Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Comprehensive Medical...

Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins

Comprehensive Medical Assisting, 3rd Ed

Unit Two: Fundamentals of Administrative Medical Assisting

Chapter 6 – Managing Appointments


Appointment Scheduling Systems Appointment Scheduling Systems

Manual Appointment Scheduling

• 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

– Meetings, vacations, rounds, “buffers”

• Review carefully and communicate with staff

• Document all cancellations and reschedules


Sample Page From a Manual Appointment Book

Sample Page From a Manual Appointment Book


Appointment Scheduling Systems Appointment Scheduling Systems

Computerized Appointment Scheduling

• Main advantage: Convenience

– One-time entry of repeating schedule components

– Easy search for available appointment times

– Many useful printout formats

– Interface with account information


Types of Scheduling Types of Scheduling

Structured Appointments – Each patient is allotted a fixed time and duration

• Advantages – Optimum use of time and facility– Opportunity for advance preparation

• Disadvantage – Patients may need more time than expected– Pin down time needs– Incorporate “buffer” time



Structured Appointments – 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



Flexible Hours – Different times on different days

• Accommodate patients and providers with varied schedules

Open hours – First come, first serve

• Eliminates some patient complaints

• Effective time management is difficult

• Can raise confidentiality issues


Factors that Affect Scheduling Factors that Affect Scheduling

Patients’ Needs

• 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

You control the schedule; don’t let it control you!



Providers’ Preferences and Needs

• Adjust to each provider’s punctuality habits

• Allow each provider time for other duties– Receive and return calls– Review reports– Dictate notes– Outside duties

• Establish protocols for unscheduled visitors



Physical Facilities

• Number of users

• Amount of space

• Quantity and availability of equipment

Understand the space and equipment required.


Scheduling Guidelines Scheduling Guidelines

General Guidelines

• Always write the patient’s phone number on the schedule

• Leave open time slots every day to accommodate problems

Be pleasant and helpful



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

• Contact the referring physician

The first encounter is critical.



New Patients

• 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

• Check your work


Patient Reminders Patient Reminders

Appointment Cards

• 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

• Write in ink


An Appointment Card Will Help the Patient Remember His or Her Appointment and Reduce No Shows

An Appointment Card Will Help the Patient Remember His or Her Appointment and Reduce No Shows


Patient Reminders Patient Reminders

Telephone Reminders– Call the day before using the phone number agreed– Keep it simple, including your name, your office,

and the appointment date and time– Check the move-up list and document the call

Mailed Reminder Cards– Send at least a week before– Maintain stock postcards and a tickler file for annual

examination reminders


Sample Reminder PostcardSample Reminder Postcard


Adapting the Schedule Adapting the Schedule

Emergencies

• Have policies to determine can the emergency be treated in the office?

• Have questionnaires to evaluate for a constellation of symptoms

Patients Who Are Acutely Ill

• Obtain the information the physician needs to decide when the patient should be seen



Walk-In Patients

• See emergencies ASAP; refer decisions to physician

– Work in or reschedule

Late Patients

• The patient must wait until the physician is free

• Establish an office rescheduling policy

• Schedule habitually late patients at the end of the day



Physician Delays

• Call patients as soon as possible to reschedule

• Inform patients in the waiting room at once

Missed Appointments

• Determine the reason and reschedule

• Notify the physician of habitual no-shows

Document, document, document!


Cancellations Cancellations

By the Office

• Notify patients ASAP; ask the patients to call to reschedule

• Apologize to patients in the office

By the Patient

• Determine the reason

• Make sure patient understands the need for follow-up

• Check the move-up list to fill the vacancy

• Notify the physician of habitual no-shows

Document, document, document!


Making Appointments for Patientsin Other FacilitiesMaking Appointments for Patientsin Other Facilities

Referrals and Consultations

• Check insurance requirements, including precertification and paperwork. Is the physician on the preferred list?

• Provide physician and patient contact info, including the reason and urgency and whether it is a consultation or referral

• Record the call

• Ask for notice of no-show

• Provide written notice to the patient

• If patient makes an appointment, ask for notice



Diagnostic Testing

• Get instructions – What test(s), how soon

• Get patient conflicts

• Provide the laboratory with patient info, patient lab and appointment info

• Provide the patient with verbal and written explanation of any required preparation

• Document the appointment and post the target date for results in your tickler file



Surgery• Determine and follow precertification requirements

• Call the facility with the physician’s requirements – Patient info and insurance info and precertification number

• Provide the patient with any preadmission forms or instructions

• Write down dates, times, and locations for the patient

• Document the appointment

• If necessary, arrange for hospital admission


When the Appointment Schedule Does Not WorkWhen the Appointment Schedule Does Not Work

If problems are frequent

• Evaluate 2 to 3 months of the schedule

• Involve all staff in your study

• Identify persistent problems– Habitual lateness– Insufficient time allotted– Too many staff make appointments

• Adjust routines to address the problem


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