1. Introduction to Appointment Scheduling
The key concept to remember in all appointment scheduling is It is to create a schedule with minimal waiting for the patient and smooth function of the office.
How can conflict arise between the needs of the office and the desire of the patient to be seen as soon as possible after arriving at the medical office? 1

2. Guidelines for Appointment Scheduling
Maintain confidentiality of the patient
Speak clearly and do not appear to be rushed
Concentrate on the person to whom you are speaking
Avoid external and internal distractions
Obtain complete information
Repeat information for accuracy
Schedule the proper amount of time f
Document all necessary information
Why is it important for the medical assistant to concentrate fully when scheduling an appointment by telephone? In person? 2

3. Appointment Book Methods
Each physician may have his own book, section, column or page in the book
Choose a format that suits the practice
Pages may be set up in
10 or 15 minute intervals
Appointment books are usually written in pencil
Changes can be made easily in the appointment book
Daily schedule is typed and used for permanent record
What factors might be considered when choosing an appointment book?
If your practice had two physicians, would you prefer to use one appointment book for both physicians or a separate appointment book for each physician? Why? 3

4. Computer Scheduling Methods
Appointment intervals can be adjusted easily
Each physician has a screen or column for each day
Easier to change appointments or set up repeating appointments
Daily appointment schedules can be printed quickly
Why is it important to set up the basic appointment interval in a computer scheduling program before beginning to make appointments?
What are advantages and disadvantages of using a computer appointment scheduling program? 4

5. Daily Appointment Schedule
Used to pull medical records for patients being seen that day
Official schedule is a legal document
Additions in black ink
No-shows and cancellations on the day of the appointment marked in red ink
Posted in area inaccessible to patients or covered with a sheet of paper
To protect patient confidentiality
What is the daily appointment schedule used for?
When should the daily appointment schedule be created if using a manual appointment book? A computer scheduling program?
What are the implications if the daily appointment schedule is a legal document?
How is the daily appointment schedule posted so that staff have access to it but patient confidentiality is protected? 5

6. Pair & Share “The Schedule”
Students pair up and share something that they learned from the presentation so far…
What did you remember or think was important?
What seemed a little confusing to you?
Any questions?

7. Time Specific Stream Scheduling
Most common way to schedule appointments
Steady flow of patients (like a stream)
The length of time scheduled for the appointment depends on the patient’s needs – for example
30-45 minutes for a new patient
10-20 minutes for an established patient
30-45 minutes for a physical examination
Why do some offices schedule more time for individual appointments than other offices?
What are the advantages and disadvantages of patients arriving in a steady stream for appointments? 7

8. Wave Scheduling
Patients arrive in “waves” so that there is always a patient waiting
Three or four patients are scheduled every half-hour
Patients are seen in the order in which they arrive
Sometimes ill patients are taken before those with routine appointments
How do patients react if they realize that one or more other patients may have been given the same appointment time?
If three patients have the same appointment time, which patient is seen first?
What are the advantages and disadvantages of patients arriving in “waves” for appointments? 8

9. Modified Wave Scheduling
Patients are given appointments at specific times during the first half of each hour (usually longer)
Several appointments
One long appointment, such as physical examination
Second half-hour used for wave (usually shorter)
Work in patients
Finish appointments from the first half-hour
Schedule several rechecks on the half-hour
What are advantages of the modified wave appointment scheduling compared to wave scheduling?
Why is it often very helpful to have two or three patients who may not need a long time for appointments scheduled for the same appointment time? 9

10. Double Booking Two patients are given the same appointment time
One patient may be seen by physician while the other is having diagnostic tests performed
It is a way to work in urgent patients
Why do many offices double book patients?
If the medical office uses double booking as a method to add patients with urgent problems to the schedule on the day of the appointment, how will this affect the flow of appointments? 10

11. Open Booking Patients told a range of hours for their visit
Used in clinics
Used for urgent care before or after office hours
Works best where there is a constant stream of patients
Patients seen in the order in which they arrive
What experience have you had with open booking? Did it increase your waiting time?
When is open booking usually used? 11

12. Clustering or Categorizing
Scheduling patients with similar problems or conditions together
Physical examinations
Prenatal patients in an OB/GYN practice
Patients having the same diagnostic procedure
Can be an entire day or part of day
Do physicians like to do several physical examinations or examine several new patients back to back? Why or why not?
Why are pregnant patients often clustered at a different time from patients with infertility problems?
How might a pediatric office cluster patients? 12

13. Pair & Share “Types of Scheduling”
Students pair up and share something that they learned from this section of the presentation …
What did you remember or think was important?
What seemed a little confusing to you?
Any questions?

14. Multiple Offices
Physicians may see patients at different office locations
Appointments may be booked through a central system or at each individual office
If booking centrally, it is important to clarify with the patient which office they wish to visit
Paper medical records may need to move from office to office
What special concerns arise related to appointment scheduling if there is more than one office belonging to the same practice?
Why might a medical practice schedule appointments for multiple offices from a central office? From each office independently?
Why are patients encouraged to select one office if a practice has more than one location, and make most appointments at that office? 14

15. Setting Up the Appointment Matrix
Appointment matrix is usually set up for 6 months in advance and shows available appointment times
Times when a physician is not available to see patients are blocked
In a computer system, blocked times are usually a different color from available appointments
Several factors that influence the appointment matrix
Scheduling system or format
Physician preferences and needs
Facilities and equipment
Why is the appointment matrix usually only prepared six months in advance?
What are typical reasons to block times from the physician’s appointment schedule? 15

16. Appointment Intervals
Appointment interval is minimum time allotted for one appointment
10-minute interval
15-minute interval
20-minute interval
Patient may be given more than one block of time depending on type of appointment
All appointments are multiples of the basic appointment interval
How does the time interval for a basic appointment affect the appointment matrix?
Which type of appointments require the least time? The most time? Why? 16

17. Physician’s Preference and Needs
Times are blocked from the schedule when the physician has other obligations or is not available
Times are blocked for lunch, meetings, and catch-up
Days are blocked for vacation, conferences, lectures, etc.
Facilities and Equipment Requirements
Physicians may have special needs for equipment or treatment rooms
Schedules may have to be coordinated
Physicians like to have at least two examination rooms available to see patients
Improves efficiency and time management
Which physician obligations are likely to be the same or similar every day?
Which physician obligations are likely to occur regularly but not every day?
Which physician obligations may change after the schedule has been established? 17

18. Pair & Share “Considerations”
Students pair up and share something that they learned from this section of the presentation …
What did you remember or think was important?
What seemed a little confusing to you?
Any questions?

19. Guidelines for Scheduling Established Patients
Insurance billing defines an established patient as one seen in the medical office within the past 3 years or has a current medical record
Record patient name, physician, date of birth, and telephone number
If a return appointment, the interval or time needed was usually indicated by the physician at the previous visit
Schedule as close as possible to date specified by the physician
Ask patient for day of the week and time of day that is convenient, then offer open times
If patient is in the office, write patient name, date, and time of appointment on an appointment reminder card for the patient
Why do insurance companies differentiate between new patients and established patients when setting up reimbursement schedules?
What are possible reasons that a patient who has not been seen for more than three years is treated as a new patient for billing purposes?
If a computer system is used, how does the medical assistant identify that he or she has located the correct patient before making the appointment? 19

20. Guidelines for Scheduling Special Situations
If patient must have diagnostic tests, be sure they are scheduled so that results have been received before the next appointment
Office may only be making appointments 6 months ahead and patient may not need to return until after that time
Ask patient to call later for appointment
Place patient’s name on reminder list
How should laboratory tests be scheduled related to follow-up appointments?
Why does the medical assistant attempt to schedule fasting laboratory tests in the morning?
What are examples of laboratory tests or diagnostic tests that require the patient to be fasting?
How can the medical office remind patients to make appointments for intervals that are longer than the appointment matrix has been created? 20

21. Guidelines for Scheduling New patients and Referrals
Obtain complete information about a new patient
Obtain referral form if patient has a referral
Set aside appointment time for new patient, usually minutes
Give patient directions to office
Send information according to office policy
Health history form
New patient brochure
Make appointments for referrals as soon as possible
What information must be obtained from a new patient when making an appointment?
What does the medical assistant need to find out if the patient is being seen for something other than primary care? 21

22. Guidelines for Scheduling non-patient appointments
Pharmaceutical representatives
Salespeople
Usually given specific appointment times
Often during lunch or another time period that has been blocked from the schedule
When are physicians willing to make appointments to see pharmaceutical representatives?
What types of equipment might the physician wish to consult with a salesperson about?
What is the advantage to the physician of making a specific appointment with an individual who is not a patient?
If the physician does not make appointments with pharmaceutical representatives, how is the respresentative handled? 22

23. Guidelines for Changing Appointments
If using appointment book, erase original appointment and enter all information in new slot
Some offices may require that the information be left in the book and a line placed through the cancelled appointment
If using computer schedule, use “move appointment” feature
Moves all information to new slot
Deletes original appointment
Appointments may be changed because of change in physician’s schedule
Do you think it is faster to change an appointment in an appointment book or in a computer scheduling program? Why?
Why is it important to be sure that all information is transferred when changing appointments? 23

24. Guidelines for No-Show Patients
No-shows are patients who do not keep appointments and do not call to cancel or reschedule
Marked in red on the appointment schedule
Failure to keep the appointment documented in the medical record
No-shows usually reviewed after three occurrences
May be asked to find another physician because they do not adhere to treatment plan
Why should all no-show appointments be documented in the medical record?
Why do many office place a telephone call to patients who fail to keep an appointment?
What are possible legal implications if patients frequently fail to keep appointments? 24

25. Managing Late Patients
Offices usually have a policy regarding late patients
If the patient telephones, he or she may be worked in on arrival
Habitual latecomers may be given the last appointment of the day or told a time earlier than they are scheduled
Why are late patients a problem for the smooth process of appointments?
If a late patient is turned away, how might the patient respond?
How late is really late? 25

26. Guidelines for Scheduling Walk-Ins or Same Day
Patients who come into the office, without an appointment, and ask to be seen
If need is urgent, physician may work patient into the schedule
If need is routine, person may be offered an open appointment and told to return
Why is it generally not recommended to see walk-in patients unless the physician intends to do so regularly?
What factors should determine if a walk-in patient is seen or given an appointment for another day? 26

27. Guidelines only!!!
These are only some of the common guidelines and may differ according to the procedures of a particular office.
Best practices are to learn the protocol for the office you are working for all of the mentioned situations.

28. Pair & Share “Guidelines”
Students pair up and share something that they learned from this section of the presentation …
What did you remember or think was important?
What seemed a little confusing to you?
Any questions?