1. Chapter 37 Patient Reception
Elsevier items and derived items © 2009 by Saunders,
an imprint of Elsevier Inc.

2. Pretest
True or False
The first thing the medical assistant does when opening the office is to unlock the file cabinets, medical record files, and medicine cabinets.
After opening the office, the medical assistant should be sure that the telephones are switched to the day message or call the answering service.
An electronic task system consists of a folder for each month and a folder for each day.
Medical records are usually pulled the evening before the appointment.
A radio, CD player, television, or DVD player is usually turned on in the morning before patients arrive.
Elsevier items and derived items © 2009 by Saunders,
an imprint of Elsevier Inc.

3. Pretest, cont. True or False
The autoclave is often run just before closing the medical office so that instruments can dry overnight.
Only one person should be permitted to stand at the reception desk at a time.
A new patient must sign a form acknowledging receipt of HIPAA privacy practices.
Only the top side of the insurance card must be photocopied.
If a patient has managed care insurance, a referral form may be required to see a physician other than the primary care provider.
Elsevier items and derived items © 2009 by Saunders,
an imprint of Elsevier Inc.

4. Preparing for Patients
Opening and Closing the Medical Office
Duties of first person in the office:
Disarm the alarm system
Turn on the lights
Unlock the door through which patients enter
Unlock file cabinets, medical records files, and medicine cabinets
Turn on all of the office equipment that will be used
Elsevier items and derived items © 2009 by Saunders,
an imprint of Elsevier Inc.

5. Preparing for Patients, cont.
Checking for Messages and/or Faxes
Duties to prepare telephone system for the day’s activities:
Switch from the night/weekend message to the day message on the voice mail system
If office uses an answering service, need to notify service that office is open
Elsevier items and derived items © 2009 by Saunders,
an imprint of Elsevier Inc.

6. Preparing for Patients, cont.
Checking for faxes that have arrived overnight
Route to the appropriate person
Make sure fax machine has adequate amount of paper
Retrieve messages from a separate prescription request mailbox
Elsevier items and derived items © 2009 by Saunders,
an imprint of Elsevier Inc.

7. Preparing for Patients, cont.
Preparing for the Day’s Activities
Review the day’s tasks
Note any deviations from normal routine
Prepare manual day sheet if it will be used
Review electronic task system or tickler file
Tickler file is set of 12 folders (one for each month) plus 31 additional folders (one for each day of the month
Contains notes, bills to be paid, other items for the day when it must be handled
Elsevier items and derived items © 2009 by Saunders,
an imprint of Elsevier Inc.

8. Preparing for Patients, cont.
Making Sure Patient Charts Are Prepared
Patient charts are usually pulled the evening before the appointment
Charts are arranged with an appointment schedule for each physician
A charge slip is printed for each person and placed with the record
May be printed when charts are pulled
May be printed when the patient arrives
Elsevier items and derived items © 2009 by Saunders,
an imprint of Elsevier Inc.

9. Preparing for Patients, cont.
Appointment schedules are updated as patients are added
Appointment schedule printed for each physician and placed throughout the office
Charts are usually kept at the front desk until the patient arrives
Elsevier items and derived items © 2009 by Saunders,
an imprint of Elsevier Inc.

10. Preparing for Patients, cont.
Checking the Office and Waiting Room
Waiting room should be checked for:
Cleanliness
Neatness
Correct temperature
Elsevier items and derived items © 2009 by Saunders,
an imprint of Elsevier Inc.

11. Preparing for Patients, cont.
Neat and Tidy Waiting Room
Elsevier items and derived items © 2009 by Saunders,
an imprint of Elsevier Inc.

12. Preparing for Patients, cont.
Television, radio, and/or DVD player in waiting room should be turned on
Any toys in children’s play area are cleaned regularly
Holders for patient information brochures are tidied and restocked
Elsevier items and derived items © 2009 by Saunders,
an imprint of Elsevier Inc.

13. Preparing for Patients, cont.
Checking Equipment and Supplies
Office should be checked visually for safety
Fill paper trays of copier and printer
Check examination rooms and restock as needed
Turn on equipment in laboratory as needed and run controls
Unload autoclave if it was used the night before
Elsevier items and derived items © 2009 by Saunders,
an imprint of Elsevier Inc.

14. Preparing for Patients, cont.
Closing the Medical Office
Autoclave may be run and medical records pulled at the end of the day
Allows instruments to dry overnight
Gives more time in the morning
Make backup copy of main computer hard drive as needed
Elsevier items and derived items © 2009 by Saunders,
an imprint of Elsevier Inc.

15. Preparing for Patients, cont.
Other duties are reverse of opening the office:
Turn off all equipment except fax machine and telephones
Change telephone system to night message and/or call answering service
Lock the door through which patients enter
Lock file cabinets, medical record files, and medication cabinets
Make sure kitchen equipment is turned off
Turn off lights
Alarm system is set as the last person leaves
Elsevier items and derived items © 2009 by Saunders,
an imprint of Elsevier Inc.

16. Patient Check-In
Important to acknowledge each person who enters the office as soon as possible
Prevents person from feeling awkward
Sign-in sheet should have adhesive peel-off strips to preserve confidentiality
Elsevier items and derived items © 2009 by Saunders,
an imprint of Elsevier Inc.

17. Patient Check-In, cont. Maintaining Confidentiality
Sliding glass window prevents people in the waiting room from hearing telephone conversations, etc., in the reception area
If open desk, medical assistant (MA) avoids conversation with patient when another patient is at the desk
Only one patient at the reception desk at a time
If information provided is sensitive, patient is taken to private area
Elsevier items and derived items © 2009 by Saunders,
an imprint of Elsevier Inc.

18. Patient Check-In, cont. New Patients
Forms completed and/or signed by a new patient
Personal and insurance information (if not already recorded)
Consent for treatment/release of information form
Form authorizing assignment of benefits
Payment will go directly to the office
Elsevier items and derived items © 2009 by Saunders,
an imprint of Elsevier Inc.

19. Patient Check-In, cont. Sample New Patient Information Form
Elsevier items and derived items © 2009 by Saunders,
an imprint of Elsevier Inc.

20. Patient Check-In, cont.
Acknowledgement of Receipt of HIPAA Privacy Practices
New patient is given a copy of the notice of office privacy practices
New patient signs a form acknowledging receipt of notice of privacy practices
If office policy, new patient signs a general form consenting to release of information
Elsevier items and derived items © 2009 by Saunders,
an imprint of Elsevier Inc.

21. Patient Check-In, cont.
Sample Acknowledgement of Receipt of HIPAA Privacy Practice
Elsevier items and derived items © 2009 by Saunders,
an imprint of Elsevier Inc.

22. Patient Check-In, cont.
Optional Consent for Disclosure of Protected Health Information
Elsevier items and derived items © 2009 by Saunders,
an imprint of Elsevier Inc.

23. Patient Check-In, cont. Patient History Form
New patient fills out a history form before seeing the physician
May be mailed to the patient or given before the first visit
Elsevier items and derived items © 2009 by Saunders,
an imprint of Elsevier Inc.

24. Patient Check-In, cont.
Verifying Insurance and Obtaining Authorizations
Photocopy both sides of the insurance card
Some insurance companies require authorizations every time the patient sees the primary care physician
Medicaid patients usually have to be verified and/or receive prior authorization for each visit
Medicaid is an insurance program established by the federal government
Medicaid pays for low-income patients’ medical needs
Medicaid patients can be verified by card reader, telephone, or fax
Elsevier items and derived items © 2009 by Saunders,
an imprint of Elsevier Inc.

25. Patient Check-In, cont. Card Reader to Verify Insurance
Elsevier items and derived items © 2009 by Saunders,
an imprint of Elsevier Inc.

26. Patient Check-In, cont.
Other types of insurance may necessitate calling the patient’s insurance company to obtain authorization for treatment
Call if there is a question about whether the insurance will cover the visit before patient is seen
Elsevier items and derived items © 2009 by Saunders,
an imprint of Elsevier Inc.

27. Patient Check-In, cont. Verifying a Managed Care Referral
For physician other than primary care provider, a paper or electronic referral form may be required
Referral form will state how many visits are allowed
Elsevier items and derived items © 2009 by Saunders,
an imprint of Elsevier Inc.

28. Patient Check-In, cont.
Referral form will state problem for which the patient is being referred
If a referral, must accept what insurance pays
If not covered by insurance or no referral form, patient must be informed of responsibility for bill
Elsevier items and derived items © 2009 by Saunders,
an imprint of Elsevier Inc.

29. Patient Check-In, cont. Established Patients
Verify that billing information is correct each time patient visits the office
Update information when there are any changes
Elsevier items and derived items © 2009 by Saunders,
an imprint of Elsevier Inc.

30. Patient Check-In, cont. Accepting Copayments
Copayment is a fixed amount of money that the patient is required to pay each time he or she receives medical treatment
Amount is usually printed on the patient’s insurance card
Copayment may be collected before the visit because it is a fixed fee
Patient is given a receipt for copayment and amount is recorded on patient’s charge slip
Elsevier items and derived items © 2009 by Saunders,
an imprint of Elsevier Inc.

31. Patient Check-In, cont.
Indicating That the Patient Is in the Waiting Room
After patient has been checked in, medical record is placed in designated space
Patient placed in examination room when one is free
Forms are inserted in the medical record or scanned into an electronic medical record
Elsevier items and derived items © 2009 by Saunders,
an imprint of Elsevier Inc.

32. Patient Check-In, cont.
Charge slip is usually attached to front of medical record or routing slip
Physician will complete the charge slip
Patient information is checked and/or added in the computer
Elsevier items and derived items © 2009 by Saunders,
an imprint of Elsevier Inc.

33. Orienting Patients to the Medical Office
Information for New or Prospective Patients
Brief description of the physicians and information about them
How long each physician has been in practice
Each physician’s credentials
Which physicians are accepting new patients
Elsevier items and derived items © 2009 by Saunders,
an imprint of Elsevier Inc.

34. Orienting Patients to the Medical Office, cont.
Specialties of each physician in the office
Information about languages spoken
Location of the main office and satellite offices
Directions to office(s)
Information about parking
Information about access to public transportation, if applicable
Elsevier items and derived items © 2009 by Saunders,
an imprint of Elsevier Inc.

35. Orienting Patients to the Medical Office, cont.
Types of insurance that the practice accepts
Payment policy
How far in advance to make appointments and policy on canceling appointments
“Call-in” times or when the physician will return calls
What hospitals and/or nursing homes the physician is affiliated with
How medication refills are handled
Elsevier items and derived items © 2009 by Saunders,
an imprint of Elsevier Inc.

36. Orienting Patients to the Medical Office, cont.
If Physicians Aren’t Accepting New Patients
Some doctors may not be accepting patients
They already have as many patients as they can handle
They have been out on leave
They are planning to retire
Elsevier items and derived items © 2009 by Saunders,
an imprint of Elsevier Inc.

37. Orienting Patients to the Medical Office, cont.
Instructions for First Appointment
Tell patients how much time to allow for the visit
Remind patients to bring all medications to an initial visit
Elsevier items and derived items © 2009 by Saunders,
an imprint of Elsevier Inc.

38. Orienting Patients to the Medical Office, cont.
Case Study for Discussion
Donna Pohl calls the office to ask about the medical practice. An acquaintance has recommended Dr. Sylvia Lawrence. She says that she prefers a female physician. She asks for information about her and her specialty. Dr. Lawrence specializes in general internal medicine. At the current time she is pregnant, and her due date is 1 month away.
Elsevier items and derived items © 2009 by Saunders,
an imprint of Elsevier Inc.

39. Orienting Patients to the Medical Office, cont.
Although Dr. Lawrence is still seeing established patients, she has instructed Keisha not to make any appointments for her with new patients for the next 3 months. The other physician in the practice, Dr. William Rudner, also specializes in general internal medicine.
Elsevier items and derived items © 2009 by Saunders,
an imprint of Elsevier Inc.

40. Orienting Patients to the Medical Office, cont.
Patient Information Booklet
Many offices have an information booklet or brochure
Important to keep booklet up to date
Patient information booklets are very successful marketing tools
Elsevier items and derived items © 2009 by Saunders,
an imprint of Elsevier Inc.

41. Orienting Patients to the Medical Office, cont.
Protecting Patient Confidentiality during Check-in
HIPAA regulations are not specific about sign-in lists
If possible, other patients should not know who is in the waiting room
Sign-in lists with peel-off labels are recommended to minimize time that name is visible
When staff calls the patient, name is removed from the list
Elsevier items and derived items © 2009 by Saunders,
an imprint of Elsevier Inc.

42. Orienting Patients to the Medical Office, cont.
Silent wireless paging systems are available
Patients may indicate seat position on a chart at the desk to avoid having to call their name
Computer screens should be turned so that patients at the reception desk cannot see them
Shredder should be located at front desk to destroy any notes with patient names that are not saved
Elsevier items and derived items © 2009 by Saunders,
an imprint of Elsevier Inc.

43. Posttest
True or False
As soon as the medical assistant has opened the office, he or she usually runs the autoclave.
After opening the office, the medical assistant should check the fax machine for faxes that may have arrived overnight.
A tickler file is used to remind the medical assistant of tasks to be done on a specific day.
The first major task for the medical assistant in the morning is to pull the medical records for all patients to be seen that day.
Holders for patient information brochures are often located in the waiting room.
Elsevier items and derived items © 2009 by Saunders,
an imprint of Elsevier Inc.

44. Posttest, cont. True or False
The medical assistant turns off all equipment as the last thing when closing the office.
A sliding glass window between the waiting room and reception desk helps maintain patient confidentiality.
A new patient must sign a form providing consent for treatment and release of information.
Insurance companies usually require authorization every time the patient sees the primary care physician.
If the patient has a copayment, it is usually collected before the patient sees the physician.
Elsevier items and derived items © 2009 by Saunders,
an imprint of Elsevier Inc.