Every pediatric practice has a limited amount of time to provide training for the staff related to managing the revenue cycle. Some areas to focus training for front desk team members and Medical Assistants/Nurses of a pediatric practice include:
Front Desk Team Members:
The staff that work the front desk team are an important part of optimizing the revenue cycle for the practice. They should be checking insurance eligibility, collecting co-pays, and collecting past-due balances that are flagged on the patient chart. A well-trained front desk team member will also verify the current demographic and insurance information in the practice. Some questions to verify for patients include: Is the patient eligible for the VFC program? Who are the current parents/guardians? Who are the siblings and/or other family members associated with the family? Additionally, the front desk team should verify the current address, telephone numbers, and emails associated with the patient account. Some front desk team members help families set up their patient portal and answer many questions related to the practice, such as billing questions. High performance by the front desk team enhances the practice revenue and is an important part of the revenue cycle team.
The Medical Assistants or Nurses should be able to enhance the productivity of providers by capturing additional information on the patient. This information includes: preferred language, race, ethnic group, smoking status, gender identity, history of present illness, as well as taking and recording vitals on the patient. Some MAs and nurses also review the previous vaccines and identify vaccines that the patient is behind on. A good Pediatric EHR system should identify which vaccines the patient is behind on, based on the practice’s recommended vaccine schedule. The MAs and nurses usually fulfill tasks including giving vaccines to the patient during the visit.
A training program should review the processes and procedures for the area described above.
A person from the practice should monitor and manage the consistency that the medical staff performs in each of these areas. There should be an acceptable standard for performing these duties and the ability for a team member to obtain additional training if they are not consistently performing at or above the standard.
Consistency in the medical staff performing in their roles enhances the potential for the practice revenue cycle. The back-end billing team should be communicating via the EMR system on issues such as out of date insurance or current patient/family balances.