Collins– The Goal by Eliyahu M. Goldratt– The Fifth Discipline by Peter Senge– All books by John Maxwell
• Medical Group Management Association– Local www.mgma-sl.org– State www.mgma-mo.org– National www.mgma.com
• Other Organizations– American Academy of Family Practice www.aafp.org– Organization of your specialty– The Journal of Medical Practice Management
• Click to edit Master text styles• Second level• Third level• Fourth level• Fifth level
Our Role As Leaders . . .
Finding the gifts people have to give
Inviting them to give them, and
Honoring the result when they do
• Click to edit Master text styles• Second level• Third level• Fourth level• Fifth level
DON’T GIVE UP . . .