Understanding New Patient Check-In Procedures

A "new patient" is someone presenting to a practice or provider for the first time, or who hasn't been seen in ≥3 years (per CMS/E&M guidelines). Check-in involves:

Standard New Patient Workflow

1. Registration: Demographics, insurance, emergency contact, pharmacy, preferred language, portal enrollment
2. Consent & Policy Forms: HIPAA acknowledgment, treatment consent, financial responsibility, telehealth consent, communication preferences
3. Clinical Intake: Completed by MA/nurse before provider:
   • Chief concern, HPI (History of Present Illness)
   • Review of Systems (ROS)
   • Past Medical/Surgical/Family/Social History
   • Medication reconciliation (current meds, allergies, OTC, supplements)
   • Vital signs, height/weight/BMI
   • Depression/suicide screening (PHQ-2/9), substance use, fall risk, advance directives
4. Insurance Verification: Eligibility, benefits, prior auth needs, copay collection
5. Provider Encounter: Comprehensive history & exam (E&M level 99202–99205 based on MDM/time)
6. After-Visit Summary: Diagnoses, plan, prescriptions, referrals, follow-up, patient education materials

Key Differences: New vs. Established

Component	New Patient	Established Patient
History/Exam	Comprehensive	Problem-focused to comprehensive
Time (typical)	45–60 min	15–30 min
CPT Codes	99202–99205	99211–99215
Reimbursement	Higher	Lower

Efficient check-in sets the tone for the therapeutic relationship and ensures accurate billing.