The front desk is the first and last thing your patients see. So it’s very important to have competent and truly caring people on there. To help you level up your front desk, Dee Bills is here with 5 key stats that you need to keep track of as a front desk.
Dee Bills started Front Office Guru because she recognized that her business was hemorrhaging production, efficiency, and profits because of the shortcomings at her front desk. Recognizing that front desk personnel needed more training she went on a 1-year mission to create a highly efficient front desk department, and her business changed dramatically. She now trains PT (and other healthcare) teams on how to run their front offices productively and effectively so providers can be most successful.
In today’s episode, join Nathan Shields as he talks to Dee Bills about the 5 key statistics that she tracks at the front desk to ensure things are running optimally. Remember, it’s the front desk’s job to coordinate care and it’s the provider’s job is to provide the care.
Listen to the podcast here
The 5 Key Stats Of The Front Desk With Dee Bills, PT Of Front Office Guru
Thanks so much. This is awesome. This is one of my favorite interviews to do.
I’m sure this might be our third. It’s good to catch up with you and see what you’re working on. You’re doing a ton of amazing stuff with Front Office GURU. For those people who haven’t read it, number one, go back and read the previous episodes related to front desk things in general. Get a little sense about where Dee Bills came from, her story, and what she’s doing to improve front desks across the country in all industries, not just physical therapy. For those who haven’t heard that story before or don’t know exactly what Front Office GURU is, give us a quick synopsis about your back history and Front Office GURU.
I’ll do the abbreviated version, Cliff’s Notes. As a physical therapist, I was in treatment for close to twenty years. Mike started getting some coaching and consulting for his practice, and they were like, “Dee needs to be there too.” I don’t think I ever saw myself as an owner or a manager. I was happy treating. Being committed to that, I shifted and started working in my office.
I was taking a financial course and like, “We need to make more money. We’re not going to survive. How do we do that?” They’re like, “Find where you’re believing.” I sat there in this course and was like, “Front desk, front desk.” I realized that my front desk didn’t have cancellation and scheduled training. Our schedule looked like this. I was like, “I got to handle this.”
I was blessed. I didn’t have to provide or treat at that time. I started digging in at the front desk and creating systems that worked. We took our arrival rate from 75% to, I think my team now has it at 96%, 97% every day without me there, thank God. It evolved from there. People started asking for help. One day I looked at Mike, and apparently, I’ve been saying this for months, but I was like, “I think I want to do this.” He’s like, “Good, go do it.” I was like, “I’ve got to be serious about it.”
I took my first client. In fact, I was emailing her, and five years later, it evolved. I now have a client in Africa, so I can officially say I have a worldwide product. We’ve met and talked online. Front Office GURU came from me developing systems for our practice that worked well and seeing how it put my front desk in the right mindset and driver’s seat. It divided the duties in practice in the right way so that when everybody’s trained up, we have a very good machine that provides great care and all of that.
What I love about it and why I’ve referred my coaching clients over to you is that we need to recognize that we’re not the front desk experts as physical therapists. We shouldn’t assume that because we’re high-achieving people who accomplished great things and do good things for people. That doesn’t mean we’re good at the front desk. Anytime you can hire out to save energy and allow you to focus on other things, I think it is highly valuable. If there’s one place in the entire clinic that can lose you the most money, it would probably be the front desk. Wouldn’t you say?
When you think about it, they’re the first, last, and every point of contact in your practice. Their job is to coordinate care. Your job as a provider is to provide the care. As an owner, your job is to run the practice. If you don’t have well-trained people at your front desk, you’re losing those more challenging sales, money, visits, and also, your providers end up having to handle things that they shouldn’t handle. They shouldn’t talk about money. They should be like, “This is the plan of care.” Your front desk is like, “Let’s talk about how we’re going to make that work.”The front desk is the first and last point of contact patients have in your practice. They decide whether they come back or not. Click To Tweet
It’s interesting how some of those super significant KPIs like arrival rate. I have a KPI calculator that I got through the peer-to-peer network, but if you can improve that arrival rate from 80% to 85%, that’s maybe a 15% increase in arrival rate. What that does to your bottom-line profit margin is a 40%, 50% increase over the course of the year. Improving something like that simply improves net profit margins because your expenses stay the same. Focusing, spending the effort and time on a single statistic that the front desk handles and that you’re not individually handling yourself can go a long way.
It’s a big part. It also creates ownership. Our front desk manages quite a few stats like five main steps. When they’re all running like they are very high, there’s a winning mindset. You and I know that from past training that we both had, but in order for a team member to have ownership in their position, they have to not only be trained, but they have to track their own stats or metrics on it and be able to say, “I’m hitting a target. I’m not.” They also have to have the training and the tools to know where to go to fix it. It’s not like, “Here’s your arrival rate, great. Your arrival is not good.”
Your front desk is like, “I don’t know how to fix it.” There’s a big part of owner training or training isn’t the owner getting training because if you’re the owner and the only one that gets training, you’re going to single hand this forever. I remember Mike doing that early on where he was the only one getting training. He’s like, “I want to get down to a normal workweek.” He was like 70, 80 hours because nobody else was trained yet. The minute we started training staff, now he was able to step away, do other things, and expand himself.
I know people who are reading are going to kick me if I don’t ask the question. Your front desk has five key stats. Do you mind sharing?
It’s on my blogs and website. There are five. The first one is one that most staff or clinics don’t track consistently, and that’s calls converted to evals, so that’s your conversions. You were talking about the arrival rate being a financial boom if you get it up. Believe it or not, if you can do the math on your average plan of care, let’s say it’s $1,000. For every additional new patient your front desk converts, that’s a potential $1,000 plan of care. The average practice could lose anywhere from 5 to 10 a week if your front desk isn’t trained on selling anything other than that low-hanging easy fruit. That’s the first one.
Do you count all calls as potential sales calls, essentially? Anyone that’s not an active patient is a potential sales call?
Yeah. What do people say? We’re trying to identify the easy ones, “I need physical therapy,” “I need your help,” or whatever service you provide. What about the people that say, “What are your hours? Do you take my insurance? Do you do cupping because I saw that at the Olympics?” I like to put that out there. It was a big one a few years ago.
If they’re untrained, the average front office person being very kind and generous will say, “Sure, absolutely. I’ll have to check on that,” or whatever the answer is. Think about this, the average patient doesn’t call it your practice or the average person doesn’t pick up the phone and call your practice if they don’t need your help right now.
The average person doesn’t always recognize that they need your help. They think, “Yeah, I’ll pick up my cell phone, and I’ll reach out to them.” I’ll be like, “I saw your ad.” Instead of this front desk leading them where they need them to go, what ends up happening is they answer that question. The next thing they have to do is ask a question. They say, “Would you like to go ahead and get scheduled?” What do you think, on average, the average person who’s not ready to commit says? “I’ll call you back.”
Now, we don’t have any information. By the way, for all the people that use the online voice stuff and collect all this data, your front desk doesn’t want to call those people back because they didn’t develop a relationship with them. We’re talking like $500,000 a year a practice could improve handling that first step, which is conversions.
It’s transitioning those window shopping calls into new patients.
Obviously, we have to have the support network behind it, the PTs, PTAs, or whatever provider we have, but if you’re running on a not full schedule right there, there’s a huge way. We’re not getting one visit like we would handling a cancellation. We’re getting 10 to 14 visits if we’re a recurring treatment model. That’s the first one.
Arrival Rates & Schedule Efficiency
The next main stat is arrival rates. You can diversify your arrival rate and look at new patient arrivals and current visit rivals because you could think, “I have a crappy arrival rate, but your current patients are all showing up.” It’s your evals that are the problem. That’s a whole other area that you need your front desk to be trained in.
We look at the new patient conversion arrival rate. Those are the two big ones. We’ll look at schedule efficiency. That’s the motherload of all mothers because scheduling efficiency or utilization relies on all these others should’ve said that one last, and then the next one, which you and I have tracked over the years, is percent.
If they’re not tracking efficiency and utilization, I know what it is.
Schedule utilization, schedule efficiency, whatever you call it, is based on the number of visits you have available that your providers could provide on a given day. How many of those are filled on a given day? That’s affected by refills, cancellations, ad-ons, new patients, visits kept per week, all of that. That one is the motherload. People look at visits per week as an indicator. I like to look at schedule utilization as an indicator.In order for a team member to really have ownership in their position, they have to track their own metrics. Click To Tweet
I’m starting to think the same thing. I’m glad you’re backing me up on this. I’ve been telling owners you track total visits. That’s like a migrator, but that utilization efficiency number tells you so much. I see it as the one key thing that the front desk is responsible for. It’s getting patients in the door.
That’s what I teach them. Your main responsibility is to fill that schedule because the provider’s main responsibility is to provide the care. If you think about it, your provider is your resource. I don’t care what specialty you’re in. Your provider is your resource. It’s the one that provides the care that helps people. If we don’t make sure that the providers are maximized, we’re not maximizing our ability as a practice to help people. As an owner, you and I can say, “That’s why we’re here. It’s to help people.” The very last thing in my courses is schedule utilization and schedule efficiency because you have to convert evals and leads. You have to get those leads to show up. You have to schedule out a plan of care.
You have to get them to arrive consistently so they don’t drop out. All of that carries over to your schedule being full. It’s not always marketing. It’s not always the reason why your schedule isn’t filled. It’s not because your front desk is bad. You and I were talking about that. I got a Master’s. I had five and a half years of schooling. People go to school for 6 or 7 years to get their Doctorate, and if you do any other training.
I look at that as a provider. Even when you first came out of school, nobody said, “There you go. Go treat patients.” You got a little mentoring and maybe not a lot, but you’ve got mentoring and worked your way in. Think about the front desk. We didn’t go to school for that. You didn’t go to school for that. When they come on board, what kind of training did they get?
I have talked to some practices. I’m always impressed when they’re like, “Yeah, I got a training program.” They’re like, “I want to make it better.” The average person tends to be on the job. Sally trained Sue. Have you ever played a game of Telephone when you were a kid? Maybe your kids do that. What happens is you get around that circle. It changes. I might whisper happy days in your ear, but by the time it gets around twelve of us or whatever, somebody else could think it’s like Sally plays or different things.
If one person’s training another, and that’s your sole training at your front desk, if the first person changed anything, the second person isn’t necessarily getting the same thing as the next person and the next person and whatever. I like to look at standardization. We have conversions and arrival rates, and you can split that up. It should be a clean arrival rate. I’m going to qualify that. It’s on my site too. I learned this from Shawn Kirk years ago.
You have patients scheduled prior to now. The arrival rate is all arrival rate measures is how well your patients understand that they either need to show up or give you notice. Whatever your notice is, 24 hours, the night before closing, the day before by 2:00 PM. Anybody who calls to cancel or doesn’t show up is a cancellation, even if they reschedule for another day. A lot of practices run off of the, “If they cancel today and they reschedule for tomorrow, that’s not a cancellation,” but it is. Why?
How many spots am I taking up for one visit? It’s taking up the one that I canceled and the one for tomorrow. On top of that, since it’s measuring your missed visit policy and your expectation of arrival, refills and add-ons don’t count for arrival rates. If I add you to my schedule, that counts towards schedule utilization. Rivalry is simply anybody that was on and who showed up. If I had 100 on, but only 98 of those 100 showed up, it’d be 98% arrivals. It’s important to look at all these stats. They’re tiny little ways that we lose visits, or we lose that effectiveness.
There’s an opportunity there to get the team on board when it comes to arrival rates. It’s almost harder to convince the team, the front desk, and the providers that arrival rate is important. It all comes down to your patients needing to show up to get better. They get better faster when they show up according to their plan of care. Them dropping out makes you less efficient as a provider. No matter how many times you see them, it doesn’t make up for the fact that you missed giving them care. It extends the care, which is in no one’s best interest. If you want to be a powerful provider and clinic, you provide as much care as fast as possible to get them the best results as soon as possible. A negative arrival rate shows that you’re not doing that.
It’s so funny that you say that. When you talk to Tony later, ask him about our conversation because we were talking about that. Look at it this way. We’re there to help patients. I don’t care what specialty. All we’re there to do is help our patients. If a patient cancels and can’t get another patient in, you didn’t have one patient who didn’t get care. You got a second. The real reason we need our patients to show up or give us enough notice is so that we have enough time to help other patients get the care that they need and deserve.
A big part of what I do is when I start working with teams and show them it’s about patient care. Marketers will talk about closing up that funnel. Once that patient is in your funnel, we have to be able to give these people care as quickly as possible to get the results. Think about Amazon and texting. You and I grew up before all that stuff. You look at the population now. How fast do they want to be recovered?
There’s no answer. Yet we’re asking people to commit 12 or 14 visits in some recurring models. Sometimes longer, sometimes less, but our skills teach us it’s going to be this. If a person’s canceling all the time, they’re not getting results. High rate of cancellations and no-shows increases drop-offs. When somebody drops out of care, that’s where people start to believe that PT doesn’t work or that any service, I don’t care what it is. I don’t go to the chiropractor and drop out.
I worked with chiropractors. If people only come in once every six weeks, it’s that model. The chiropractors feel down and feel like they’re not being productive or effective either. I’ve worked with medical offices that have patients that need to come in for recurring blood draws. The front desk is like, “If we can handle this and get patients to give us better notice, we can get more people in the door that want to be there.”
Not to belabor the point, but if you don’t make that connection, an increased arrival rate equates to fulfilling the clinic’s purpose, which is what is in the best interest of the patients. Patient results improve if our arrival rate improves. If we don’t make that connection, it’s very easy for them to default that you’re all about the numbers. You only care about lining your pockets with profits.
You have to show them that it’s logical, but if you don’t iterate or show them that an increased arrival rate results in increased results for patients. There are studies that show that you’re missing the opportunity. It has to start with a sound and logical way for them to want to be part of increasing the survival rate and putting their foot down and saying, “Mr. Patient, you have to come in to get the results we’re talking about.”
It’s simply about mindset and scripting. Your PTs have a role in that. I always tell people, “If you work at a front desk as a patient care coordinator, everything up until eval is you.” If your front desk isn’t trained, great. Your PTs or whatever provider is doing these services. If your front desk isn’t trained, you’re losing the ability to help people. Your funnel is broken. Here’s your marketing, front desk, and your provider.
If your front desk isn’t trained, everything up until that initial appointment or that email, you could have a huge break right here. Great marketing, and we keep investing in marketing because we’re trying to get more patients, but we’re spending all this money. We can convert what’s there or get them to arrive. That’s a big part of this with that. Your front desk has a huge job in your practice. They’re not receptionists. They are coordinators and their job is to handle those things that you’re talking about so that the provider can provide the care.As a front desk, your job is to fill the schedule. The provider's job is to provide the care. Your provider is your resource. Click To Tweet
Visits Per Week Tracking
We’ve talked about three of the stats.
We’ve got those first three, conversions, arrival rates, and schedule utilization. The next one is visits kept per week or percent prescribed. As a provider, if you’re a recurring treatment model and you prescribed 3 or 2 times a week, this is measured by a patient and, overall, by your patient list. What’s the percentage of visits per week that each patient is coming in for or attending because that also affects cancellations and dropouts?
That’s getting the patient to reschedule no matter what and not adding it to the end of care because the patients need our care now, not six weeks from now. By the way, if you add it to the end, that’s where you get those patients to drop out one visit before they’re discharged. In theory, they needed it sooner. There’s that one.
I’ve seen a couple of studies. Honestly, if you’re in an outpatient orthopedic clinic, it’s hard to get great results, the best results are once a week. I don’t know about you, but when owners start tracking that statistic, they assume that patients are coming between 2 and 3 times a week and track that average. It’s closer to 1.7, 1.8, 1.9, which means more people are coming 1 in 2 times a week. That tells me your patients are not getting the best results that they could. I would expect that number to be closer to 2.2, 2.3, if they were coming pretty well.
You’ve obviously read the same study I did. If a patient’s average over the course of care is anything less than it was like 1.96, their likelihood of dropout and unsuccessful completion rises exponentially. The more it gets below two a week, the more it is. As a provider, it is our responsibility to get that patient in the door consistently every week. When you do, your average successful completion goes up. Mike was telling me whatever the number was. For years, that number was 60% on average in the US, 60% for PTs have a successful completion. I was like, “No, I can’t have that.” I think we run it like 85%, 90% is our goal.
The 2018 WebPT study said that the successful discharge rate was closer to 30%.
That’s what Mike told me, and I was like, “I missed that.” I was a little embarrassed, but to me, that’s like playing roulette with your patients.
Seventy percent of your patients are essentially failing. They’re going home and saying, “Physical therapy didn’t work for me.” They dropped off and didn’t believe in it. Maybe there’s a small percentage of them that were legitimate. They were discharged early and didn’t say anything. If we have a 40% success rate, that’s still pretty horrible as a profession.
That’s where it makes it harder to justify what we do and those higher reimbursements we were talking about. You and I were talking about that earlier, but people’s financial responsibility for their medical care has gone up exponentially. The media wants you to think it’s because of the provider or the doctor. In reality, it’s the insurance company putting more of the responsibility onto all of us. When you have to justify, even if you’re in a treatment model, it’s solely insurance-based, no private pay, no out-of-network. If you want to handle your patients, you have to be able to have great outcomes. You need your providers to feel like they’re winning, and you need the patients to see that they’re winning to justify a higher model.
The number of these statistics outside of the arrival rate isn’t tracked on a regular basis. Correct me if I’m wrong, but unfortunately, a lot of the EMRs out there don’t help you track these. It requires some manual effort most of the time.
We use a series of spreadsheets. It’s not our ideal scene. I am trying to work through that with EMRs now. It’s important to be able to track and have accurate measurements. I’ll say to staff, “On Thursday for next week, you should know anybody who’s not scheduled for their full plan of care.” When they go running a report, the report only shows the patients that dropped off altogether. I’m like, “It’s too late because now you spend hours trying to get them on the phone at the front desk.” Here’s a tip for you guys. You’ve got to handle the people Thursday and Friday that are walking through your door that is not scheduled for their full plan of care for the next week.
I’m working on that with one of my practices that I’m doing one-on-one. This owner has come back to me three times in the last five years. We are digging in on this one with his team, making sure that by Thursday and Friday, they already have all their patients that could be booked for next week are booked for next week. They know how many extra emails they need to do or what else they need to do to manage their patients.
This was a successful action of ours that I’ve tried to teach my clients as well. We did what was called The Weekly Walkthrough on Thursdays with the front desk. This was the front desk’s responsibility to report to the clinic director or owner in a very small clinic. It ended up being a fifteen-minute meeting max if it was run well, but it all starts with having a clean, active patient list. It has to be clean.
All dropouts are taken care of. You’ve discharged them. You tracked those discharges. You have a clean patient list, and it’s an Excel spreadsheet scheduled for next week. How many times did they come in this last week? How many times are they scheduled for next week? Is it according to the plan of care? If they’re not scheduled for their plan of care visits, you need to have comments and status next to each of them.
We highlight their patient name by a certain color, and they immediately get put on our unscheduled list for next week. Even if you’re in for one, but you’re supposed to be in for three, you’re on our unscheduled list on Thursday. I’m glad you’re working on that. I work on that too with clients because it’s not easy to track that one.
It requires a little extra manual work, but I will tell you the practices that track that and handle their patients on Thursday and Friday. The front desk feels like they’re winning. They don’t feel like they’re behind. The owners are happy. The clinical staff isn’t wondering where their patients are. The goal is at least 70%, 80% successful outcomes.
We started hanging success stories on our clinic walls probably years ago. In 2021, during the pandemic, we repainted the clinic. We took it all down, and they reorganized stuff the way they wanted it on the walls. The clusters on our walls now of successful completions, patients come in, like, “That’s cool. Look at that. There I am from the last time I was here.” You’re able to promote more when you have the ability to say, “Look at our successful completion.”As a practice, if you don't make sure that the providers are maximized, you're not maximizing your ability to help people. Click To Tweet
It simply started from me standing there. I was treating full-time at the time and saying, “We had a slew of new patients. We’re not significantly busier. What is going on?” I gave the responsibility to the front desk to write down every single patient that was supposed to come in and tell me exactly where they were and why they were not in. After doing that, it became this successful action that we continue to do week after week.
This was back in the day called The Weekly Walkthrough because we had paper charts in our horizontal files. We walked through with our fingers down each file. Where is Alex Alvarez starting with the A’s? Where Susie B, whatever her last name is, Susie Brown? We’d go through the alphabet and say, “This one’s discharged. Why are they in this active file?” We take them out. That was it.
It’s key. It’s interesting that you said a clean list. When I instill this worksheet with practice, it’s in my higher-level training because they’ve got to get through the basics with their front desk first. When I install this in practice, I’m like, “I’ve got to get a list of patients going.” They’re like, “We have 400 patients on our list.” We all laugh about it. I was like, “I told you this would happen.”
We all joke around, but it’s because like their PTs didn’t finish some of their discharges or patients dropped out, and nobody got that patient. We publish a list multiple times a week for our clinical staff of patients that are not fully scheduled so that our clinical staff helps our front desk. It’s not just a front desk action at that point. There’s clinical responsibility.
That’s the word that comes to mind. That’s when you’re taking responsibility for the patients that have come to you. Let them drop off and two weeks later, say, “What happened to so-and-so? I never saw them again. They were nice,” and that’s it. No, you take responsibility for the care they entrusted to you and call them and say, “You remember our agreement. You got to come in in order to get better and handle it.” That’s where, number one, the entire team has dropped the ball. Number two, the providers are so busy that they can’t track all of them. You have to have a system in place.
That’s where the coordinators come in. If your front desk manages patient care, your PTs, specialists, whatever your provider is, can provide the care. There is ownership on both sides of that spectrum. As soon as they become a patient, it’s not a front desk action to manage. The front desk has stats. Those five stats are important, but they tell a story either at the front desk, like prescribed or visits kept per week. However, you want to track that percentage that tells us clinic wide.
If the front desk isn’t scheduling people, and they’re letting it add up, great. If there are problems where a provider struggles to get a patient to commit to their plan of care or isn’t keeping patients, which I talk to owners about all the time, if they’re not keeping patients on the schedule as a provider because they’re not creating that constant value, we don’t know where to look if we’re not tracking that stat. That’s where you spend more money on marketing and everywhere else. All of these stats show patients that are in your system already.
If you shore those up and you’re flowing patients in and keeping them on a schedule, you can do more with less patients, which is something that happened to us several years ago. We can do more without having to market or promote. We were talking about this earlier with fails. If you have too many failed attempts to help somebody, what do you do?
You throw up your hands. You’re like, “Either I’m not a good trainer, or they can’t figure it out.”
It doesn’t matter which side of the spectrum we’re talking about the provider or the front desk. I obviously focused on the front desk. The providers come up in my training. If we have too many patients canceling or people who drop out of care because we don’t know how to discuss the cost of care or convert those callers that have questions, especially your front desk, this is where a lack of training breeds a lack of confidence.
They have these added-up fails. You may not tell them they fail, but they’re human. They feel that they fail. It’s like, “I’m in this job. This is what I’m supposed to be doing. It’s 25 cancellations today.” To them, that’s racking up fails. What you see is eventually, they lose that excited mindset. They give up. That’s where they quit. They don’t quit because they hate you. They quit because they’re like, “I can’t do this anymore.”
They hang it up and say, “If no one’s going to hold me accountable, I guess this is okay. I keep doing what I’m doing because I’m getting paid.”
They also do it. It’s not even that I see this all the time. They aren’t even worse than them doing it for that reason because that reason becomes very obvious. They stop challenging patients and handling patients because they’re scared or don’t want them to fail. They only go for the easy patients. Not because they’re bad people. We all do this. If I do ten discovery calls and ten owners go, “No,” heck yeah, I’m going to want to hang it up.
I used to do neuro patients. It was a long-term treatment plan for me. I wasn’t orthopedic. If I had a lot of patients who didn’t recover, we’re talking pretty bad head injuries, stroke patients. I can remember times when I would be exhausted and want to walk away because if I wasn’t getting the product I needed to get, it’s not that they stopped trying because they didn’t care. They stopped trying because they literally feel they have failed and don’t know what to do. As owners, that’s where we come in to improve our mindset. You were asking me earlier about mindset. That’s a big part of this.
Over The Counter Collections
That’s over-the-counter collections. It’s easy, but that’s the hardest one. Are you collecting 100% of what’s due at the time of visit? The new law in 2022 puts that into perspective for all of us. Do we know what we’re supposed to collect at the time of the visit? Are we collecting it? Are we only going for the easy ones? At which point, we become the bank as a practice owner.
I started in our clinic helping Mike with some collections and billing so that I could shore that area up. It’s not because I wanted to do it. God bless the billers out there. I tell Will that all the time, “God bless you.” That’s a big thing for us. If we don’t know what’s due at the time of visit, we don’t notice when an insurance company drops its rates. That’s where we start losing money.If you're flowing patients in and are keeping them on a schedule, you can actually do more with fewer patients. Click To Tweet
We were like, “This time in 2021, I was doing the same number of patients, but I’m making 10% less.” We should know at all times what we should be collecting at the time of the visit and try to collect at the time of the visit. If you’re in care, I’m your provider, three months after you’re done with care, do you potentially remember how amazing I was?
There are a lot of fuzzy generalities that were good.
You get a bill for me three months later. Does that on your priority list?
No. I’ve got a bill from a lab on my phone right now that I’ve been sitting on for a few weeks.
I got one from my daughter, who’s away at college. She had to run to urgent care. A man collects at the time of visit, but that man will make a provider that bills him wait. I laugh with that all the time. I’m glad to meet other guys like him. Think about it in reverse. If I dropped out of care, what’s coming back? If you’re at PT chiropractic care, what’s coming back for that patient?
They’re paying for their deformity. Remember when you said earlier about PT doesn’t work. We’ve got this belief that PT doesn’t work. You bill me when the insurance company completes processing. You’re already not in a good relationship with me because you dropped out of care. You didn’t want to own the fact that you didn’t complete care. It’s my fault you didn’t completely care, not yours as a patient. Add to that, and now I give you a bill for $200, $700, whatever it is.
Where’s that bill going to go? There’s a relationship that goes downhill. That person could have come back to you if they get a $300 or $700 bill three months down the road. As a patient, your relationship with them could completely be broken at that point. They’re like, “Forget you, and I’m going to put this over here. I’ll pay it eventually.”
That’s the final nail in the coffin right there.
I like to look at all of these things with a front desk because when you can get these five things working well, now the practice is running like a much more well-oiled machine. When I say machine, it’s not cookie-cutter. We’re talking about your patients walking through the door. The first word you hear out of their mouth is, “You guys got it going on. This is like a system right here.” That’s what we want because that’s where our referral source comes from.Referral source comes from well-placed systems. Click To Tweet
Don’t you feel like after doing this for so many years, when you have those systems in place and things run smoothly, the focus can now be on the care? That would be the highlight of everything so that the front desk interactions are almost that are secondary and should be secondary when so many times they are at the forefront.
Focusing On Care & Stats
Your front desk’s job is to create a relationship with the patient and manage that patient’s care so that there’s no rub. Think about it. If I’m on the phone with you and I’m talking to you and don’t sound confident, and then you haven’t seen the provider yet or in years. That’s another case that can be a problem.
Your life’s changed. You’re talking to me on the phone. I’m not at the front desk. I’m not confident. What’s your trust level in practice and the provider going to be if their front desk isn’t confident and doesn’t sound and look like they have it going on, not on the phone call, but during the cancellation process, with scheduling, or with collections. What happens to the relationship and the trust level of the patient?
It doesn’t start off on the right foot.
It doesn’t continue. It’s where all those little systems like your stats are great. They’re so important to track. I always teach at practice, and early on, they look at me like I’m crazy when I do one-on-one, but your stats tell the story of what’s working and what’s not. I’ll give you a good example in our clinic. We track conversions. We split conversions between patients that call less and patients we have to call, those Facebook leads and referrals. It could be very different patients, but you should still have the same path. You don’t need to have seventeen paths because it creates confusion.
I worked with our team in our practice remotely. Mike and I are now out of practice. The management team had a target. This is what they kept thinking was the problem. “This is the problem.” Mike and I sat here 1,000 miles away and pulled up the stats. I’m like, “That’s not your problem. That’s your problem.”
My front office staff had enough fail on handling those Facebook leads that come in off of, “I didn’t sign up for anything.” The front desk had backed away from it. My clinical team thinks it’s certain other areas of their practice like the management team. Being able to show them, “You guys look at this stat right here.” They can manage by that statistics, but now we could say to the front desk, “Let’s go back and look at this one area.”
Owners will say things like cancellations. If you don’t have a set training program on how to handle cancellations from the eval, like how to prevent them, and you don’t have a set process of what to say, how to handle the patient along each step of the way, you think, “We’ve got to charge more fees. We have increased our cancellation fee, or my front desk needs to handle the patient this way.” What if I said there is a way to prevent it and put your front desk in the driver’s seat, and you almost never charge a fee? Imagine how everybody would feel like they were winning.It's not just about hiring the right people. It's about having the right training that fits your practice. Click To Tweet
Owners feel like they’re winning. The front desk would be like, ” I don’t have to charge a fee all the time.” Your patients would be like, “I got it. I’m going to show up, or I’m going to call you.” Imagine if the arrival rate drops. Now we know that’s connected to the cancellation program and how we handle our patients. This is where we look, and that’s it.
It’s not just hiring the right people. It’s having the right training that fits your practice, gets the product, and tracks the stats. If you track the stats, the stats tell you where to look. We knew from that one stat we were to retrain our front desk. If we have a PT whose stats are down, it’s that PT and where do we put them back through training? “These aren’t a problem. This is the problem.” Let’s put them through patient compliance or depends on what they’re not following at that moment.
The five stats to summarize again.
Calls converted to evals, so your conversions. You will get ten times more return out of handling that one than you will get cancellations. We still don’t like cancellations because owners vibrate. They are stressed out when they see those colored marks on the schedule. Conversions, arrival rate, keep it together, but you can also split it into two new patient arrivals versus regular patient arrivals. Schedule efficiency is the mother of all mothers. You and I agree. Present, prescribed, or visits kept per week. You can track that on a per-patient level or a practice overall patient level. Over-the-counter collections. Are you collecting what’s due at the time of visit?
Those five stats and this conversation are completely different forms of what we plan on talking about.
You and I can talk about everything.
What I need to do is we need to schedule another conversation. What we wanted to cover is what is the mindset and the personality of the perfect front desk person? What mindset should they have as the coordinating care? This is for not just those front desk people that you have to train up to be great ones, but also what you need to be looking for in the hires.
It’s easy to get desperate. We all went through this with the massive resign and whatever. Everybody had a turnover. Everybody was going, “What do I do? I don’t have enough staff.” Finding the right people is key, but maintaining the right people is key. There are two sides to mindset. It’s the hiring mindset, who you hire, and then keeping them up, so they don’t have all those fails. I would totally talk about that.
That’s our teaser for our next episode. We’re going to have a part two to this. We’ll come back around and talk about hiring and training the perfect front desk person.
Thank you for that. You and I could talk forever.
Thanks for your time. You shared a ton of great information. If people wanted to get in touch with you or Front Office GURU, how do they do that?
They can simply email me at Dee@FrontOfficeGuru.com or go to FrontOfficeGuru.com. You can schedule a free call if you want to talk to me more about problems you’re having or you can check out my new online academy if you’re looking for a simple process.
Thank you so much, Dee. I appreciate it.
Thank you, my friend. I appreciate it.
About Dee Bills
I started my career as a physical therapist and spent over 20 years in various settings. In 2004, my husband Mike achieved his career-long dream of owning an outpatient PT practice. In 2011, we recognized that with the impending changes in healthcare, we wouldn’t survive without making changes and improving our practice efficiency and expanding our reach. As he began working on practice expansion, I began managing the administrative side of the practice.
Over the past 6 years, I’ve developed front office systems to increase efficiency, organization, and patient control, created a recruiting and hiring machine to accurately locate only the highest quality administrative staff, and I’ve built company-wide policies and procedures, job hats and expectations, as well as practice-wide training procedures.
These systems have provided our practice the opportunity to expand without Mike and I having to do all the work and spend endless hours working in the practice. My front office systems have improved new patient conversions, patient arrivals, schedule efficiency and collections beyond industry standards which has allowed him to focus on his dream and not on crunching numbers.
In 2016, I realized how much I missed helping others and I founded Front Office GURU. My mission is to help other private practice owners achieve similar success in their practice by training their front office staff and offering consistent systems to install in the practice.