The Perfect Front Desk Employee And How To Find And Create Them With Dee Bills Of Front Office Guru

As a follow-up to our last episode, Dee Bills of Front Office Guru shares what makes the best Front Desk/Patient Care Coordinator in terms of mindset, attitude, personality, and ability. There is an ideal mindset and an ideal way to train your front desk that will significantly affect your patients and your PT clinic for the better. The front desk greatly contributes to the welfare of patients in your PT clinic. Dee shares her insight in this episode so PT owners can learn how to improve the production at the front desk to have an overall positive effect.

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I’m bringing Dee Bills of Front Office GURU back onto the show because we got distracted and had a different conversation in our last episode than what we had planned. Thanks for taking the time to come back, Dee. I appreciate it.

Nathan, thank you so much for having me. I love chatting with you. This is good. We got to finish the conversation.

There’s more to cover. I’ve already gotten comments about the previous episode. If you didn’t read it, we talked about the five key stats of a front office, front desk and patient care coordinator. You name it. That was a greatly valuable conversation but what we wanted to talk about is what you’re looking for and what kind of perfect mindset the front desk employee has as they’re manning that position. Let’s get into that. What are you looking for? How are you training those front desk employees to have a proper mindset? What is the owner looking for?

The first thing we should always clear up is the word mindset, which is the attitude or belief that someone has. We all have a mindset about different things but when you’re looking at your front desk, you’re looking to make sure that they’re in the right frame of mind or have that right attitude about what their product is, what their purpose is and why are they there. They’re the first and last main point of contact for your practice. You want to make sure that they can handle your patients. There’s a lot that goes into that.

That’s one of the main issues. When you step in to help offices, they don’t know what their purpose and product are clearly. A lot of them say, “My purpose might be to,” and such guides their mindset to, “I’m supposed to check insurance benefits and get authorizations.” You’re like, “You’re supposed to do that but that’s not your main thing.” It is important to get clear on this.

I can pull things off too because if you hire somebody who thinks their job is to answer the phone and schedule people that want to be scheduled, you’re missing out on a huge patient population that still needed your help. Nobody calls your practice because they want to know if you take their insurance. They call your practice because they need your help. A big thing that we want to look for and a big thing I train front office staff members to handle is recognizing that no matter who’s calling, they need your help and having the right mindset, “I’m here to help.”

Their purpose is to help people like yours and mine as providers have been or are. It’s like, “What does it mean to help somebody when you’re at the front desk?” As a provider, we know what it is. It’s to get you results and help you to live a higher quality of life or get over that injury. Often when we hire our front office staff or they’re working for us, they don’t necessarily have that purpose or product in mind. They think, “I’m a receptionist. I’m just here to answer the phone,” but that’s not true or that’s all they do.

What’s an optimal mindset that they should have? Do you give any examples of how they should be talking on the phone and engaging with the patients?

The first thing you have to remember is you can have a positive or a negative mindset about anything. Let’s say we’re talking about scheduling a patient. You’re the patient and I’m the PCC. We’re talking on the phone and I’m like, “He’s got a lot of questions. He’s a difficult patient. There’s no way he’s going to schedule.” What’s going to happen at the end of that? You’re not going to schedule. In theory, I created that. You can also have a positive mindset or belief, “I don’t care what this guy says. I’m getting him scheduled.”

You want to make sure that your front desk can handle your patients.
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The first thing we work on in my courses or training is your product and purpose. We go right into this type of patient handling. The first thing we talk about is the mindset. It’s getting over the “This is a difficult patient” mindset. It’s getting over, “He’s not going to take this appointment time because it’s the worst time of the day.” We talk about going into that conversation with every patient with, 1) I am going to be able to help them and, 2) I am going to help them. No matter what crazy stuff you come up with as a patient, your PCCs have to have that mindset.

I have a pretty clear picture of what the optimal biller mindset is. That person is dogged. When insurances owe them money, they take it as a personal affront if the insurance isn’t paying. They get emotionally involved in it and will go after the $5 copay as hard as they will with the $50 copay. They’re not afraid to call and say, “You owe us money. How can I collect it?” They don’t worry and ask questions about the finances. They get into it. I’m clear about what a biller looks like. I know in essence what a great front desk person looks like because they have the mentality that they care about that person’s care t o the point where they can be relatively upfront and honest like, “You need this care and to be here.”

One of those mindsets that come up often that I’m sure you have to work through is, “They’re not going to schedule because they got a $50 copay each visit.” That’s commonplace. “I wouldn’t pay $50 for physical therapy each visit. Why would I push that on somebody else?” I’m sure you have to work through that and help them understand, “It’s a $50 copay. Spread it out over 10 to 12 visits. That’s $500 to $600. Maybe if you put the right context, they would be more than happy to pay $500 to be able to throw a ball again.” We’re even not thinking about that. What is the best interest for them physically? Focus on that.

Your description of a biller could apply to your front desk. First of all, your front office staff, whoever you’re hiring or whoever is on your team has to see that at the end of the day, those stats we talked about measure their product, which is that ability to help a person. How do we help a person at the front desk? We have to identify everybody that calls that needs our help. We talked about that. We can’t allow objections to getting in the way.

I call you and I’m like, “I want to know if you take my insurance. Can you tell me what your hours are?” A big part of putting your front desk in control of that bus, because in theory, they are, is helping them to be dogged in getting your patients scheduled. You’re a patient. If you call my office and you’re not on the schedule, 99% of the time, I have to be able to qualify that and get you on the schedule. They have to have that mindset of, “The only way I can help you is to get you to see the provider. Whoever the provider is, I’ve got to get you in.” They have to be willing to take on a sales mindset.

If you think about it, your front desk sits in a lot of parts of your organization. They have to be able to develop a relationship. If I don’t develop a relationship with you on that first phone call, people can go anywhere they want. They can make that choice on that first phone call. That first impression does develop a patient mindset. If I’m a patient and you’re cold calling, “How can I help you? Are you a current patient? Let’s get you scheduled,” there’s no relationship there and an agreement that you’re the place for them to be. People have so many choices. The internet or Google gives us a lot of choices.

They have to be of that mindset that their job, no matter what you say, is to get you on the schedule, get you there and get you care. They have to be of the mindset to get you to show up. Whatever crazy objections you throw like, “I’m at work. I realized it is not a good day,” they have to be willing to confront that and be like, “You told me this.” They have to be dog-eared in the fact that, “I got to get you in the door because you’re going to continue with your pain or whatever problem that you have until you get in to see the provider.” They have to have that as a purpose.

They almost have a motherly instinct because the way they say it usually isn’t like, “You need to get in.” It’s very caring. Sometimes it can be laughing as they say, “Come on, you’re supposed to come in.” They have a lighthearted attitude about it but they are serious. You can tell something about that motherly instinct. Compassion and empathy come across in whatever they’re saying to get that person on the schedule.

They have to be good. Part of sales is being good at creating relationships. Your front office sits in sales. Everything I do as a patient care coordinator is a sale. I have to sell you on the need to come in and on that appointment time that I have now, not three weeks from now because you’re like, “That’s the best time for me.” “It’s now when you have a problem.” I have to sell you on that $50 copay. Another big part of that mindset is all of our baggage comes with us wherever we go.

Part of helping our front desk learn how to manage patients is leaving that at the door. I have this discussion with them. We talk about explaining the benefits and costs of care and having those tough discussions, “Do you live on a budget?” They go, “I do.” I was like, “Do you ever look at somebody’s cost of care and go, ‘I can’t pay that?'” They go, “Yeah.”

I’m like, “You can apply that to the patient because if you have that mindset when you’re explaining a patient’s benefits to them, you handed them a problem.” I could look at that and go, “I want to be able to throw a lacrosse ball with my son or daughter. I can’t do that.” If you apply it as a problem as a patient care coordinator, I will all of a sudden go, “Maybe I shouldn’t want to pay $50 or $100 depending on deductibles, a visit and things like that.”

That makes me think that if they question the value of $50 per visit for physical therapy, that comes across to the patient, “$50 a visit is a lot. I don’t know if you’re getting $50 worth of value out of this clinic.” That’s a big no-no. They have to be convinced themselves that what they’re providing in their clinic is more than worth it. They should go out of their way to pay $50 to get better. They have to overcome that mindset. I could see that being a big hurdle.

That’s a developed mindset. Think about it. We have talked about this 100 times before. You and I are providers. How many of us are providers? How many years of school did you and I go to master our craft? We still came out of school where some people do residencies or internships. Some have a mentor for a couple of months or a year. Yet we hire people for our front desk, which is a sales position. Believe me, I’ve sat there. We expect them to produce early on, right away and fast.

You have to develop a mindset. I understand. You may have fears of paying that cost of care but if you don’t handle that within yourself as a patient care coordinator, you will project that onto the patient. Think about that. The patient’s money is going somewhere. It’s either going to come to us if we’re talking about physical therapy or occupational therapy. As a provider, we know that we’re going to handle that. If it doesn’t come to us, where are they going to go and spend their money?

There’s the injection after injection or wherever it’s going to go. We have to look at this as a business. Our front desk has to be able to see this as a business. We’re not selling our crappy product here. With every clinical provider I know like PT, OT or speech, if somebody doesn’t need our care or we’re not the right providers, we’re pretty darn good at going, “I’m not the person you should see first. Let’s refer you to X.” Does that happen on the other end? I don’t know.

I look at that and say, “We have to help our front desk understand that our product is honestly the most non-invasive form of help you can get.” If they don’t come to us, they’re either going to spend the rest of their lives or months at a time suffering in pain, which will cost them money, time, happiness and the ability to live a high quality of life. They could lose their job and end up with lots of bills. We were talking about this. I went to a quilt convention with a friend years ago.

I was telling one of my clients. We were wandering around. I’m walking through and they said, “There’s an E-Stim unit group selling E-Stim units to these ladies who spend too much time in a chair quilting.” PTs, you should do this. Go to these conferences or conventions in your area or promote them. These ladies are dropping thousands of dollars at these conventions. That’s a good example of where that money is going. It might be unnecessary but if I could get my hands on one of those patients, I can give them the tools for life.

That front desk person has to have a belief that the physical therapy they provide and the physical therapists within are experts in musculoskeletal care. They provide a tremendous amount of value that isn’t necessarily measured by the copay. We provide more value than what we are getting paid financially in most cases. That has to start with the owner and the providers themselves recognizing that they provide immense value and truly believing that.

You can have a positive or a negative mindset about anything.
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If that doesn’t come across and if the front desk doesn’t believe it, then it’s impossible for that front desk to then portray that, hear that value and recognize the urgency for which those patients need to come in. They have to believe that, 1) We provide immense value and, 2) We are musculoskeletal experts. We provide the solution to their problems.

If they don’t believe that, it’s going to be a hard sell. On top of that, if they’re not people persons and they don’t get energy from engaging with people all day, that’s a tough job to have because that’s all you’re doing all day. You want to find those people who want to engage with patients, call out, talk and develop relationships. You got to find that right away.

They have to be willing to communicate well. We have several steps in our hiring program. One of the steps before I ever bring anybody in is to do a phone interview. I always like to say, “If you can’t sit on the other end of the phone and talk to me like you’re talking to your mom or best friend and you can’t have a focused, interested and excited conversation with me, what are you going to be like when you’re working with patients?” Day in and day out, you’re on the phone with people over and over again.

The practice is Mike and I joined it very late in the game to help him on the admin side. One day, my mother-in-law was helping us out. She has been a patient of ours forever on and off over the years. She knew I was doing all this hard work. One day, she texts me, “Call your clinic.” I wasn’t there. I was driving in. Finally, I called her. I’m like, “What?” She’s like, “Call your clinic and then call me back.” I called the clinic. Eeyore was working at my front desk.

This was early in the game long before I was doing this. I kid you not, it was like, “Good afternoon. LSTC. How can I help you?” I’m like, “She sounds dead.” I don’t know about you but the average person listens to who answers your phone. That’s a big thing we look for. Can you spend for an interview 30 minutes in our clinic answering our phones? I’m not looking, “Can you handle my clinic stuff?” I haven’t taught you that yet but, “Can you handle those conversations?”

We give them a script. It’s four parts to a greeting and then say, “I would be more than happy to help you with that. I have the right person that can help you. Give me one second. I’m going to transfer you over.” Trust me. We will have the staff or trusted others call the clinic and listen to that tone of voice because I could look at this person in my clinic and not see it. I love my mother-in-law for that. I got on the phone that day. When Eeyore entered the phone, I was like, “That’s why our evals are doing this.”

I agree with you that they have to care. They can’t be a cold impersonal person. They have to realize that’s sales. Sales are relationships. It’s not giving people everything they want. It’s being willing to have tough conversations. It’s also that relationship. A patient for life is never going to happen if your front desk isn’t interested in that patient and being like, “Nathan, what did you do this weekend?” They’re interested in them and their need for your help. That’s another mindset.

There are those people who have a front desk person. You want someone at the front desk that’s organized. Maybe you take someone on that is organized yet doesn’t have the personality or isn’t clear. I get that starting with their purpose and product is a great place to start and helping them understand that. Are there 1 or 2 other things that helped turn that ship and get them headed in the right direction?

My name is a big part of it. This was my biggest reality check years ago when I was in the practice with Mike. As providers, we go to school for years. The people we hired to treat our patients have gone to school for years. They have skills training. They know how to handle things. We might have to help them tweak it. If you’re hiring somebody because they say they have experience somewhere else, they could be bringing with them a ton of bad experiences or habits that they learned at another provider.

If you’re like me and you hire people that have no experience, either way, if you don’t train them up on what you need and want, what your systems are and what you expect for handling patients, you’re doing them a disservice. Prior to the training that I’ve created, the average front office person is on the job. It’s playing that game of telephone. I whisper in somebody’s ear and they whisper in somebody’s ear.

All of a sudden, you as an owner walk upfront and you’re like, “That’s not what we were doing 3 months or 1 year ago.” The staff is like, “That’s what so-and-so told me.” So-and-so is like, “So-and-so told me this.” You’re like, “I don’t believe in it.” Training is a big part of it and making sure that they understand their roles. We’re not geared towards sales. We’re geared towards relationships but we’re not necessarily geared towards handling those tough objections and all of that.

Training is a big part of it so that you can give them what they need to not be afraid to confront people because if you don’t, that’s where you will find them filing, faxing and leaving voicemails versus working hard to get that patient to call them back, “That Nathan guy was difficult the last time he was here. What do you think is the mindset I go into that with? Please don’t answer the phone.” I say that on my coaching calls and they start laughing because they know exactly what I’m thinking.

I’m like, “Don’t do it because you could make a list of all the people you don’t want to talk to you.” We all laugh and move on. The other thing with that is scripts and drilling. There’s a reason why your staff doesn’t use the script that you got off the internet and handed to them. I can give you 50 scripts. Your staff isn’t going to be able to use it without understanding the why behind using it. What does it do for them? How does it help them and the patient?

That’s the training side of it and then there’s the drilling side of it. Look at professional athletes. Look at you and me as PTs when we had to learn shoulder mobs. You had to practice that over and over again until you felt that end feel or until you understood the grades. Will you look at your front desk staff if you aren’t willing to practice with them? I give you a script. I expect you to learn it or at least learn how to use it context-wise. That’s the training you have to give them.

The other side of that is if you don’t practice it with them, they don’t have somebody to practice it with. I used to play soccer in high school. If I wanted to hit that top-left corner of the net, I better stand outside on that field. My dad built a goal. I used to have the practice out there over and over again to hit that top-left corner. If I want to do that, I’ve got to practice.

The same expectation has to be there for your front desk. That’s part of the mindset. This is all of us. You accumulate fails. “I didn’t figure it out that time. That’s a fail.” That’s the number one reason why staff quit or fail at their job. They’re not trained or haven’t been encouraged to practice the right way to handle something or work with somebody to do that. It’s the number one reason that they will fail at their job and why all of a sudden you hire somebody and then 2 to 6 months later, they’re down.

It’s the Eeyore status. They have failed too many times at trying to help somebody. It’s not because they suck at their job. It’s because either they don’t have the training behind it to know why they’re doing it or the drills and the practice into it. We don’t put a front desk person on the floor online until we train them on one thing, practice it and put them out on the front desk line.

Some we pull back off the lines, train them on something else, put them back on and expect them but I won’t move you forward in training. I try to teach others this too. We try hard, “Don’t give them something new on their lines until they can handle it.” If I’m like, “Here’s a script on this. Let me do this and that,” which is my first day of training for the first team that I built. I had to go home exhausted because I had spent thirteen hours talking to people and trying to show them things. I would go home and it was awful. It’s training and drilling. Those are the keys.

Your front desk has to be able to develop a relationship.
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In our team, we did a lot of role-playing. Initially, some people hated it but you have to force the issue and give them the opportunity. You might give them a script but maybe sometimes they need to come up with their words so it feels comfortable for them. You can say, “Say these words or these three sentences verbatim.” Maybe they don’t feel comfortable saying that verbatim but they can use their personable form of that to say the same thing.

You want to play with that and intonations. We would do that with providers, especially about how they’re “selling” the plan of care, getting patient engagement or talking about what we’re going to do with them to get them engaged. You have to do that with the front desk over and over again and practice that. Maybe you have experience in this.

I would assume people who anxiously want to engage with people are more than happy to role-play with you. It’s usually the little bit more introverted, “I don’t want to do this or engage with people,” that don’t want to role-play. They might not be the best fit for the job in the first place but people who want to engage with people are more than willing to do that kind of training.

That’s a good question to ask when you’re interviewing somebody, “How do you feel about learning?” This came up in one of the groups I was in. Some of the people that are applying for the front office job want $27 an hour or some high amount of money. I understand that but one of my questions would be, “How do you feel about learning?” Here’s one of the big things I’ll do in my process. If I can’t afford somebody’s very high request for salary, there are two things I look at. One is stats.

“If you can produce and you’re producing at this level, you’re that valuable to me but when you first start with me, you can’t produce at that level. How do you feel about starting at this number and working toward that number? As fast as you can get to this level of stats, I can get you to that number.” That’s one part of it. In the role-playing part of it, they have to find their script. When I do my Cancellation Prevention Program, it’s the only place where I say, “Don’t change my scripts. I still want you to sound like you and Sally to sound like Sally but from years of 95% or better arrival rate, I know that works.”

When I give other scripts, I’m like, “There are keys to using any script. The first is I have to have the right mindset and sound certain because if I don’t sound certain, you as the patient are going to take me down a path.” I always say, “You’re going to go down that Alice in Wonderland path where you don’t want to go and then you can’t get out.” You have to know what the purpose is and how to handle them. That’s where the practice comes in. You can do that in the hiring process.

That’s where the phone script that we hand somebody comes in. We want you to learn this. You’re going to answer the phone and we’re going to listen to you. Do you sound like a robot? “I can help you with that. I’m going to transfer you to the right.” Are you like, “I can help you with that. I’ve got the perfect person for you to talk to you. Give me a second. I’m going to transfer you over.” The next time you say it, maybe you say it slightly differently but it still has that high level of certainty and interest in help.

We all know that the front desk person is the face of the clinic, essentially. Patients are going to see them as they come in and leave. Huge interactions and a lot of issues can occur at the front desk that has nothing to do with the physical therapy care you provide. If that goes south, then it’s a reflection on the clinic as a whole even if you provide great therapy. What are some 2, 3 to 5 keys to generating a great first impression?

The tone of voice is one. Think about it. Let’s say you’re the patient walking into that practice for the first time. What are you looking for in that front desk person? The first thing I’m looking for is, do they greet me? Are they prepped and ready for me to come? A big part of that is, are they looking and listening? Do they get to know people quickly? Do they acknowledge that person?

Even if I’m on the phone with somebody, I should be able to look up and be like, “One minute, I’m on the phone,” even if I’m all by myself in the clinic. Do I have that good personality to be able to do that? Am I willing to confront things I don’t like to confront? I don’t mean confront in a bad way like, “Let’s fight about it,” but, “I know this is a difficult patient.”

I’m working with two pediatric practices one-on-one. It’s funny. I laugh with them. They’re across the country from each other but they both have the same issues with parents. I’m a parent. You’re a parent. I will fight tooth and nail to the death for my kids to have the right care. In a pediatric PT practice, those parents are used to fighting a system to get their kids the care they need to improve developmental issues or delays.

They come into your practice ready for a fight. Yet think about the average PT practice or practice that’s treating pediatric patients. They’re so loving and caring but then these parents come in. These poor PCCs are like, “Here comes another one.” I’m like, “You got to get over that mindset.” It’s like, “I can confront this and show her that.” Their certainty is involved in that.

I have to sound certain when I’m talking to people. A good thing I always say is, “Don’t ask a yes-no question.” You don’t want your PCCs to say, “Does that time work for you?” If I’m like, “Nathan, I can get you in at 10:00 tomorrow,” that’s a great way to say it. I go, “Does that time work for you?” I gave you a yes-no question. What do you think you’re going to say 85% of the time?

“I’m not so sure.” It’s easier to be noncommittal.

That’s where the objections go up if the PCC doesn’t sound certain if they ask a lot of yes-no questions. That’s where the nice get in the way. That’s something that has to be trained out because social graces have taught all of us that being nice is making sure it’s okay. The reality is if I know you need help, no matter what your objections are, I don’t have to be a jerk. I always say, “Ladies and gentlemen, you have to be the smiley and lovely presentation at the front desk.” They have to be willing to recognize the difference between social graces, which is being nice to people. You called to cancel and I’m like, “Would you like to get rescheduled?” That’s a trained thing because it’s not something that fits into the average person naturally.

Some of that goes back to the certainty that you’re talking about. I’m making some connections as you’re talking. As you ask yes-no questions and if that’s okay for you, you’re coming from a place of uncertainty. You’re unsure like, “It’s not okay if you’re not okay.” Whereas if you don’t ask the yes-no questions and give them options that are acceptable to you, then you’re coming from a place of certainty, “This is when we’re available to help you and when you need to come in. I’m not going to ask you your opinion on that. We know what’s best.” It goes back to something I remember one of my guests said, “The patients will only take your therapy as seriously as you do.”

If you don’t think it’s of value, you think it’s okay to cancel or come 1 time a week instead of 3 times a week and you’re okay with that, then they’re going to be okay with that. If you say, “You can’t come in one time a week and get the same results. That’s impossible. You can’t come in whenever you want. You can only come in at these times that are available for your provider. It’s not your world and we’re living in it. This is where we’re coming from,” then they will understand you are serious and take it as a serious commitment between the two of you. Whereas if you’re flexible and wishy-washy, then they’re going to be wishy-washy with the care.

The reality is you’re right. That’s your whole practice. First of all, our entire practice’s main purpose is to help people. It doesn’t matter if I’m in billing because if I don’t do a good job with billing, verifying or authorizations, the patients can be pretty pissed off when all of a sudden, they have a $10,000 deductible and thought it was $1,000. It’s even billing and clinical sales too. I have to make sure that you buy into the plan of care. We have to remember, who’s the expert here, us or the patient? Even if the patient’s best friend is Dr. Google, I still went to school to get my degree and so did you.

Part of sales is just being good at creating relationships.
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It’s not just our front desk. It’s why I use patient care coordinators and not receptionists or representatives as the term when I hire people for my front desk and speak to them. A coordinator’s job is to coordinate things. Whereas a receptionist’s job is to make it feel like they’re receiving but it doesn’t give you the impression that they have to handle somebody. Unless you want your clinicians, PTs, OTs or whoever else scheduling patients and taking time away from providing care, you need that person in the front that isn’t afraid to have a tough conversation.

In most cases, they need your help to know how to do that. They need somebody to role-play and tell them why. That’s a big problem with scripts. If I don’t teach my front office team why, how that helps and how it’s going to help them, they might be like, “What am I doing wrong here?” I say the same thing, “Let’s look at the difference here.” It puts a lot of undue burden on them because then they don’t know how to handle that problem.

They’re navigating something unfamiliar to them. They’re left to their devices. That can waste a lot of energy. They can then endure a lot of mini-failures, which can be deflating.

It is hugely deflating. It doesn’t matter whether you’re clinical or front office if you rack up enough failed attempts to help somebody. I’m a PT for years. I look at a PT and say, “New grads, if we don’t provide them with sales training and patient management training, they get in there and want to do the same thing the front desk wants to do.” They say, “This is the plan of care.” The patient goes, “It’s so expensive. They told me how much it was going to be. I can’t do this.”

You look at that and say, “I went to X number of years of schooling. It’s way longer now than when I went. I’m the expert here.” I’m not saying they say that outwardly to the patient but if they don’t have that tough conversation, they’re not creating that value. For me, it’s very rare for a patient in our practice to be one time a week even late in the game because they have stopped seeing the value and having that progression we need them to have. They’re going to go somewhere else if you don’t meet their needs.

As you implement some of these things, I’m sure you can see changes in clinics rather quickly once you start doing some of the basics, whether it’s making sure they’re clear about their purpose and product and doing a little bit of role-playing. As a rule of thumb, what change in key statistics do you see regularly? If you show them these things, are you seeing arrival rates jump from 80% to 90% rather quickly? Are you seeing over-the-counter collections? What real-world changes are you seeing as you implement some of these in a small amount?

My number one goal is to put your front office staff in a position of control, not bad control like, “I’m going to drag a patient along the way.” That’s not control. Control is the ability to know what I’m supposed to be doing, get a result or product and help that patient. What you will see first of all when you work with them is they’re sitting up a little bit higher. They’re like, “I know how to handle that,” even if it’s the simplest little thing of, “I can get you in at 10:00 or 2:00.”

They start using more statements in their scripting versus, “Would you like to? Could you?” They start to speak more directly. They are sitting up a little bit taller and start to realize their role. Their role is not to fax, file or phone. Those are all tools that we use. Their role is to help that patient get care. All the stats go up. If you put in the right training at your front desk, stick with it, you have the right people and you’re not afraid to replace people, your stats will go up and stay up. It’s those stats we talked about.

You want your front desk team to be converting as many of those leads, referrals, phone calls and walk-ins as possible because the person needs your help now. They don’t need you a month from now. I’m not saying they don’t but if I’m calling now, I need it now. Conversions of people go up. My goal for most practices is that 90% of leads are converted on that first phone call, not down the road. That is a tough one. That’s a sales call.

We have a set of processes that we want them to do during that phone call to handle it. There are new patient arrivals. If they don’t arrive, you can’t treat them, prescribe a plan of care and fully sketch out plans of care. They should go up. You should be seeing 95% or more of your evals that have come out agreeing to a plan of care because agreeing to the plan of care is your clinical side. Schedule out a full plan of care because that provides more certainty for your practice.

There’s the arrival rate. I spend about five weeks with practice on my cancellation program because I want them to have the same results. The average practice that works with me regardless of where they start is hitting around 93% to 94%. That’s pretty fast. Even before we hit the end of those five weeks, I’ll give you the pediatric practice. It’s not very far for me. There are some disbelievers in that group. They’re like, “These are kids. Kids get sick. This happens.”

Before they even rolled it out, they have a little bit of stomach flu going on. The numbers have gone down a little bit. They were at 93% and had been 70% prior to that. I see that it doesn’t matter unless they don’t use it. If somebody is not using the training, whether it’s me providing it, somebody else providing it or you change it, you and I know that from other training we have done. We go change something that works.

I have a good friend. We Voxer almost daily. We were talking about something. I’m like, “Are you tracking stats?” We were going back and forth about this. I was like, “The stats tell the story.” All of those stats tell you what’s working in your clinic and what’s not. If you’re not tracking them, you have no story to evaluate. Some other owner once said, “No stats, no discussion.” I’m like, “Are no metrics no discussion? I like that.”

It is true. If you are not tracking stats, you have no clue. You walk around spinny and confused. If you don’t use the stats to tell you what’s working and what’s not, you’re going to be pretty frustrated because you think, “This is the problem.” It doesn’t matter what department but it’s the front desk for sure. If they’re doing the stats and the stats are down, it’s telling you and your staff where to fix it.

Here’s the last question. Thank you for your time. This is April 2022. I get this question quite often. What are you seeing on average as far as a decent pay range for a patient care coordinator? Do you have any idea? This was years ago but $15 an hour would do us okay. It’s closer to $17 to $20-plus.

It’s somewhere between about $17 and $20. My friends in New York, some of my friends in California and the people that were on that thread were talking mid-$20. Here’s my thing. You can pay somebody too much money that can’t produce for you. I’m going to take it in a little bit different direction here because this is a conversation I have with people. I’ve done this before. I’ve hired people that I couldn’t afford but I convinced them to take what I could afford. When they produced, I paid them what they wanted. It’s part of the interview process.

You can’t sacrifice what your practice can afford. Think about it if I pay you at the top of the range. Let’s say I pay you $27 an hour. You either have experience at another clinic but not the experience necessarily I need or you don’t have experience but you’re like, “I deserve $25 an hour.” Where do I go from there when I finally do get you producing? Whether you work with me or another consultant or you create your training, you’re investing a lot of time and money to help this person to be able to be highly successful in their job.

PT, mentors and front office, you want to make sure that person is producing when you pay them that. I like to say, “This is where I’m at with this. I can afford X to start. I’ve already qualified. Are you willing to learn because I’m going to train you heavily for the next five weeks?” I’m looking for a lot of interest in that. My hiring process has testing in it. It’s like, “Here’s something to learn overnight. Come in tomorrow. You’re going to do it.” If they come in and are not using it, it’s not worth my effort.

If I know you need help, I need to get you in no matter what your objections are.
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Part of this is qualifying before you get to that salary talk of, “Here’s what you want to make. How fast do you want to do that? Are you willing to work hard, produce, start tracking your metrics and prove to me that you’re worth $25 an hour?” If they’re not, it’s almost like beating a dead horse. The average is pretty close to $19 to $20. It’s like, “The arrival rate and conversions better be killing it.” If you’re not, I can have providers that I’m paying and a place that I’m paying for. I’m not generating enough income and our margins are tight. I would look at that on that. It’s not black and white.

It’s an opportunity, especially if you’re talking to someone who has medical experience. “FYI, our arrival rate is at 80%. I can pay you what you want with $20 to $22 an hour if you can get that up from 80% to 92% to 93%. Do you think that’s something you can do? Are you up for that?” Having those conversations during the interview might save you a lot of headaches instead of laying that on them after the hire. Talk to them about over-the-counter collections, hiring and what their purpose and products are. “Your job is to not just fax the results. Your job is to get patients on the schedule.” Having those kinds of conversations upfront might go a long way.

It’s huge. If you don’t do it, you’re opening yourself up to a world of problems.

Thanks for your time, Dee. It was great to catch up again.

It’s always great to chat with you, Nathan. Thanks for finishing our conversation and us staying in the right direction.

If people want to get ahold of you, how do they find you?

They can check me out at FrontOfficeGURU.com. I have a free report on my website they can check into. You can schedule a free call if you’re like, “I want you to train my front desk or look at options.” It’s learning more about you and making sure we’re a good fit.

I’ve referred plenty of my clients over and gotten great value. Especially as owners, we don’t have the playbook for the front desk. We train as we go. It’s a little bit easier to say, “Someone else has the playbook. Invest in that. They’re going to provide you with everything you need.” It’s easier to go down that route instead of starting from scratch.

I’ve already made all the mistakes for you. After years of doing one-on-one with practices at this point, not only have I made my mistakes and handled them in my clinic. As I work more with practice, I learn more. The system gets better and faster. That’s the goal.

Thanks for sharing.

Thank you so much. I look forward to chatting with you again sometime soon on my side of things.

Thanks, Dee.

Have a great day, Nathan. Thanks.

My experience as a practice owner has led me to develop specialized training for my front end staff to help us capture all potential patients at the initial call and to prevent the high rate of patient drop offs that can occur when the front end has difficulty handling patient needs and objections. My programs offer private practices specialized front office training to ensure your staff can prevent common issues from occurring. When your front office is well-trained, your practice begins to run like a well-oiled machine and you maximize your practice’s efficiency.

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