Front office protocols matter as much as what happens in the exam room
Risk Management

Front Office Protocols are as Important as What Happens in the Exam Room

Front desk personnel are often the first point of contact for patients, family members and caregivers within a practice. Even simple errors can have a negative impact on patient well-being and leave you open to risk.


It’s important that the person is in this position is trained properly in office protocols. This not only helps to make a good first impression but to also reduces potential risks.

What should your protocols be? According to an article published by AHC Media, “The best strategy is to copycat. See exactly what the industry does, and then do exactly that,” Stein says. “If those protocols reflect what is going on in the industry, and if you follow those protocols very closely, that will practically preclude liability for the [your practice] because negligence is defined as a deviation from what is going on in the industry.”

Regularly review the following policies and procedures at your practice:

Communication etiquette including:

Identification, greeting and check-in procedures

  • Greeting your patients by name and proper title (Mr./Mrs.) helps personalize the patient encounter and builds good rapport
  • Remember, making a good impression is a priority during every interaction, not just the first time

Answering and putting patient calls on hold

  • When answering calls, identify yourself and the name of the office to the caller
  • Ask for permission and wait for the answer before placing a caller on hold
  • If a message is taken, advise when a response might be provided

Handling angry or disgruntled patients

  • Have a chain of command for handling patient complaints
  • Patients with substantive complaints should be invited to discuss their concerns in person rather than over the phone

Triaging Calls:

  • Train employees on how to triage calls and handle emergency/urgent care concerns, including when to interrupt the doctor.
  • Telephone protocol grids are a good tool to manage calls received, and they may help staff triage calls more effectively. More importantly, these grids help staff better understand to whom a call should be directed. Guidelines for telephone protocol grids should specify what information staff members must obtain from a patient in order to facilitate an accurate assessment.
  • Providers may be responsible for any acts or omissions committed by staff members – even when the provider does not know about them. Therefore, you should consider having only clinical staff handle telephone triage as allowing non-clinical staff to provide medical advice on your behalf can increase your liability.

Documenting Calls:

  • Document telephone calls – including the caller’s name and relationship to the patient, the date/time of the call, the reason for the call, any advice given/instructions provided and a call back number.
  • Documentation of all clinically relevant telephone calls must be noted in the patient’s record. Using a standard triage encounter form is recommended for consistency and to help capture relevant information from the call.
  • All telephone calls involving the exchange of medical information or questions about a patient must be documented. Clinically relevant calls can include, but are not limited to: information on prescriptions or prescription refill requests, reports of complication or concerns, requests for advice and calls to patients regarding test results or other follow-up efforts. This includes telephone calls taken after hours.
  • It is important that all telephone entries are reviewed by the healthcare provider. The only way to validate involvement in the care is to document your efforts.

Every process in your practice should be reviewed from the perspective of mitigating potential risk. Policies and procedures go a long way in this regard.


The information in the NCMIC Learning Center is offered solely for general information and educational purposes. It is not offered as, nor does it represent, legal or professional advice. Neither does this information constitute a guideline, practice parameter or standard of care. You should not act or rely upon this information without seeking the advice of an attorney familiar with the specific legal requirements of the state(s) in which you practice. If there is a discrepancy between the site and an insurance policy you have with NCMIC, the policy will prevail.