Medical Office Workflow Assessment Form
Assess how your medical office workflow operates, where bottlenecks occur, and which improvements would have the biggest impact. Do not include sensitive medical or health information.
Workflow Profile
Practice Area or Workflow Area Being Assessed
*
Respondent Role or Job Title
*
Office Size or Patient Volume Band
*
Please Select
Solo practice
2-5 staff
6-15 staff
16-30 staff
31+ staff
Under 20 patients/day
20-49 patients/day
50-99 patients/day
100+ patients/day
Other
Primary Workflow Focus
*
Please Select
Patient scheduling
Appointment check-in
Patient intake
Insurance verification
Clinical documentation
Referral management
Billing and claims
Phone and message handling
Lab or results follow-up
Care coordination
Other
Workflow Assessment
Workflow Assessment Matrix
*
Rows
Poor
Fair
Good
Very Good
Excellent
Appointment scheduling
1
2
3
4
5
Patient intake
6
7
8
9
10
Insurance verification
11
12
13
14
15
Front-desk communication
16
17
18
19
20
Chart/record handling
21
22
23
24
25
Billing handoff
26
27
28
29
30
Follow-up coordination
31
32
33
34
35
Internal task handoffs
36
37
38
39
40
Overall workflow efficiency
*
Poor
1
2
3
4
5
6
7
8
9
Excellent
10
1 is Poor, 10 is Excellent
Operational Bottlenecks and Improvement Priorities
Top workflow bottlenecks
*
Patient intake delays
Appointment scheduling inefficiencies
Insurance verification delays
Charting/documentation backlog
Referral processing delays
Billing/coding delays
Communication gaps between staff
Lab/imaging result follow-up delays
Room turnover delays
Other
Biggest improvement priority
*
Reduce patient intake delays
Improve appointment scheduling
Speed up insurance verification
Reduce documentation backlog
Improve referral processing
Reduce billing/coding delays
Improve staff communication
Accelerate result follow-up
Improve room turnover
Other
Comments on specific process issues, delays, or inefficiencies
Follow-up Details
Preferred Follow-up Method
*
Email
Phone
Other
Best Time to Contact
Additional Follow-up Notes
Submit Assessment
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