Front Office/Back Office: Cooperation or Conflict?
In a well-run, happy, competent office, the clinical staff and the business staff work together. Each is necessary for the office to succeed. Each is necessary for patients to receive proper care. However, clinical staff and business staff are not necessarily on the same page all the time. What draws a person to the treatment side of dentistry is often a desire to provide hands-on care to patients. What draws a person to the business side of dentistry is often an aptitude for organization and management. While it is common in many offices for there to be some overlap of front office/back office duties, a difference in staff temperaments is often a fact of life.
As a hygienist, I would love to have unlimited time to bond with my patients, perform my procedures, handle unexpected issues and promote necessary treatment. I would love for my dentist to be available right at the time I would like him to appear for the exam. I would like to have a big budget for new instruments and all the latest technology, and to never have to take care of any discussions of fees and insurance. And I would like for the front office to handle all computer problems so that I can concentrate on treatment.
My co-worker in the front office would love to have unlimited time to deal with insurance, billing, and unexpected issues patients have concerning their statements. She would love for the dentist to be available and willing to listen to her suggestions about promoting prompt payment for treatment. She would love to have a big budget for new office equipment and computer program improvements. And she would like for the back office to handle all treatment questions and issues so she can concentrate on making sure the front office is running smoothly.
Neither of us is likely to get all of the items on our wish list, particularly the part about having “unlimited time” and the “dentist always available”. However, we can cooperate with each other, and in doing so, increase the likelihood of having more of our work time spent on what we like and do well, rather than on what we don’t like, and therefore, often don’t do well.
Since the goals of the office include well-treated patients and good production; work together to promote this. Clinical staff should always point out and encourage necessary treatment, and make it easy for business staff to follow-up. Business staff can reciprocate by handling form generation and payment processes.
For example: I see that my patient may need a crown for a cracked tooth. Current radiographs show a breakdown in tooth structure, and I have taken a photograph today. The dentist diagnoses the need for a crown and explains that there is an undermined distal-lingual cusp as well as recurrent mesial decay under an existing inadequate amalgam. I enter all of this information in the computer chart. At the close of the appointment I walk my patient to the front desk, bringing along her routing slip and telling the business coordinator: “Dr. Smith wants Ms. Patient to have a crown on #30. That tooth has a crack in it as well as some decay. I have entered the necessary information in the computer chart so you can access that for Ms. Patient’s insurance. Dr. Smith thinks that this tooth should be taken care of soon so that it doesn’t break into the nerve.”
Now that the business coordinator knows the dentist and I have talked to the patient about what is recommended, she can access all that she needs for preparing a claim, and she can talk to the patient about the fee and what insurance may cover. She also knows that Dr. Smith wants the patient to come back soon. She is not left to field questions from the patient such as “Why can’t I just get a filling?” or “Can I wait to have this done until next year?” Instead, she can concentrate on making sure that all aspects concerning scheduling, billing, insurance, and patient payment are completed. Her time is spent on what she does well.
As the hygienist, I am not spending time entering a treatment plan, generating an insurance claim, or talking about fees. I focused on identification of possible necessary treatment, explaining and illustrating the problem via radiograph and photograph, providing essential treatment notes, and assisting the dentist in promoting treatment according to his diagnosis. My time is spent on what I do well. We work together to provide proper treatment, a smooth transition from the clinical arena to the business arena, and a professional, personalized approach to what the patient needs.
While individual offices may have different mechanisms for accomplishing day-to-day tasks, it is important to develop a philosophy and plan for making sure that it all gets done. In some offices it may make sense for the back office to engage in more computer entry. While in others, a front office person may be required to provide more in the way of treatment recommendation explanations.
Two ideas that might help right now:
1. Identify one “time-waster” the front office has to deal with and see if the clinical staff can help out. A common complaint is that patients get to the front desk with no transition in place and seem to not know why or if they should be coming back. One or two minutes is all it takes for the clinical person to provide such information to the front desk. Plus, it is a courteous method of releasing patients, similar to walking guests at your home to the front door when they leave.
2. Identify one “time-waster” the clinical staff has to deal with and see if the business staff can help out. A common complaint is that clinical staff end up taking charge of “too much” computer entry. Treatment plan and insurance claim generation can be accomplished at the front desk if the proper information has already been entered in the computer.
The important thing to remember is that we do better within an atmosphere of cooperation! The office runs more smoothly, patients are happier, and the bottom line is better.
Carol Tekavec RDH is the Director of Hygiene for McKenzie Management. Carol can improve your hygiene department in just one day of training “in your office.” Interested in knowing more about how to improve your hygiene department? Email email@example.com.
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