Managing Appointments Comprehensive Medical Assisting Fundamentals of Administrative Medical Assisting

Appointment Scheduling Systems: Manual Each provider’s appointments Sample Page from Manual Appointment Book HOURS Dr. Jones Dr. Smith Dr. Strom Lab 8 00 Meeting George Hamilton Hospital Rounds Jim Hart 15 Kindergarten PE Rosie O’Donnell 30 Ralph Lauren Brad Pitt 45 Abe Lincoln 9 Betsy Johnson Howie Mandell Johnny Carson 555-2222 555-4444 CPE 10 Mandy Moore Susan Hill Recheck Work Injury Diana Ross 555-1111 #ref by Prime Care Cross out unavailable times Review carefully and communicate with staff Patient name Phone numbers Reason for visit The appointment book should have space for: - Each provider’s appointments - Appointment info, including patients’ name, phone numbers, and reasons for visits. Establish the matrix. Cross out unavailable times with a brief explanation. Document all cancellations and reschedules. Review carefully and communicate with staff. Document all cancellations and reschedules CANCELLED

Appointment Scheduling Systems: Computerized One-time entry of repeating schedule components Easy search for available appointment times Main advantage is Convenience Many useful printout formats Interface with account information Name: Address: Phone #: Insurance: Appointment Date: Computerized Appointment Scheduling offers the following conveniences: One-time entry of repeating schedule components, Easy search for available appointment times, Many useful printout formats, and An interface with account information.

Types of Scheduling Structured Appointments ADVANTAGES DISADVANTAGES Each patient is allotted a fixed time and duration ADVANTAGES Structured appointments allot a fixed time and duration for each patient.   Advantages are: Optimum use of time and facility, and Opportunity for advance preparation. Disadvantages include: Patients may need more time than expected, Pin down time needs, and Incorporate “buffer” time. DISADVANTAGES Optimum use of time and facility Opportunity for advance preparation Patients may need more time than expected Pin down time needs Incorporate “buffer” time

Structured Appointment Methods CLUSTERING Patients with similar needs WAVE or MODIFIED WAVE Multiple patients scheduled in blocks FIXED Each patient assigned a specific time and duration STREAMING Time is allotted according to anticipated need DOUBLE BOOKING Two patients for each time slot Methods of setting structured appointments are: Clustering – Clustering patients with similar needs Wave or modified wave – Multiple patients are scheduled in blocks Fixed – Each patient is assigned a specific time and duration Streaming – Time is allotted according to anticipated need Double booking – Two patients for each time slot  

Other Types of Scheduling Flexible Hours Different times on different days Open Hours First come, first serve Eliminates some patient complaints Effective time management is difficult Can raise confidentiality issues Accommodate patients and providers with varied schedules “Flexible Hours” means that the office is open at different times on different days accommodating patients and providers with varied schedules. “Open Hours” is a first come, first serve basis. This method does eliminate some patient complaints, however, it can make effective time management difficult. If a lot of patients come in at the same time, you may need to call out each patient’s name to bring them back to the examining room, and this can raise confidentiality issues.

Factors that Affect Scheduling Duration of Symptoms Reason for Appointment Acute or Chronic Condition Patient’s Needs Most Convenient Time You control the schedule. Don’t let it control you! Transportation Constraints Staff To Be Seen The patient’s needs are major factors that affect scheduling. Reason for appointment Duration of symptoms Acute or chronic condition Most convenient time Transportation constraints Staff to be seen Third-party payer constraints Documentation requirements Remember, you control the schedule. Don’t let it control you. Documentation Requirements Third-Party Payer Constraints

Provider’s Preferences And Needs Adjust to each provider’s punctuality habits Provider’s Preferences And Needs Allow each provider time for other duties: Receive and return calls Review reports Dictate notes Perform outside duties Scheduling is also affected by the provider’s preferences and needs. Adjust to each provider’s punctuality habits. Because certain providers tend to run late, budget that time into the schedule. Allow each provider time for other duties: Receive and return calls Review reports Dictate notes Perform outside duties Lastly, establish protocols for unscheduled visitors. Establish protocols for unscheduled visitors

Physical Facilities Physical Facilities Number of users Amount of space Quantity and availability of equipment The physical facilities also affect scheduling with the: Number of users, Amount of space, and Quantity and availability of equipment. Make sure that you understand the space and equipment required. Understand the space and equipment required

Scheduling Guidelines General Guidelines HOURS Dr. Jones Dr. Smith Dr. Strom Lab 8 00 Meeting George Hamilton Hospital Rounds Jim Hart 15 Kindergarten PE Rosie O’Donnell 30 Ralph Lauren Brad Pitt 45 Abe Lincoln 9 Betsy Johnson Howie Mandell Johnny Carson 555-2222 555-4444 CPE 10 Susan Hill Work Injury 555-1111 #ref by Prime Care Always write the patient’s phone number As general scheduling guidelines: Always write the patient’s phone number on the schedule. Leave open time slots every day to accommodate problems. Leave open time slots every day CANCELLED Be pleasant and helpful

The first encounter is critical New Patients Do you need directions to our office? INFORMATION POLICIES Patient contact Referrer Payer Payment Paperwork needs See you May 1st at 10:30am! The first encounter is critical For new patients: Get patient contact, referrer, and payer information; Explain payment policy and paperwork needs; Give directions, establish a message protocol, and confirm the date and time; Check your own work; and Contact the referring physician.   The first encounter is critical. Because first impressions count, you want to convey an efficient yet friendly atmosphere.

Don’t forget to check your work New Patients Check for possible conflicts HOURS Dr. Jones Dr. Smith Dr. Strom Lab 8 00 Meeting George Hamilton Hospital Rounds Jim Hart 15 Kindergarten PE Rosie O’Donnell 30 Ralph Lauren Brad Pitt 45 Abe Lincoln 9 Betsy Johnson Howie Mandell Johnny Carson 555-2222 555-4444 CPE 10 Susan Hill Work Injury 555-1111 #ref by Prime Care Don’t forget to check your work Check the schedule for possible conflicts. Offer a specific date and time. Put the patient’s name and phone number on the schedule. Provide the patient with an appointment card. Don’t forget to check your work. APPOINTMENT CARD Offer a specific date and time Rachel Weisz 555-1234

Patient Reminders Appointment Cards APPOINTMENT CARD Patient’s Name: Provide a card for the NEXT appointment only APPOINTMENT CARD Patient’s Name: Date: Time: Physician’s Name: Physician’s Phone: Keep series on the same day and time Include the patient’s name, date and time of appointment, and physician’s name and phone number. Try to keep series on the same day and time. Provide a card for the next appointment only and write in ink. An appointment card will help the patient remember his or her appointment and reduce no-shows. Helps the patient remember his/her appointment Reduces no-shows

Telephone Reminders Hello, this is Michelle to remind you about your appointment tomorrow at 9am with Dr. Leon Call the day before using the phone number agreed. Keep it simple. Include your name, your office, and the appointment date and time. Check the move-up list and document the call. Call the day before using the phone number agreed Keep it simple: Include your name, your office, and the appointment date and time Check the move-up list and document the call

Mailed Reminder Cards Send a week before Mail out reminder cards at least a week before. Maintain stock postcards and a tickler file for annual examination reminders. Maintain stock postcards and a tickler file for annual examination reminders

Adapting the Schedule EMERGENCIES ACUTE ILLNESSES Obtain information for physician to decide when the patient should be seen Determine if emergency can be treated in office Evaluate for a constellation of symptoms For emergencies, have policies to determine if the emergency can be treated in the office. Also, have questionnaires to evaluate for a constellation of symptoms. For patients who are acutely ill, obtain the information the physician needs to decide when the patient should be seen.

Adapting the Schedule WALK-IN PATIENTS LATE PATIENTS For walk-in patients, see emergencies ASAP. Refer these decisions to the physician. Work the patient in or reschedule. For late patients, the patient must wait until the physician is free. Establish an office rescheduling policy and schedule habitually late patients at the end of the day. See emergencies ASAP (refer to physician) Work in or reschedule Patient must wait Establish rescheduling policy Schedule late patients at end

Adapting the Schedule PHYSICIAN DELAYS MISSED APPOINTMENTS Document! When there are physician delays, call patients as soon as possible to reschedule and inform patients in the waiting room at once. For missed appointments, determine the reason and reschedule. Notify the physician of habitual no-shows. Don’t forget to document, document, document! Determine the reason Reschedule Notify the physician Call patients to reschedule Inform waiting patients

Cancellations BY THE OFFICE BY THE PATIENT Document! When appointments are cancelled by the office, notify patients as soon as possible. Ask the patients to call to reschedule. Apologize to patients in the office. When the patient arrives at the rescheduled appointment, thank the patient for being flexible and apologize for any inconvenience.   For cancellations made by the patient, determine the reason. Make sure patient understands the need for follow-up. Check the move-up list to fill the vacancy and notify the physician of habitual no-shows. Once again: Document, document, document! Determine the reason Make sure patient understands to follow up Check move-up list Notify the physician Notify patients ASAP Ask patients to reschedule Apologize to patients in office Thank patient and apologize

Referrals & Consultations When making appointments for referrals and consultations: Check insurance requirements. Include precertification and paperwork. Is the physician on the preferred list? Provide physician and patient contact info. Include: Reason Urgency Consultation vs. Referral If patient makes the appointment, ask for notice When making appointments for patients in other facilities for referrals and consultations: Check insurance requirements, including precertification and paperwork and whether or not the physician is on the preferred list. Provide physician and patient contact info, including the reason, urgency, and whether it is a consultation or referral. Record the call and ask for notice of no-show. Provide written notice to the patient. If patient makes the appointment, ask for notice. Provide written notice to the patient. Record the call and ask for notice of no-show.

Diagnostic Testing When making appointments for diagnostic testing: Get instructions. What tests need to be performed? How soon? Get patient conflicts. Provide the lab with info: Patient Patient Lab Appointment When making appointments for patients at other facilities for diagnostic testing: Get instructions. What tests need to be performed and how soon? Get patient conflicts. Provide the laboratory with information regarding the patient, the patient lab, and the appointment. Give the patient verbal and written explanation of any required preparation. Document the appointment and post the target date for results in your tickler file. Document the appointment and post the target date for results in your tickler file. Give the patient verbal and written explanation of any required preparation.

Surgery If necessary, arrange for hospital admission When making appointments for surgery: Determine and follow pre-certification requirements. Provide the facility with physician’s requirements: Patient Info Insurance info Pre-certfication # If necessary, arrange for hospital admission When making appointments for patients at other facilities for surgery: Determine and follow pre-certification requirements. Call the facility with the physician’s requirements: Patient information, insurance information, and pre-certification number. Provide the patient with any pre-admission forms or instructions. Write down dates, times, and locations for the patient. Document the appointment. If necessary, arrange for hospital admission. Document the appointment Write down: Dates Times Locations for the patient. Provide the patient with any pre-admission forms or instructions.

Identify persistent problems Adjust routine to address the problem Scheduling Problems If the schedule doesn’t work, evaluate it for 2 to 3 months Involve all your staff Identify persistent problems Adjust routine to address the problem If the appointment schedule doesn’t work and problems are frequent, evaluate it for 2 to 3 months. Involve all staff in your study. Identify persistent problems such as habitual lateness, insufficient time allotted, or too many staff making appointments. Adjust routines to address the problem. Habitual lateness Insufficient time allotted Too many staff

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