Scheduling Appointments Chapter 10

Introduction Scheduling keeps the office functioning smoothly throughout the business day. If scheduling is not done efficiently, the entire office does not function efficiently.

This chapter will examine: Three methods of appointment scheduling How to recover from schedule interruptions Setting up a scheduling matrix Dealing with consistently late patients Reasons for failed appointments

Guidelines for Appointment Scheduling Some offices stick to a strict schedule. Some are more flexible. Some are never on schedule, no matter what day or time an appointment is made.

Guidelines for Appointment Scheduling Appointment scheduling systems must be individualized to each specific practice. When scheduling, consider three things: Patient need Physician preference and habits Available facilities

Patient Needs Determining Office Hours and Appointment Times: Is the office located in a busy metropolitan area or a rural area? What are the average ages of the patients? Is the area more industrial or residential? What types of patients are seen? Are evening and weekend appointments essential for most of the patients served?

Assessing Patient Needs What is the purpose of the visit? Will the patient require the physician’s time, or will other staff members perform all or part of the service? What is the age of the patient? Does the patient need an after-school appointment? Does the patient object to traveling after dark? Will the patient have problems taking off work for appointments?

Physician Preferences and Habits Does the physician become restless if the reception room is not packed with waiting patients? Does the physician worry if even one patient is kept waiting? Is the physician methodic and careful about being in the facility when patient appointments are scheduled to begin?

Physician Preferences and Habits Is the physician habitually late? Does the physician move easily from one patient to another? Does the physician require a break time after a few patients? Would the physician rather see fewer patients and spend more time with them or more patients throughout the day?

Available Facilities Make certain that the facilities needed for each patient will be available when scheduling appointments.

Methods of Appointment Scheduling The two most common methods of appointment scheduling are: Computer-based Appointment book

Appointment Books Consider the following features when choosing an appointment book. The size should conform to the desk space available. The book should be large enough to accommodate the practice. The book should open flat for easy writing and reference. The book should allow space for writing when the appointment will be, who the patient is, and why the patient is being seen. Bottom line = Physician preference

Appointment Books Color-coded books are easy to use and are helpful when the patient is to be seen a certain number of weeks later.

Computer Scheduling Computers can select the best appointment time based on the information entered about the patient. The length of time needed for various procedures can be entered in advance, and when that procedure is scheduled, the correct time will be automatically allotted.

Computer Scheduling Computers can search by patient name and find all scheduled appointments. More than one person can use the scheduling program at one time. Printouts can be produced for all of the employees who need that information.

Self-Scheduling Patients can log on and schedule their own appointments. Allows for patient confidentiality by showing only available appointment times. Reduces calls to the office. Available to patients 24 hours a day. Computer-illiterate individuals will object to such a system, so phone scheduling should still be made available.

Advance Preparation Establishing a Matrix Block off time slots when the physicians are not available: - Holidays - Days off - Lunch, dinner, and other breaks - Time for hospital rounds - Meeting times - Vacations

Types of Appointment Scheduling Open Office Hours Also called tidal wave scheduling. Patients are seen in the order of their arrival. Often used in rural practices. Can result in long wait times. Can overburden office staff members.

Types of Appointment Scheduling Scheduled Appointments Practitioners can see more patients with less pressure. Scheduling appointments takes skill, organization, and efficiency. The scheduler must know the length of time involved with various procedures and various classifications of office visits.

Types of Appointment Scheduling Flexible Office Hours Evening hours Weekend hours Extended hours late in the evening Early morning hours

Types of Appointment Scheduling Wave Scheduling Creates short-term flexibility within each hour. Assumes the actual time needed for all patients will even out over the course of the day. Schedules three patients for one time slot. Those three patients are seen in the order of their arrival.

Types of Appointment Scheduling Modified Wave Scheduling Two patients arrive at the top of an hour. A third patient arrives at half past the hour. This hourly cycle is repeated throughout the day. Can be modified further, such as scheduling three patients for one hour and none the next hour.

Types of Appointment Scheduling Double Booking Scheduling two patients at the same time. Often frustrating for patients. Scheduler must consider the reason for the appointment when using this method to ensure enough time is allotted for the patients. Grouping Procedures Scheduling like procedures together

Types of Appointment Scheduling Advance Booking Set appointments far in advance whenever possible. Give patients appointment cards to remind them of their time and date. Confirm appointments as they approach. Reschedule if needed.

Time Patterns Leave some open time during each day’s schedule. Keep one available appointment in the morning and in the afternoon. Schedule time for the physician to take a break in the morning and afternoon.

Time Patterns Remember that Mondays and Fridays are heavy phone and appointment days. Allow for more buffer time on these two days.

Patient Wait Time Be aware of the amount of time patients have been waiting. Patients should be called to the back office at their scheduled appointment time. Patients should not have to wait more than 5 or 10 minutes from then to see the physician .

Patient Wait Time (cont’d) If the patient has waited more than 15 minutes in the reception area, offer an explanation for the delay. Give the patient the option of waiting or rescheduling

Telephone Scheduling Use excellent telephone technique when scheduling appointments. Be considerate of requested times whenever possible. Explain why a time is not available, and offer a substitution.

Offering Patients Choices Offer the patient: A choice of days A choice of morning or afternoon A choice of times

Writing in the Appointment Book Write legibly. Remember that the appointment book may be subpoenaed to court. Put the patient’s contact phone number next to all entries. Use cell phone numbers whenever possible.

Scheduling New Patients Gather as much information as possible on the telephone when scheduling the first appointment. Attempt to get all of the information needed to construct the patient’s medical record. Determine the amount of time needed for the office visit.

Scheduling New Patients Offer the first available appointment to the patient. Remember to offer choices when scheduling the appointment. Explain parking issues. Give accurate directions to the office. Explain the approximate cost for the first visit, and make the patient aware of payment policies for new patients.

Preparing for New Patients Mail patient information packets if there is time before the actual appointment date. Send the information via email if possible. Determine if the patient is a referral. Send a thank-you note to the person who referred the patient. Confirm the appointment the day before.

Scheduling Established Patients In Person Usually done when the patient is leaving the office after an appointment. Offer the patient choices in day, date, and time. Always offer an appointment card. Provide excellent customer service to the patient.

Scheduling Established Patients By Telephone Offer the patient a choice of day, date, and times. Ask the patient if there have been any significant changes in address, phone numbers, or insurance coverage if he or she has not been to the office in a while.

Scheduling Other Types of Appointments Inpatient Procedures Call the facility where the appointment is to take place. Provide any information requested about the patient. Determine what the patient should bring to the facility when arriving for admission. Provide all appointment details to the patient in writing, if possible.

Scheduling Other Types of Appointments Outpatient and Inpatient Procedure Appointments Call the facility where the appointment is to take place. Provide any information requested about the patient. Determine what the patient should bring to the appointment. Provide all appointment details to the patient in writing, if possible.

Physician Orders Some physicians give patients the orders to take with them for inpatient and outpatient admissions. Often, orders are written on a prescription form for outpatient procedures and treatments.

Series of Appointments Some patients need a series of appointments for repeat or continued treatment. Try to set the appointments for the same times and days for ease of remembering. Provide appointment cards to the patient.

Series of Appointments

Special Circumstances Late Patients Be understanding when emergencies occur. Make certain patients are aware of policies that affect late patients. Tell habitually late patients to arrive 30 minutes before their actual appointment time.

Special Circumstances Rescheduling Canceled Appointments Make certain to remove the original appointment before scheduling the new appointment.

Special Circumstances Emergency Calls Triage the call according to policy. First, make certain to obtain a phone number and address where the patient is located. Project a caring and reassuring attitude.

Special Circumstances Acutely Ill Patients Follow office policy in deciding whether the patient should be scheduled for the same day. Escort acutely ill patients directly to examination rooms if possible on their arrival.

Special Circumstances Physician Referrals Honor requests for fast scheduling of patients who are referred by other physicians if at all possible. Obtain patient information from the referring office, if possible.

Special Circumstances Patients without Appointments Follow office policy for seeing patients without appointments. If the patient does not need to be seen immediately, schedule for the first available time. Make the patient aware of the appointment policy.

Special Circumstances Failed Appointments or No-shows Confirm appointments according to office policy. Attempt to reschedule the appointment. Make certain the patient understands the cancellation policy. Some offices charge patients for failed appointments if they do not cancel within 24 to 48 hours before the scheduled time.

Other Types of Appointments Other physicians Pharmaceutical representatives Salespersons Miscellaneous callers

Planning for the Next Day Look over the appointments. Review the medical records of patients to be seen. Make certain all laboratory reports and other information is available for physician review.