Front-End Revenue Cycle Best Practices for Rural and Critical Access Hospitals

Some of the most important ways you can create a positive patient experience and a smooth revenue cycle begin before patients ever arrive at your rural or Critical Access Hospital. Many of these front-end activities are related to scheduling and registration in advance of a patient’s visit.

Pre-Visit Best Practices

To set up a patient for success, start by thinking about the 5 Ws (plus 1 H) you might remember from school, Who, What, When, Where, Why, and How:

  • Who is going to arrive? Will it just be the patient, or will they bring a family member (or an entourage of family members)?
  • What will they bring with them? What do they need to provide when they show up? (like insurance cards)
  • When are they going to arrive? For an 8:00 procedure, can they arrive on time, or do they need to come early? When will the staff be ready for them?
  • Where will they show up? Should they go to the ER or the registration desk, or will they be admitted directly to the floor?
  • Why are they coming? Do they know what services they will be receiving, or are they coming in to figure out the care they need?
  • How will they pay for services? Do they have insurance, or are they planning to pay for services themselves?

These are the questions you are asking to manage scheduling and registration, but they are also the questions the patient will be asking. If you follow these scheduling best practices, you can anticipate and get ahead of potential challenges:

Put the patient at the heart of the revenue cycle process.

This is your first point of contact with new patients. You have the chance to build a good relationship with patients before they come in, fostering satisfaction and loyalty through small actions. A simple phone call, explaining what they need to do and answering any questions they have, goes a long way.

Encourage revenue cycle staff to help build a better business for the hospital.

Remind every staff member to act as an agent for patient satisfaction and, ultimately, loyalty and relationship management. Provide scripts for staff to follow to provide consistent, high-quality customer service.

Create standardized processes to streamline the patient experience.

Develop a pre-registration process to improve registration on the day of the visit, and address any non-covered services. Standardize data provided by referring physicians for scheduled services, and centralize scheduling for services in one place so patients are aware of required documents and financial obligations. Develop a process to ensure the physician order is available at the time of scheduling or ahead of the service date.

Pre-register patients.

Obtain and enter:

  • Patient’s demographic information, such as patient’s name, date of birth, address, phone number, gender, and race
  • Reason for a patient’s visit or pre-ordered service
  • Insurance carrier information, such as the subscriber number, group number, and subscriber demographic info
  • Employer information
  • Preferred pharmacy

Complete insurance verification.

Verify insurance in advance to make receiving payment more efficient and minimize the chance of claim denials. Use the patient information obtained from scheduling and registration to go through the following steps:

  • Run verification on all admissions, including reference lab tests
  • Leverage the use of available online verification tools
  • Perform insurance verification on any secondary and tertiary insurance
  • Look for Medicare-aged patients presenting their cards who are covered instead by a Medicare Advantage plan
  • Review Medicare-aged patients that do not present any Medicare or Medicare Advantage information
  • Understand that self-pay patients may qualify for state Medicaid coverage or charity care
  • Predetermine if services will meet medical necessity or need prior authorization
  • Ascertain if “No Surprises Act” provisions are required (for example, good faith estimates, notice, and consent)
  • Identify required co-payments, deductibles, and previous balances
  • Track insurance verification rate to ensure process is efficient and effective


To learn more about how our team can help you with revenue cycle best practices, connect with our team.