16 Schedule Management

Learning Outcomes (cont.) 16.1 Describe how the appointment book is key to the continuity of patient care. 16.2 Identify how to properly apply a matrix to an appointment book. 16.3 Compare different types of appointment scheduling systems. 16.4 Identify ways to organize and schedule patient appointments.

Learning Outcomes (cont.) 16.5 Model how to handle special scheduling situations. 16.6 Explain how to schedule appointments that are outside the medical office. 16.7 Implement ways to keep an accurate and efficient physician schedule.

Introduction Scheduling systems Scheduling situations Appointment book Types How each is used Scheduling situations Appointment book Legal aspects Documentation

The Appointment Book A well-managed appointment book Creates an efficient patient flow Shows respect for everyone’s time Unexpected events that occur Early and late arrivals Emergencies Patient’s who require extra time Learning Outcome: 16.1 Describe how the appointment book is key to the continuity of patient care. The office is dependent upon physician preferences and habits, the facilities available, and patient need. Few patients are willing to wait more than 20 minutes. To avoid waiting, patients may Arrive after their scheduled appointment time. Come in earlier in hopes of being seen before their scheduled appointment time. May avoid the schedule entirely and walk in expecting to be seen. Unexpected events can disrupt the schedule. Good planning and scheduling can help a medical practice run smoothly in spite of unexpected obstacles.

Computerized Scheduling Lock-out feature Access Identification of problem patients “Search” feature Reports feature Color-coding feature Learning Outcome: 16.1 Describe how the appointment book is key to the continuity of patient care. Computerized scheduling is becoming more common. Advantages over handwritten systems: Selected areas can be locked out for designated purposes. Information can be accessed from multiple areas within the office. It help to identify problem patients – cancellations, no-shows, and late arrivals. It provides a “search” for upcoming appointments to ensure proper follow-up care is given as well as for a requested day or time availability It provides reports on overall scheduling practices. It adds color coding as to identify areas designated for certain types of appointments. Screen captures of SpringCharts™ Electronic Health Records software are reprinted with permission from Spring Medical Systems, Inc. All rights reserved.

Online Scheduling Not for all office types Cost and security have been barriers Prior to purchasing an e-scheduler Assess practice needs Determine potential for use Research products Learning Outcome: 16.1 Describe how the appointment book is key to the continuity of patient care. Online Scheduling Not recommended for all office types. Allows patients to schedule themselves or request an appointment via the internet. Cost and security have been the barriers to many offices, however, cost is becoming more reasonable and programs are initiating new security measures Before adopting an e-scheduler, assess the practice needs, survey patients regarding web access and potential for usage, and be diligent in your research about available products, particularly regarding privacy issues. One example is Compass Scheduling at www.compassscheduling.com.

Apply Your Knowledge Good Answer! What advantages does a computerized scheduler have over a paper appointment book related to continuity of care? ANSWER: It enables you to identify possible noncompliant patients who cancel appointments, often arrive late, or are no-shows It enables you to search for upcoming appointments to ensure follow-up care is given. It allows for access from multiple areas so a physician could check for a patient in an examination room. Learning Outcome: 16.1 Describe how the appointment book is key to the continuity of patient care. Good Answer!

Applying the Matrix Block off times the doctor is unavailable to see patients Schedule around those times Unblock appointments if physician becomes available Learning Outcome: 16.1 Describe how the appointment book is key to the continuity of patient care. The procedure for creating the matrix is the same whether the schedule is kept in an appointment book or an electronic scheduler. First establish the matrix – the basic outline of times the physician is and is not available for patient appointments. In a paper format, draw an “X” through the unavailable time slots with a brief explanation. Electronic schedulers often use colors to designate the reason the provider is out; they may also place an “X” in the time frames selected. The day’s schedule is then built around the established matrix. If the physician’s schedule is changed and he will be seeing patients, Paper – “X” should be removed and patients scheduled as usual. Electronic – time frame is unblocked.

Required Patient Information Obtain patient information Patient’s full name Home and work telephone numbers Purpose of the visit Use only approved abbreviations Learning Outcomes: 16.2 Identify how to properly apply a matrix to an appointment book. Some offices use both a traditional appointment book and a computerized system. If the computer fails to work, the appointment book has all the necessary information. To schedule an appointment, you sill need the following patient information: Patient’s full name – check the correct spelling of the patient’s name. Daytime telephone numbers – repeat to ensure accuracy. Purpose of the visit – a brief description using approved abbreviations without disclosing the patient’s diagnosis or violating HIPAA. Refer to TABLE 16-1 Common Abbreviations Used in Appointment Scheduling.

Standard Appointment Times Create a list Standard appointment times Time needed for common tests This helps in choosing an appropriate appointment book or scheduler Learning Outcomes: 16.2 Identify how to properly apply a matrix to an appointment book. Working with the physician(s), create a list of standard appointment times as well as the amount of time to allow for tests that are commonly performed in the practice. The list helps identify which openings are appropriate for the appointment type or procedure involved. This listing will also assist you in choosing an appropriate appointment book or scheduler, as most are based on 10-, 15-, or 30-minute increments. Refer to Table 16-2 Typical Appointment Times for specific Appointment Types

The Appointment Book as a Legal Record Keep appointment books 3 years Entries – clear and easy to read Corrections or changes Draw a single line through the entry Add appropriate comment Initial the entry Document in medical record Learning Outcomes: 16.2 Identify how to properly apply a matrix to an appointment book. Because the appointment book is a legal document, the schedule should be written in blue ink (although many offices still prefer black ink). Never erase a name or use correction fluid to blot the name out. Draw a single line through the name. Beside it write in the reason such as “NS” or “can” and reason why cancelled. For rescheduled appointments (RS), write the date, time of the new appointment. Initial the entry. This information should also be documented in the patient’s medical record to track possible compliance issues.

GOOD JOB! Apply Your Knowledge ANSWER: 3 5 2 1 4 S/R CPE f/u CAN P&P Use your knowledge of abbreviations and scheduling to order these from least time required to most time required. (1= least time required and 5= most time required) ANSWER: 3 5 2 1 4 S/R CPE f/u CAN P&P suture removal 10–20 min. complete physical examination 30/60 min. Learning Outcomes: 16.2 Identify how to properly apply a matrix to an appointment book. Refer to Table 16-1 Common Abbreviations Used in Appointment Scheduling and Table 16-2 Typical Appointment Times for specific Appointment Types GOOD JOB! follow-up appointment 5–15 min. cancellation 0 min. Pelvic examination and Pap Smear 15–30 min.

Appointment Scheduling Systems Goals Smooth flow of patients Minimal wait time Open-hours scheduling No appointments Emergency room, urgent care centers and some rural practices Learning Outcome: 16.3 Compare different types of appointment scheduling systems. The system used usually depends on the type of practice and physician preferences. Regularly review system to see whether it is meeting its goals for the practice. Open-hours scheduling Patients arrive at their own convenience with the understanding that they will be seen on a first-come, first-served basis unless there is an emergency. For legal and tracking reasons an appointment book or electronic scheduler is still needed to record patients as they arrive. Establish a matrix so you will know when a doctor is out of the office. Advantage – eliminates problems caused by missed appointments. Disadvantages Possible long wait times Cannot retrieve patient’s record before they arrive

Appointment Scheduling Systems (cont.) Time-Specified Scheduling Stream scheduling Patients are scheduled for specific times Regular intervals Amount of time – based on the reason for the appointment Learning Outcome: 16.3 Compare different types of appointment scheduling systems. Stream scheduling assumes a steady stream of patients all day long at regular, specified intervals. Once the matrix has been applied and physician availability has been established, it can be determined how many slots or blocks should be used for each appointment type. When a visit requires more time, you simply assign the patient additional back-to-back slots.

Appointment Scheduling Systems (cont.) Wave Scheduling Flexibility to allow for Patients who arrive late Patients who require more or less time Uses an hourly target number of patients Arrive at the same time Seen in order of arrival Learning Outcome: 16.3 Compare different types of appointment scheduling systems. Works effectively in larger medical facilities that have enough departments and personnel to provide services to several patients at the same time. Based on the reality that some patients will arrive late and that others will require more or less time than expected. The goal is to begin and end each hour with the overall office schedule on track. Determine the number of patients to be seen each hour by dividing the hour by the length of the average visit. Patients to arrive at the beginning of the hour and have the physician see them in the order of their actual arrival. Problem with this system – patients may realize they have appointments at the same time as other patients and may become confused, annoyed, or angry.

Appointment Scheduling Systems (cont.) Modified-wave scheduling Patients scheduled in 15-minute increments Four patients scheduled during the first half hour and the second half hour is left free for catch-up Double-booking system Two or more patients scheduled for the same time Used when patient with no appointment needs to be seen Learning Outcome: 16.3 Compare different types of appointment scheduling systems. Modified-Wave Scheduling Patients might be scheduled in 15-minute increments or four patients are scheduled to arrive at planned intervals during the first half hour, leaving the second half hour unscheduled. Appointments that are anticipated to require more time should be scheduled at the beginning of the hour. This method allows time for catching up before the next hour begins. Double-Booking Two or more patients are purposely scheduled for the same appointment slot and assumes that both patients will actually be seen within the scheduled period. Useful when patient’s can be seen by different practitioners, i.e. nurse practitioner and physician. Helpful if a patient needs to be seen that day but no appointments are available. To avoid these circumstances, some offices purposely leave one or two appointment slots open each morning and each afternoon, to accommodate these “urgent” appointments

Appointment Scheduling Systems (cont.) Cluster scheduling Groups similar appointments Useful if specialized equipment has limited availability Advance scheduling Scheduling weeks or months in advance Leave a few slots open for unexpected needs Combination scheduling – using two scheduling methods Learning Outcome: 16.3 Compare different types of appointment scheduling systems. Advance Scheduling – useful for scheduling annual examinations. Combination Scheduling – an office might use cluster scheduling for new patients and double-booking for quick follow-ups.

Apply Your Knowledge Right! A large pediatrician office commonly must “squeeze in” patients in that have become ill. The practice also plans to begin offering immunizations only two days a week. Which scheduling system(s) would you recommend for this medical practice? ANSWER: Combination scheduling system consisting of cluster scheduling for the immunizations and wave or modified-wave scheduling to allow for the needed flexibility of emergency patients. Learning Outcome: 16.3 Compare different types of appointment scheduling systems. Right!

Organizing and Scheduling Appointments Be professional Accommodate patient’s needs if possible Time needed Patient status Chief complaint Learning Outcome: 16.4 Identify ways to organize and schedule patient appointments. When arranging appointments, always keep in mind that you are representing the office. How you interact with patients will have either a positive or negative impact. Try to be as accommodating as possible to the patient but at the same time uphold the policies and protocols of the office. Patient status (new or existing patient) and chief complaint will dictate the length of time needed for an appointment.

New Patients Those not established at the medical office Obtain all necessary information Contact information Insurance information Co-pay information New patient forms Learning Outcome: 16.4 Identify ways to organize and schedule patient appointments. Patients who have never been seen by the practice or not seen in three or more years are considered new patients. Obtain all the necessary information, including The correct spelling of the person’s name Home address, daytime telephone number Date of birth Insurance information – the full name of the guarantor (if not the patient), and his or her relationship to the patient Remind the patient that his copayment (in required) is due at the time of the visit. Ask the patient to arrive 15-30 minutes early to filling out the required “new patient forms” if they have not been sent to the patient prior to the appointment. When the new patient arrives for the appointment, he/she should also be given the HIPAA guidelines for your office while his or her chart is being prepared for the visit. Refer to Procedure 16.3 Scheduling Appointments

Established Patients Currently seen by the practice Return appointments Make as patient is leaving office Set pattern Appointment reminder card Learning Outcome: 16.4 Identify ways to organize and schedule patient appointments. Established patients have been seen by the practice within the last three years. Return appointments for existing patients are often made at the time of check-out. For patients who are followed routinely, schedule appointments in a set pattern, such as the third Tuesday of each month. Give the patient an appointment card to remind them of the appointment. If the appointment is made by phone and time permitting, ask if they would like a reminder card mailed to them. Refer to Procedure 16.3 Scheduling Appointments Refer to CONNECT to see a video about Scheduling Appointments .

Appointment Confirmations and Reminders Appointment cards Enter appointment in scheduler Fill out card Do not rely on memory to enter appointment into book or scheduler Learning Outcome: 16.4 Identify ways to organize and schedule patient appointments.

Appointment Confirmations and Reminders (cont.) Encounter forms/superbills Receipt for payment Information about next appointment Reminder mailings Postcard with time and date of appointment Put in tickler file on date it should be mailed Learning Outcome: 16.4 Identify ways to organize and schedule patient appointments. The superbill or encounter form Lists services performed, diagnoses, health insurance, demographic information, and account balance. Serves as a receipt if payments are made at the time of the visit. Includes an area to insert information regarding the patient’s next appointment. Reminder mailing Have the patient address a post card to himself Write the date and time of the next appointment Place postcard into tickler file Serves as backup in case patient loses appointment card Useful if appointment is made months in advance Costly

Appointment Confirmations and Reminders (cont.) Confirmation Calls To confirm a scheduled appointment Useful for frequent late arrivals or no-shows Recall notices – reminder to call for an appointment E-mail notifications Patients enroll and receive a password Notifications of up-coming appointment sent Learning Outcome: 16.4 Identify ways to organize and schedule patient appointments. Confirmation Calls   Call patients 1 or 2 days before their appointments to confirm Electronic phone systems may be used to make reminder calls Be sure a “verbal contact agreement” signed by the patient is in the medical record Refer to Procedure 16-5 Placing Appointment Confirmation Calls Recall notices Form letter sent to remind patients to call for an appointment. Used if the schedule is not available to book an appointment 6 months to a year out. E-mail notifications Newer approach to appointment scheduling Patients sign up, sign a release to allow e-mail communication, and are assigned a password by the office. The patient may request an appointment and the office returns a confirmation email of the scheduled appointment. An automatically generated reminder goes out to the patient’s email address This is not suitable for all patients or all types of appointments

TERRIFIC! Apply Your Knowledge The doctor wants Mr. Lincoln to return to the office for a follow-up appointment in two weeks. What should the medical assistant do? ANSWER: Offer Mr. Lincoln a choice of dates and times available. After entering the appointment in the book or into the computer, confirm the date and time with the patient and give him a appointment card. Learning Outcome: 16.4 Identify ways to organize and schedule patient appointments. TERRIFIC!

Special Scheduling Situations Emergencies Seen immediately upon arrival at the office Explain situation to waiting patients Referrals See referred patients as soon as possible When arranging referrals Provide choices Be sure the facility accepts the patient’s insurance Document in patient record Learning Outcome: 16.5 Model how to handle special scheduling situations. Critical thinking, creativity, and flexibility are necessary for scheduling some special cases. Being able to anticipate needs and being prepared the unplanned situation allows you to handle them more efficiently and keep the office schedule running smoothly. Emergencies You may refer the caller to the nearest hospital emergency room or instruct the caller to call emergency medical services You may ask the caller to come to the office right away Emergencies must be seen immediately upon arrival at the office. Explain to waiting patients that there has been an emergency and give them an opportunity to reschedule their appointments if they are unable to wait Refer to POINTS ON PRACTICE: Scheduling Emergency Appointments Referrals Patients may be referred for second opinions or special consultations. When referring patient to another physician give several choices, be sure the insurance is accepted, complete all paperwork, and document referral and authorization number in the medical record. Refer to CONNECT to see a video about Requesting Prior Authorization .

Special Scheduling Situations (cont.) Fasting patients Schedule as early as possible in the day Instruct patient about the need to fast and when to start Patients with diabetes Require regular meals and snacks Avoid late morning slots Learning Outcome: 16.5 Model how to handle special scheduling situations.

Special Scheduling Situations (cont.) Late arrivals Schedule chronically late patients toward the end of the day Document late arrivals or missed appointments in patient record Learning Outcome: 16.5 Model how to handle special scheduling situations. Late Arrivals – patients who are habitually late can be called to discuss the reasons for their chronic tardiness. The goal of the discussion should be to find a solution so that patients can make their appointments on time and the schedule will run smoothly.

Special Scheduling Situations (cont.) Walk-ins If it is an emergency, handle as such If no openings, offer to schedule an appointment Post a sign in the office if no walk-ins are allowed Learning Outcome: 16.5 Model how to handle special scheduling situations. Walk-Ins Patients who arrive without an appointment and still expect to see the doctor. If it is an emergency, handle as you would any emergency. Suggest to the patient that another practitioner in the office may be able to be of assistance. Even if seen by the physician, ask the person to call to schedule appointments in the future. If the office has a policy of no walk-ins, post a sign in the patient check-in area stating that patients are seen by appointment only.

Special Scheduling Situations (cont.) Cancellations Thank patient for calling to cancel Mark appointment as canceled Attempt to reschedule Document cancellation in the medical record S Smith 098-765-4321 R Hansen 456-789-0123 M Fitz 321-456-0987 J. Jones 123-456-7890 cancelled Learning Outcome: 16.5 Model how to handle special scheduling situations. When patients call to cancel appointments, try to reschedule the appointment while they are on the telephone. If patients say they will call later to reschedule, note this information in the appointment book and thank them for the notice. Cancel the first appointment before entering the patient’s rescheduled appointment. Write “canceled” in the appointment book, drawing a single line through the patient’s name. Also note the cancellation in the patient’s medical record. Slots created by cancellations may be filled by calling patients who have appointments scheduled for later in the day or week. .

Special Scheduling Situations (cont.) Missed appointments Document in the appointment book Document in medical record Inform the physician of no-shows Call or send polite reminder Wrong day Reschedule Attempt to accommodate if Patient came a long distance Made special travel arrangements Learning Outcome: 16.5 Model how to handle special scheduling situations. Missed Appointments You may call or send out a form letter with a polite reminder when patients miss appointments. Some practices limit the number of times that a patient can miss, cancel or repeatedly not show up for appointments Physicians may charge for missed appointments. If your office implements this policy, let patients know in advance before you start charging for missed appointments. Post a notice at the reception desk Add a statement to appointment cards that patients will be charged for appointments cancelled with less than 24 hours notice. Wrong Day Reschedule if patient lives locally Attempt to accommodate if patient required special transportation or traveled far Check the appointment card, if available, for date

Physician Scheduling Situations Physicians may throw the schedule off by Arriving late to the office Being called away for emergencies Being delayed at the hospital Learning Outcome: 16.5 Model how to handle special scheduling situations. Sometimes physicians disrupt the office schedule as well. If the physician is frequently late: Speak to the physician directly You might also use the staff meeting to mention that schedule often seems to get off to a late start and ask if anyone has suggestions for improving this situation. You may need to adjust the office schedule to handle the situation – block off one or two appointment slots to avoid long patient wait times. If a physician is repeatedly late, you may want to add some buffer time to the schedule.

Apply Your Knowledge SUPER! Mr. Washington needs a follow-up appointment in a week for a fasting lab tests. How should you handle this appointment? ANSWER: The appointment should be made for the first or second appointment for that day. Mr. Washington should be reminded he should not eat or drink after midnight. Learning Outcome: 16.5 Model how to handle special scheduling situations. SUPER!

Scheduling Outside Appointments Verify insurance coverage Obtain referral or approval if needed Make appointment Instruct patient Document in medical record Learning Outcome: 16.6 Explain how to schedule appointments that are outside the medical office. Verify the patient’s insurance coverage before choosing the facility or physician and obtain prior approval if needed. Document any referrals or prior authorization numbers. If the procedure is elective, ask the patient if there is a preferred date and time. Before calling to schedule a procedure, you will need the following: The patient’s medical record The exact name of the procedure, the approximate amount of time required Diagnosis Insurance information, date of birth, and patient’s contact information Ask the scheduler for any patient instructions to relay to the patient. Give the patient instructions both orally and in writing. Answer any questions. Verify understanding Document the date and time of the procedure as well as instructions provided to the patient. Refer to Procedure 16-6 Scheduling Outpatient Surgical Appointments Refer to CONNECT to see a video about Scheduling Outpatient Surgical Appointments.

Reserving an Operating Room Call OR scheduler to reserve space Preferred date and time Type of surgery Relevant patient information Insurance requirements Patient instructions Learning Outcome: 16.6 Explain how to schedule appointments that are outside the medical office. If the doctor plans to perform surgery at a hospital, call the operating room scheduler to reserve the facility. Give the preferred dates and times, the type of surgery, and the length of time the doctor will need the operating room. Provide the scheduler with all relevant patient information. Relay any requests from the doctor. You may also have to make arrangements for surgical assistants, an anesthetist, and a hospital bed for the patient following surgery. Be sure health insurance requirements are met and copies of forms and authorization numbers are filed appropriately Be sure the patient receives all necessary instructions and information regarding pre- and post-surgical care and that all questions are answered. Refer to Procedure 16-7 Scheduling Inpatient Surgical Appointments Refer to CONNECT to see a video about Scheduling Inpatient Surgical Appointments.

Apply Your Knowledge Very Good! What is the first thing you should do before scheduling an appointment for a referral to a specialty physician? ANSWER: The first thing you need to do is to verify that the physician will be covered by the patient’s insurance. Learning Outcome: 16.6 Explain how to schedule appointments that are outside the medical office. Very Good!

Maintaining the Physician’s Schedule Avoid Overbooking Maintain a Balance Avoid Underbooking Learning Outcome: 16.7 Implement ways to keep an accurate and efficient physician schedule. Your job is to help the physicians in your practice to make the most efficient use of their time. Overbooking Scheduling more patients than can reasonably be seen in the time allowed Creates stress and makes it difficult to maintain a schedule. Underbooking Leaving large, unused gaps in the schedule Does not make the best use of the physician’s time If you have to cancel appointments Apologize to waiting patients on behalf of the physician. Explain that they can wait, leave to run errands and return later, or reschedule. Document that the appointment had to be rescheduled due to an office emergency. Always make sure patients who need immediate attention are seen by another physician.

Visits Outside the Office House calls – check on home-bound Hospital rounds Nursing home visits “Mouse calls” Learning Outcome: 16.7 Implement ways to keep an accurate and efficient physician schedule. House Calls Check on home-bound or non-ambulatory patients as part of their follow-up care. General supplies for a medical bag include: Blood pressure cuff Stethoscope Specimen containers Otoscope Ophthalmoscope Prescription pad Pen light Thermometer Gloves Face shield Hospital Rounds – hospitals are utilizing a physician/specialist known as a hospitalist who reports to the PCP on the patient’s progress and findings while an inpatient. Nursing Home Visits Patients who have had long-standing relationship with the physician Patients who will be returning home after a rehabilitation stay “Mouse Calls”   Answering email inquiries from their patients. Be sure that the appropriate releases are in the patient’s file

Scheduling Pharmaceutical Sales Representatives Physician preference Scheduled block of time By appointment New representatives Request a business card Check with the physician before scheduling an appointment Learning Outcome: 16.7 Implement ways to keep an accurate and efficient physician schedule. Meeting with representatives is time consuming as the representatives will want to market their products. Some doctors set aside certain times or days during the week to meet with pharmaceutical representatives. Others prefer that the representative leave a business card with the products represented, and if the physician is interested, he will call and arrange for an appointment. When a pharmaceutical representative who is unknown to you comes into the office, ask for a business card and check with the physician or business manager before scheduling an appointment.

Making Travel Arrangements Travel and lodging arrangements Itinerary – several copies for physician and one for the office A locum tenens or substitute physician may cover practice while regular physician is away Learning Outcome: 16.7 Implement ways to keep an accurate and efficient physician schedule. You may be responsible for arranging transportation and lodging when physicians attend meetings, speaking engagements, and other events out of town. Always request confirmation documents of travel and room reservations. Itinerary – a detailed travel plan, listing dates and times of flights and events, locations meetings and lodgings, and telephone numbers. You may also have to arrange for professional coverage of the practice during the physician’s absence. Often physicians in the same or nearby practice will provide coverage. If this is not possible, a locum tenens, (Latin for “one occupying the place of another.”), or substitute physician, may be hired to see patients while the regular physician is unavailable. Check with major insurance carriers regarding credentialing of the locum tenens physician so services are covered.

Planning Meetings Find out number of people, length and purpose of meeting Secure location with adequate room, parking, and food services Secure AV equipment Send invitations Create agenda Prepare minutes Learning Outcome: 16.7 Implement ways to keep an accurate and efficient physician schedule. Another of your duties may be to assist the physician in setting up meetings for professional societies or committees. You need to know How many people are expected to attend How long the meeting will last The purpose of the meeting If a meal is to be served. Mail an invitation to all those expected to attend the meeting with the topic, names of the speakers, date, time, place, and admission costs or fees associated with the event. You may also be responsible for creating the meeting’s agenda. After the meeting, you may also be asked to prepare the minutes – the report of what was discussed and decided upon at the meeting.

Scheduling Time with the Physician Irregularities or changes in the schedule Other items for discussion Practice finance Taxes and other financial matters Professional licenses Renewal requirements for the medical staff Learning Outcome: 16.7 Implement ways to keep an accurate and efficient physician schedule. The physician should have regular meetings to discuss any irregularities or changes in the day-to-day workings of the office. If the item is not “private” or pressing it could be included in regularly scheduled office meetings.

Right! Apply Your Knowledge Why is it important to maintain a balance in the physician’s schedule? ANSWER: To help the physicians use their time efficiently. Learning Outcome: 16.7 Implement ways to keep an accurate and efficient physician schedule. Right!

In Summary 16.1 The appointment book or electronic scheduler and its matrix, when used properly, allow the office staff to respect the time of both the physician and patient, by keeping an efficient and timely flow of patients throughout the day.

In Summary (cont.) 16.2 To create a matrix you must know the usual schedule of physician availability to see patients as well as the times the physician (or practice) will not be open to see patients. The latter times should be X’d out with a short reason given as to why the time is unavailable. Follow the instructions for the electronic scheduler to block out the appropriate time frames. 16.2 To create a matrix, either in an appointment book or an electronic scheduler, you must know the usual schedule of physician availability to see patients as well as the times the physician (or practice) will not be open to see patients. The latter times should be X’d out with a short reason given as to why the time is unavailable. Follow the instructions for the electronic scheduler to block out the appropriate time frames.

In Summary (cont.) 16.3 The most commonly used types of scheduling systems are open-hours, time- specified, wave, modified wave, double booking, cluster, and advance scheduling. It is also common for offices to use any combination of the above as best suits each practice.

In Summary (cont.) 16.4 When organizing and scheduling patient appointments, always maintain a positive, professional image. The patient’s status should be considered as well as patient preference. The goal is to accommodate the patient, while still maintaining an efficient schedule. Appointments should be confirmed through appointment cards, phone calls, email notification and mailing recall notices. 16.4 When organizing and scheduling patient appointments, always maintain a positive, professional image as a representative of the office. The patient’s status as a new or established patient should be considered as well as patient preference whenever possible. The goal is to accommodate the patient as much as possible, while maintaining an efficient office schedule. Appointments should be confirmed through appointment cards, phone calls, email notification (when permitted by the patient) and mailing recall notices.

In Summary (cont.) 16.5 Handling special scheduling situations requires critical thinking skills and creativity. Scheduling situations can arise if the physician is running late or if a patient requires an emergency appointment. Other scheduling problems may also include a patient who does not show, arrives late, or arrives on the wrong day. Document any patient-related appointment issues the patient’s medical record for legal purposes. 16.5 Handling special scheduling situations requires critical thinking skills and creativity. Scheduling situations can arise if the physician is running late or if a patient requires an emergency appointment. Other scheduling problems may also include a patient who does not show, arrives late, or arrives on the wrong day. Documentation of any patient-related appointment issues should be recorded in the patient’s medical record for legal purposes.

In Summary (cont.) 16.6 In order to schedule outside appointments you will require the patient’s demographic and health insurance information along with the procedure or service to be performed and the reason for the service. Preferred dates and times should also be noted. If referrals or prior authorizations are required, you may also be required to obtain these. 16.6 Outside appointments may need to be made to laboratories, radiology services, in- and outpatient surgeries, hospital stays, or for other diagnostic tests. In order to efficiently book such appointments, you will require the patient’s demographic and health insurance information along with the procedure or service to be performed and the reason for the service. Preferred dates and times should also be noted. If referrals or prior authorizations are required, you may also be required to obtain these so that the procedure/service is eligible for payment by the patient’s insurance plan. Refer to CONNECT to see EHR exercises on the following topics: Scheduling an Existing Patient; Scheduling a New Patient Setting Up a Secondary Schedule Scheduling Events and Blocking Time Charting a No Show Finding Appointments for New Patients Creating a Patient Referral Form Creating a Patient Order Form.

End of Chapter 16 Taking a few extra minutes, going that extra mile, and giving that added special touch can make a world of difference in a very difficult situation. ~ Lisa Lockhart (From A Daybook for Nurses: Making a Difference Each Day)