1. Managing Appointments
Comprehensive Medical Assisting Fundamentals of Administrative Medical Assisting

2. Appointment Scheduling Systems: Manual
Each provider’s appointments
Sample Page from Manual Appointment Book
HOURS
Dr. Jones
Dr. Smith
Dr. Strom
Lab 8 00
Meeting
George Hamilton
Hospital Rounds
Jim Hart 15
Kindergarten PE
Rosie O’Donnell 30
Ralph Lauren
Brad Pitt 45
Abe Lincoln 9
Betsy Johnson
Howie Mandell
Johnny Carson
CPE 10
Mandy Moore
Susan Hill
Recheck
Work Injury
Diana Ross
#ref by Prime Care
Cross out unavailable times
Review carefully and communicate with staff
Patient name
Phone numbers
Reason for visit
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 with a brief explanation. Document all cancellations and reschedules.
Review carefully and communicate with staff.
Document all cancellations and reschedules
CANCELLED

3. Appointment Scheduling Systems: Computerized
One-time entry of repeating schedule components
Easy search for available appointment times
Main advantage is
Convenience
Many useful printout formats
Interface with account information
Name:
Address:
Phone #:
Insurance:
Appointment Date:
Computerized Appointment Scheduling offers the following conveniences:
One-time entry of repeating schedule components,
Easy search for available appointment times,
Many useful printout formats, and
An interface with account information.

4. Types of Scheduling Structured Appointments ADVANTAGES DISADVANTAGES
Each patient is allotted a fixed time and duration
ADVANTAGES
Structured appointments allot a fixed time and duration for each patient.
Advantages are:
Optimum use of time and facility, and
Opportunity for advance preparation.
Disadvantages include:
Patients may need more time than expected,
Pin down time needs, and
Incorporate “buffer” time.
DISADVANTAGES
Optimum use of time and facility
Opportunity for advance preparation
Patients may need more time than expected
Pin down time needs
Incorporate “buffer” time

5. Structured Appointment 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
Methods of setting structured appointments are:
Clustering – Clustering patients with similar needs
Wave or modified wave – Multiple patients are scheduled in blocks
Fixed – Each patient is assigned a specific time and duration
Streaming – Time is allotted according to anticipated need
Double booking – Two patients for each time slot

6. Other Types of Scheduling
Flexible Hours
Different times on different days
Open Hours
First come, first serve
Eliminates some patient
complaints
Effective time management is
difficult
Can raise confidentiality issues
Accommodate patients and providers with varied schedules
“Flexible Hours” means that the office is open at different times on different days accommodating patients and providers with varied schedules.
“Open Hours” is a first come, first serve basis. This method does eliminate some patient complaints, however, it can make effective time management difficult. If a lot of patients come in at the same time, you may need to call out each patient’s name to bring them back to the examining room, and this can raise confidentiality issues.

7. Factors that Affect Scheduling
Duration of Symptoms
Reason for Appointment
Acute or Chronic Condition
Patient’s
Needs
Most Convenient Time
You control the schedule.
Don’t let it control you!
Transportation Constraints
Staff To Be Seen
The patient’s needs are major factors that affect scheduling.
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
Remember, you control the schedule. Don’t let it control you.
Documentation Requirements
Third-Party Payer Constraints

8. Provider’s Preferences And Needs
Adjust to each provider’s punctuality habits
Provider’s Preferences
And Needs
Allow each provider time for other duties:
Receive and return calls
Review reports
Dictate notes
Perform outside duties
Scheduling is also affected by the provider’s preferences and needs.
Adjust to each provider’s punctuality habits. Because certain providers tend to run late, budget that time into the schedule.
Allow each provider time for other duties:
Receive and return calls
Review reports
Dictate notes
Perform outside duties
Lastly, establish protocols for unscheduled visitors.
Establish protocols for unscheduled visitors

9. Physical Facilities Physical Facilities
Number of users
Amount of space
Quantity and availability of equipment
The physical facilities also affect scheduling with the:
Number of users,
Amount of space, and
Quantity and availability of equipment.
Make sure that you understand the space and equipment required.
Understand the space and equipment required

10. Scheduling Guidelines
General Guidelines
HOURS
Dr. Jones
Dr. Smith
Dr. Strom
Lab 8 00
Meeting
George Hamilton
Hospital Rounds
Jim Hart 15
Kindergarten PE
Rosie O’Donnell 30
Ralph Lauren
Brad Pitt 45
Abe Lincoln 9
Betsy Johnson
Howie Mandell
Johnny Carson
CPE 10
Susan Hill
Work Injury
#ref by Prime Care
Always write the patient’s phone number
As general scheduling guidelines:
Always write the patient’s phone number on the schedule.
Leave open time slots every day to accommodate problems.
Leave open time slots every day
CANCELLED
Be pleasant and helpful

11. The first encounter is critical
New Patients
Do you need directions to our office?
INFORMATION
POLICIES
Patient contact
Referrer
Payer
Payment
Paperwork needs
See you May 1st at 10:30am!
The first encounter is critical
For 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; and
Contact the referring physician.
The first encounter is critical. Because first impressions count, you want to convey an efficient yet friendly atmosphere.

12. Don’t forget to check your work
New Patients
Check for possible conflicts
HOURS
Dr. Jones
Dr. Smith
Dr. Strom
Lab 8 00
Meeting
George Hamilton
Hospital Rounds
Jim Hart 15
Kindergarten PE
Rosie O’Donnell 30
Ralph Lauren
Brad Pitt 45
Abe Lincoln 9
Betsy Johnson
Howie Mandell
Johnny Carson
CPE 10
Susan Hill
Work Injury
#ref by Prime Care
Don’t forget to check your work
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.
Don’t forget to check your work.
APPOINTMENT
CARD
Offer a specific date and time
Rachel Weisz

13. Patient Reminders Appointment Cards APPOINTMENT CARD Patient’s Name:
Provide a card for the NEXT appointment only
APPOINTMENT CARD
Patient’s Name:
Date:
Time:
Physician’s Name:
Physician’s Phone:
Keep series on the same day and time
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 and write in ink.
An appointment card will help the patient remember his or her appointment and reduce no-shows.
Helps the patient remember his/her appointment
Reduces no-shows

14. Telephone Reminders
Hello, this is Michelle to remind you about your appointment tomorrow at 9am with Dr. Leon
Call the day before using the phone number agreed. Keep it simple. Include your name, your office, and the appointment date and time. Check the move-up list and document the call.
Call the day before using the phone number agreed
Keep it simple: Include your name, your office, and the appointment date and time
Check the move-up list and document the call

15. Mailed Reminder Cards
Send a week before
Mail out reminder cards at least a week before.
Maintain stock postcards and a tickler file for annual examination reminders.
Maintain stock postcards and a tickler file for annual examination reminders

16. Adapting the Schedule EMERGENCIES ACUTE ILLNESSES
Obtain information for physician to decide when the patient should be seen
Determine if emergency can be treated in office
Evaluate for a constellation of symptoms
For emergencies, have policies to determine if the emergency can be treated in the office.
Also, have questionnaires to evaluate for a constellation of symptoms.
For patients who are acutely ill, obtain the information the physician needs to decide when the patient should be seen.

17. Adapting the Schedule WALK-IN PATIENTS LATE PATIENTS
For walk-in patients, see emergencies ASAP. Refer these decisions to the physician. Work the patient in or reschedule.
For late patients, the patient must wait until the physician is free. Establish an office rescheduling policy and schedule habitually late patients at the end of the day.
See emergencies ASAP (refer to physician)
Work in or reschedule
Patient must wait
Establish rescheduling policy
Schedule late patients at end

18. Adapting the Schedule PHYSICIAN DELAYS MISSED APPOINTMENTS Document!
When there are physician delays, call patients as soon as possible to reschedule and inform patients in the waiting room at once.
For missed appointments, determine the reason and reschedule. Notify the physician of habitual no-shows.
Don’t forget to document, document, document!
Determine the reason
Reschedule
Notify the physician
Call patients to reschedule
Inform waiting patients

19. Cancellations BY THE OFFICE BY THE PATIENT Document!
When appointments are cancelled by the office, notify patients as soon as possible. Ask the patients to call to reschedule. Apologize to patients in the office. When the patient arrives at the rescheduled appointment, thank the patient for being flexible and apologize for any inconvenience.
For cancellations made by the patient, determine the reason. Make sure patient understands the need for follow-up. Check the move-up list to fill the vacancy and notify the physician of habitual no-shows.
Once again: Document, document, document!
Determine the reason
Make sure patient understands to follow up
Check move-up list
Notify the physician
Notify patients ASAP
Ask patients to reschedule
Apologize to patients in office
Thank patient and apologize

20. Referrals & Consultations
When making appointments for referrals and consultations:
Check insurance requirements.
Include precertification and paperwork.
Is the physician on the preferred list?
Provide physician and patient contact info.
Include:
Reason
Urgency
Consultation vs. Referral
If patient makes the appointment, ask for notice
When making appointments for patients in other facilities for referrals and consultations:
Check insurance requirements, including precertification and paperwork and whether or not the physician is on the preferred list.
Provide physician and patient contact info, including the reason, urgency, and whether it is a consultation or referral.
Record the call and ask for notice of no-show.
Provide written notice to the patient.
If patient makes the appointment, ask for notice.
Provide written notice to the patient.
Record the call and ask for notice of no-show.

21. Diagnostic Testing When making appointments for diagnostic testing:
Get instructions.
What tests need to be performed?
How soon?
Get patient conflicts.
Provide the lab with info:
Patient
Patient Lab
Appointment
When making appointments for patients at other facilities for diagnostic testing:
Get instructions. What tests need to be performed and how soon?
Get patient conflicts.
Provide the laboratory with information regarding the patient, the patient lab, and the appointment.
Give the patient verbal and written explanation of any required preparation.
Document the appointment and post the target date for results in your tickler file.
Document the appointment and post the target date for results in your tickler file.
Give the patient verbal and written explanation of any required preparation.

22. Surgery If necessary, arrange for hospital admission
When making appointments for surgery:
Determine and follow pre-certification requirements.
Provide the facility with physician’s requirements:
Patient Info
Insurance info
Pre-certfication #
If necessary, arrange for hospital admission
When making appointments for patients at other facilities for surgery:
Determine and follow pre-certification requirements.
Call the facility with the physician’s requirements: Patient information, insurance information, and pre-certification number.
Provide the patient with any pre-admission forms or instructions.
Write down dates, times, and locations for the patient.
Document the appointment.
If necessary, arrange for hospital admission.
Document the appointment
Write down:
Dates
Times
Locations
for the patient.
Provide the patient with any pre-admission forms or instructions.

23. Identify persistent problems Adjust routine to address the problem
Scheduling Problems
If the schedule doesn’t work,
evaluate it for 2 to 3 months
Involve all your staff
Identify persistent problems
Adjust routine to address the problem
If the appointment schedule doesn’t work and problems are frequent, evaluate it for 2 to 3 months.
Involve all staff in your study. Identify persistent problems such as habitual lateness, insufficient time allotted, or too many staff making appointments.
Adjust routines to address the problem.
Habitual lateness
Insufficient time allotted
Too many staff

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