Front Desk and Patient Flow: 11 Tips

Front desk operations—answering phones, checking in, checking out—aren’t often glorified, but performing them well is a huge part of any successful practice. “Training is the biggest place we fall down,” says Lynn Lawrence, CPOT, ABOC, COA, who detailed key components of the ultimate eye care practice at SECO 2017. This is especially true for front desk positions, he continued. “We have someone sit with them for a week and then expect them to perform as if they’ve been at the practice for years. Training is continual; it’s not a one-time thing.”

Patient flow starts at the front desk, and consciously designing and documenting the right processes will help you optimize that flow. Document every step of those processes, and follow them. “Whatever you practice, that’s what you’re going to get good at,” cautions Lawrence. “If you practice chaos, you’ll get good at chaos. If you practice structure, you’re going to get good at structure.”

Appointment Scheduling

In most small practices, the front desk attendant is the main person who makes appointments, and is responsible for keeping the schedule full. Based on the practices’ goals, “the doctor has to decide the number of exams they want to see per day and the schedule has to reflect that number,” advises Sharon Carter, who lectured along with Lawrence. Proper appointment scheduling keeps patient flow optimized and revenue consistent. It also includes guarding against no-shows, filling empty appointment slots, handling same-day requests, and knowing how to triage patient phone calls.

Tip: Make sure your front desk employee know the difference between vision plans and medical insurance and is able to explain it clearly to patients. Booking the wrong type of visit on the phone will lead to unhappy patients at checkout. For example, you don’t want a patient coming in thinking they’re going to have to pay a $25 medical co-pay when they’ll really need to pay $130 for a refraction.

Patient Check In

The front desk is the starting point for patient flow, so keep this area moving and on track. “If you get behind here, it is extremely difficult to get caught up without shorting the patient in time needed in work-up and with the doctor,” Carter says. Along with speed, you need accuracy. Billing relies on front desk for accurate demographic information. This information is what goes on the CMS claim form for insurance filing and determines if your claim is paid. If it’s not correct, you don’t get paid, and you’ll waste time following up on the denials. And don’t forget—be sure to acknowledge the patient first. Don’t make them wait. Look from your work, make eye contact, and smile.

Tip: Some practices have ditched the paper medical history form entirely, according to Carter. They simply have the patient complete it during workup with the tech, who enters it directly into the EHR. Why? The paper isn’t the legal document—that’s in your EHR—so you don’t really need it. Plus, it’s usually illegible and you’re going to ask the patient about it anyways. Then, “the patient thinks you’re dumb because they already wrote everything down and now you’re asking them again,” she says.

Patient Check Out

The check-out experience is your last chance to make a good impression, and it’s a big part of whether or not a patient stays loyal to your practice long-term. If you use an EHR, make sure the codes come forward from the exam and are linked properly with the diagnosis the doctor has listed, advises Carter. This creates the claim that will be sent to the insurance company, so be sure all charges and diagnoses are correct, she adds. Lastly, collect any out-of-pocket payment the patient owes. “The doctor is paying you to collect the money. If you can’t ask for the money you shouldn’t be there,” emphasizes Carter.

6 Simple Phrases to Diffuse Angry Patients

The front desk is usually the first touch point for an upset or dissatisfied patient. “While anyone can work with the easy people, it takes a real professional to be successful with the difficult patients” says Bill Russ, a licensed optician who gave patient-calming pointers to ophthalmologists at AAO 2016.

Even if the patient doesn’t mention anything, an intuitive front desk staffer—one well-versed in EQ—can interpret from the patient’s demeanor and body language that something is wrong. Then, he or she can dig deeper to discover the source of the issue. Once you’ve established the problem, it’s important to acknowledge the patient’s feelings, Russ says. Below, he gives frazzled front desk attendants a few ideas:

  • I can appreciate what you are saying
  • I can see how you’d be upset
  • I can hear that you are annoyed
  • I understand your concern
  • I would be upset too
  • You can trust me to take care of this


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