The Havoc Created by Duplicate Patient Entries

I had this primary-care physician that I used to go to. She was a fantastic doctor, understood my needs, took very good care of me, was on time, the front office staff were friendly - the works. That is, until it came to the billing. They had me in their system spelling my first name differently three different ways. I have no idea how they were actually paid by my insurance company, as we all know the patient name has to match the name on the card. Oh wait, I remember. They didn't get paid. They passed the balance to me rather than fixing their spelling error. The billing itself was never correct because one time one account would be charted on, billed, and monies posted to, and then next time it would be a different account. Some of these billings and postings would cross and I would get a large refund check, and the next day, a large bill for the same amount. It was just chaos.

It happens all of the time, particularly if you have a high front- or back-office turnover, who don't remember patient names or faces very clearly, or at all. Typically, software systems will discharge or archive patients who haven't been in for a while, and a year later when they return, an unseasoned staff will forget to ask, "Are you a current patients of ours? Or, "Have you seen Dr. Smith in the past?" Then they add the name to the enormous database again. This can wreak havoc on your scheduling, charting, and billing; particularly if you use more than one system.  There have been patients seen at a practice and later receive two bills with two different name spellings.

So, what's a practice administrator to do? A few simple housekeeping reminders will keep those pesky duplicates out of your systems.

• Run a patient report by birth date. This should yield your greatest opportunity to capture any duplicate entries in your system. Susan Smith and Susan Jones show up as the same birth date, and you skip over it, but Susan was married last December and changed her name. It's a good idea to make a note in the chart to ask the patient if her information has changed since the last time she was in to be sure this is (or isn't) the same person.

• Have a sign posted at your front desk: "If any of your information has changed, please let us know immediately." This can be a different last name, address, phone, insurance plan, etc.; anything pertinent to getting clean claims out the door.

• Ask your billing department to run similar reports and merge accounts. Again if you are charting and billing on one account, and a patient sends in a payment and the poster pulls the patient up by name instead of account number, they can easily post on the incorrect account, leaving one with a large bill and one with a huge credit.

It seems like a simple oversight, but it creates a lot of problems down the road. So, do yourself a favor and clean up your databases, your patients will thank you.