The Successful Conclusion Of The First Visit By W. Karl Parker, B.A., D.C., F.I.C.C., F.A.C.C. behapy@karlparkerseminars.com As discussed in the previous article, the final two steps in conducting examinations were to give the patients hope and discuss fees in private. 1. Give Patients Hope - It is important to understand this concept. It is best to NOT tell patients you can help them until the report of findings when you officially accept their case. This gives the doctor the opportunity to thoroughly review the database of history and examination findings to properly arrive at the conclusion to accept the patient and what program of care is best. It is recommended to let patients know you (chiropractic) "have had great success with cases very similar to yours." This should be followed with the famous åhope statement¼ "I certainly hope I can accept your case and help you too. We'll know on your next visit." 2. Discuss Fees In Private - It should be obvious this is best rather than in front of or even within earshot of anyone else, especially other patients and even other staff. If your front desk is arranged where the control CA can discuss the fees with the patient at least semi-privately, it is best done there. The front desk is generally where all future payments will be made and the control CA is generally the collection CA. If the front desk is not set up where there can be privacy the control CA should take the patient to a room where the fees can be discussed in private. If the X ray tech is qualified and trained, he\she can discuss the fees with the patient before the patient goes to the front desk for payment. The collecting CA should go over each service rendered and noted on the standard office fee slip explaining each service and the fee for that service. Then a total for all services should be given. The CA can make a statement similar to the following: "Today, Mrs. Jones, we performed several examinations. We performed a consultation as well as a spinal check-up and Scoliosis screening preliminary examination, for which there is no charge to you. We do this as a public service at our expense. We also performed a thorough neurological examination, an orthopedic examination, a range of motion examination, a kinesiological examination and a spinal examination and analysis. The total charge for these examinations is $_____ (Or give a fee for each exam performed). We took a (name X- ray views taken and fees charged for each). The total charge for the pictures is $ _____ which makes a total of $ ________ for today." If the fees are explained by the X- ray tech or someone other than the front desk control CA, the patient is then sent to the front desk for payment with a statement similar to the following: "You can take care of these charges today by cash, check or credit card with Judy at the front desk. Judy will also make you an appointment for you and your husband for your report of findings." When collecting the fee, the control CA should read the charges from the fee slip. When finished reading the fees, the CA should look the patient in the eyes and say "Mrs. Jones that will be a total of $ _______ for today. Will that be cash, check or credit card?" At this point look down and start writing a receipt. If you look up before the patient responds, you will have lost control of the collection process. This first visit collection procedure is very important because it will set a precedent for all future financial dealings with the patient. If you establish collection control from the beginning by following the above procedure (and all the special nuances taught at KPS), all future payment problems will be greatly minimized. If you lose control on this first visit collection process you are setting yourself up for continued future collection problems. After you have collected for the first visit charges the CA makes a statement similar to the following: "Of course, Dr. Parker will have to study the results of these examinations and pictures fully and arrive at a conclusion regarding your condition before considering accepting your case. The cost of this detailed evaluation as well as a Report of Findings consultation is included in today's charges. Dr. Parker should have this evaluation completed by........ "This next visit is very important, Mrs. Jones, for Dr. Parker will completely explain his findings in your case. He will show you your films and will explain what all of the tests have told him about your condition. If he finds the cause of your trouble, he will explain it to you as well as give you his recommendations as to what he needs to do to correct the cause of your problem. Dr. Parker feels strongly that this report, so important to your health, should be explained to both you and your (spouse, family member, close friend etc.). He will also, at that time, be happy to answer all of your questions. The earliest appointments that Dr. Parker has available at this time for you and your husband for your Report of Findings are (give choice of two appointment times). Which time would best fit your schedules. If the patient questions importance of their spouse attending the report of findings, the CAs response should be "Dr. Parker has found it to be extremely valuable if he explains your problem and what you need to do to get well to your spouse personally so he can completely understand what you are going through rather than you having to pass the detailed information along." Or, "Dr. Parker feels strongly that his patients' health is a family affair and he feels better results can be obtained if both patient and spouse fully understand his findings and all work together to get maximum results." When the appointment is made for the report of findings visit the patient should be given appropriate questionnaires, pamphlets, and instructions. Placing these in a portfolio is excellent. As the patient is given the portfolio containing the above material, the CA should make a statement similar to the following: Dr. Parker needs you to do something for him that will help him to better help you. First he would like you to read these pamphlets (show pamphlets and state titles). These will give you more information about what Dr. Parker is doing and will help you better understand your condition. You also need to complete these questionnaires which will give Dr. Parker even more in depth valuable information regarding your condition." The CA completes this visit by following up with giving the patient hope. "Well, that takes care of everything for today, Mrs. Jones. We're sure happy to have met you (shake hands) and we will be looking forward to seeing you and meeting your husband (state day and time). And, Mrs. Jones, I want you to know that I have seen Dr. Parker help many people with conditions very similar to yours (if this is true and the patient knows the CA has knowledge of the chief complaint). I certainly hope he can help you, too. (Pause). We will find out on your next visit." Do not hesitate to call the patient and ask questions to gain pertinent information when necessary. As a matter of fact it is a valuable procedure to always call the patient after the first visit to obtain additional information if you can. If after going over the consultation, examination and X-rays you are not sure you have all the information you need to determine if you can help the patient or recommend a treatment plan, delay the report of findings appointment and schedule the patient for an extended examination visit.