Chapter 7 Appointments

Objectives Review the learning and performance objectives for this chapter By the end of this chapter, demonstrate the procedures in the textbook and the job skills in the workbook

Heart of the Health Care Professional Service The ultimate art of appointment making is accomplished when the physician’s schedule is blended with the patient’s needs and convenience.

Appointment Schedule Template Well-planned guide List of designated times for patients to meet with the physician Preformatted Specific number of slots Various types of appointments

Appointment Schedule Template Well-planned guide Allows faster access Meets patient needs Decreases waiting times Manages time for physicians Cuts down on decision making

Scheduling Systems How many patients can be seen daily? How many emergencies or walk-ins? Does this vary by: Season? Day of the week? Track for several weeks See Figure 7-2

Scheduling Systems Computerized appointments Computer software program Manage template Schedule appointments See Figure 7-3

Scheduling Systems Appointment book Manual paper scheduling system Mark block times Pencil in appointments Used in smaller offices See Figure 7-5

Scheduling Systems

Scheduling Systems

Scheduling Systems Patient flow techniques Stream Fixed Interval of time for each patient Not flexible Better for specialty practices Clustered appointments Blocks of time for similar appointments

Scheduling Systems Patient flow techniques Single book Double book Time-specific Used in specialty or consulting practices Double book Two patients scheduled for same time Work in emergencies Patients may wait longer

Scheduling Systems Patient flow techniques True wave Modified wave Specific number of patients per hour All report on the hour Seen in the order they arrive Modified wave 1st ½ Hour - scheduled patients 2nd ½ Hour - walk-in, work-in, emergency

Scheduling Systems Patient flow techniques Open access Open hours Same day scheduling Open hours Patients walk in during specific hours Seen in the order they arrive

Scheduling Systems Patient flow techniques Triage Sorting patients Screening procedures

Scheduling Appointments Basic considerations Needs of the patient Convenience of the patient Preferences/habits of the physician Availability of equipment/facilities

Scheduling Appointments Managing appointments Be flexible Consider patients’ schedule Working patients School children Elderly patients Procedures 7-1 and 7-2

Scheduling Appointments View the video scenario, and watch as the medical assistant schedules an appointment over the phone Scene – MA taking patient phone call MA tip – Manual scheduling Scene – MA recording pt. symptoms (phone call) Narrator – Office policies Scene – Scheduling pt. for appointment (phone call)

Scheduling Tips and Types of Appointments Follow-up appointments Do not schedule too far in advance Unscheduled appointments Walk-in appointments Sales/pharmaceutical representatives

Scheduling Tips and Types of Appointments Emergency situations Reorganize in an emergency situation Procedure 7-3 Referral appointments Seen as soon as possible Retain good will with referring physician

Scheduling Tips and Types of Appointments Habitually late patients Schedule 15 minutes before actual time No-show patients Document each occurrence First time – call to reschedule Second time – call to reschedule Third time – physician may discharge

Scheduling Tips and Types of Appointments Cancelled appointments Reschedule Document Managed care appointments MCO measures quality of care Drop from network if scheduling is poor

Scheduling Tips and Types of Appointments E-mail appointments Internet tool scheduling meetings Clinical messaging services Online tool for appointment requests Uses encryption and firewalls More secure than e-mail

Scheduling Tips and Types of Appointments Telephone appointments If no formal visit is required Must be documented Use CPT codes Patient can be charged Insurance can be billed

Scheduling Tips and Types of Appointments Scheduling surgery Schedule surgery via telephone Complete form Notify the patient Procedure 7-4

Scheduling Tips and Types of Appointments Preoperative appointments Lab tests X-rays Postoperative appointments Follow-up appointments with surgeon

Scheduling Tips and Types of Appointments Diagnostic testing Lab tests, X-rays, EKG, bone scan Schedule an outpatient diagnostic test Procedure 7-5 Therapeutic appointments Physical, occupational, speech therapies Counseling

Scheduling Tips and Types of Appointments Hospital visits Inpatient rounds Hospitalist service Convalescent hospital visits Nursing Home House call visits Rare

Appointment Reminder Systems Appointment reminder cards Sent to patient Figures 7-12 and 7-13 Reduce phone calls Business card of specialist

Appointment Reminder Systems

Appointment Reference Sheet List of appointments for the day Computer printout Photocopy of daily sheet Typed list of names/times See Figure 7-14

Guidelines to Avoid Audits and Improve Scheduling MCO may audit scheduling procedures Contract obligations Quality of care Important part of patient care Review the guidelines

Stop and Think Handle a patient with an unverified appointment Review the scenario Decide which option you would take and elaborate on how you would word your response Give rationale for your choice

Stop and Think Determine a routine, urgent or emergency appointment Review the scenario Is this an emergency, urgent, or routine? Select one of the possible choices Why did you make that choice? Why did you not select the other choices?

Stop and Think Explain office policy for urgent and emergent appointments Review the scenario What would you say to Mr. Belgium? Remember confidentiality