1. 16
Schedule Management

2. 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.

3. 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.

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

5. 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.

6. 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.

7. 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

8. 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!

9. 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: 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.

10. 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: 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.

11. 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: 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

12. 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: 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.

13. 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: 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.

14. 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: 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

15. 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: 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.

16. 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: 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.

17. 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: 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

18. 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: 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.

19. 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: Compare different types of appointment scheduling systems.
Right!

20. Organizing and Scheduling Appointments
Be professional
Accommodate patient’s needs if possible
Time needed
Patient status
Chief complaint
Learning Outcome: 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.

21. 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: 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 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

22. Established Patients Currently seen by the practice
Return appointments
Make as patient is leaving office
Set pattern
Appointment reminder card
Learning Outcome: 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 .

23. 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: Identify ways to organize and schedule patient appointments.

24. 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: 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

25. 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
notifications
Patients enroll and receive a password
Notifications of up-coming appointment sent
Learning Outcome: 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 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.
notifications
Newer approach to appointment scheduling
Patients sign up, sign a release to allow communication, and are assigned a password by the office.
The patient may request an appointment and the office returns a confirmation of the scheduled appointment.
An automatically generated reminder goes out to the patient’s address
This is not suitable for all patients or all types of appointments

26. 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: Identify ways to organize and schedule patient appointments.
TERRIFIC!

27. 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: 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 .

28. 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: Model how to handle special scheduling situations.

29. 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: 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.

30. 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: 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.

31. 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
R Hansen
M Fitz
J. Jones
cancelled
Learning Outcome: 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. .

32. 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: 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

33. 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: 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.

34. 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: Model how to handle special scheduling situations.
SUPER!

35. Scheduling Outside Appointments
Verify insurance coverage
Obtain referral or approval if needed
Make appointment
Instruct patient
Document in medical record
Learning Outcome: 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.

36. 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: 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.

37. 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: Explain how to schedule appointments that are outside the medical office.
Very Good!

38. Maintaining the Physician’s Schedule
Avoid Overbooking
Maintain a Balance
Avoid Underbooking
Learning Outcome: 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.

39. Visits Outside the Office
House calls – check on home-bound
Hospital rounds
Nursing home visits
“Mouse calls”
Learning Outcome: 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 inquiries from their patients.
Be sure that the appropriate releases are in the patient’s file

40. 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: 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.

41. 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: 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.

42. 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: 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.

43. 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: 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.

44. 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: Implement ways to keep an accurate and efficient physician schedule.
Right!

45. 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.

46. 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.

47. 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.

48. 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, 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, notification (when permitted by the patient) and mailing recall notices.

49. 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.

50. 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.

51. 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)