Scheduling Appointments

Scheduling Appointments
Chapter 40 Scheduling Appointments Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

Pretest True or False For legal purposes, a daily schedule is usually the official record of appointments. Corrections or changes to the official daily schedule are usually made in pencil. Most medical offices use some type of time-specified appointment system. In the stream method of appointment scheduling, each patient is given a different appointment time. An example of clustering patient appointments is making appointments for new patients. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

Pretest, cont. True or False
In the appointment matrix, times when physicians are available to see patients are blocked. Demographic data for new patients are usually obtained when scheduling the first appointment. Many medical offices call patients a few days before an appointment as a reminder. The physician can usually admit a patient to the hospital without insurance preauthorization. Patients usually call the hospital to schedule their own surgery. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

Introduction to Appointment Scheduling
It is important to create a schedule with minimal waiting for the patient It is important to facilitate the smooth function of the office Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

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 Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

Guidelines for Appointment Scheduling, cont.
Obtain necessary and complete information Repeat information for accuracy Schedule the proper amount of time for the type of appointment Document all necessary information Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

Methods of Scheduling Appointment Books
Appointment book is usually spiral-bound so that it will lie flat Each physician usually has his or her own book Choose a book that suits the practice Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

Methods of Scheduling, cont.
Pages may be set up in 10- or 15-minute intervals Appointment books usually kept in pencil Changes can be made easily in the appointment book Daily schedule is typed and used for permanent record Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

Computer Scheduling Appointment intervals can be adjusted Each physician has a screen for each day Easier to change appointments or set up repeating appointments Daily appointment schedules can be printed Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

Daily Appointment Schedule Used to pull medical records for patients Used as a list of patients who will visit the office 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 Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

Types of Scheduling Time-Specified (Stream) Scheduling
Most common way to handle appointments Steady flow of patients (like a stream) The length of time scheduled for the appointment depends on the patient’s needs 30-45 minutes for a new patient 10-20 minutes for an established patient 30-45 minutes for a physical examination Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

Types of Scheduling, cont.
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 Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

Modified Wave Scheduling Patients given appointments at specific times during the first half of each hour Several appointments One long appointment, such as physical examination Second half-hour used for wave Work in patients Finish appointments from the first half-hour Schedule several rechecks on the half-hour Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

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 Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

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 Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

Clustering or Categorization 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 Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

Multiple Offices Physicians may see patients in different offices
Appointments may be booked through a central system or at each individual office If booking centrally, it is important to clarify with patient which office he or she wishes to visit Paper medical record will need to move from office to office Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

Setting Up the Appointment Matrix
Appointment matrix usually set up for 6 months in advance Appointment matrix shows available appointment times Times when a physician is not available to see patients are blocked Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

Setting Up the Appointment Matrix, cont.
In a computer system, blocked times are usually a different color than available appointments Several factors influence the appointment matrix Scheduling system Physician preferences and needs Facilities and equipment Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

Appointment Intervals
Appointment interval is minimum time unit 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 Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

Physician’s Preference and Needs
Times are blocked from the schedule when the physician has other obligations or is not available Hospital rounds Nursing home visits Times are blocked for lunch, meetings, and catch-up Days are blocked for vacation, conferences, lectures, etc. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

Facilities and Equipment Requirements
Physicians may have special needs for equipment or treatment rooms Schedules may have to be coordinated If possible, one or more physicians should be scheduled whenever the office is open Physicians like to have at least two examination rooms available to see patients Improves efficiency and time management Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

Guidelines for Scheduling
Established Patients Insurance billing defines an established patient as one seen in the medical office within the past 3 years Has a current medical record Record patient name, physician, date of birth, and telephone number Written in appointment book for manual system Appear automatically when correct patient is chosen in computer appointment system Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

Guidelines for Scheduling, cont.
If a return appointment, the interval was usually indicated by the physician at the previous visit Patient given the time interval preferred by the physician for return appointments (often called follow-up visits) 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 Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

Special Situations If patient must have laboratory tests, be sure they are scheduled so that results have been received before the next appointment If patient must be fasting, schedule laboratory tests early in the morning 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 Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

New Patients and Referrals Obtain complete information about a new patient Get patient’s full name, daytime phone number, reason for visit, or type of visit For referrals, obtain name of referring physician Obtain referral form if patient has a referral Office of referring physician usually makes appointment and sends referral form Patient sometimes brings the form to the appointment Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

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 Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

Same-Day Appointments Some problems are usually treated the same day the patient calls Wounds without fracture or dislocation Sprains and strains Nausea, vomiting, or diarrhea that persists more than 3-4 days Fever higher than 101F for children and higher than 103F-104F for adults Sudden illness or severe pain without bleeding, fainting, or loss of consciousness Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

Sore throat, especially with fever Burning, frequency, or urgency on urination Vaginal bleeding in a pregnant woman (office or emergency department) If primary physician’s schedule is full, patient may be offered an appointment with another practitioner Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

Urgent Care and Emergencies Give all callers a chance to talk before putting on hold in case it is an emergency Refer emergency calls to the physician Urgent calls can be transferred to any licensed professional If physician is not present, refer caller to emergency medical services (911) Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

Medical Conditions Referred to Emergency Medical Services Conditions that may result in damage to body structures: Breathing problems, or respiratory arrest Severe chest pain, or cardiac arrest Bleeding that cannot be controlled Large open wounds Any suspicion of internal bleeding Potential poisoning or overdose Bleeding in, or injury to, a pregnant woman Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

Conditions that result in a change in the level of consciousness: Loss of consciousness Disorientation Confusion Loss of alertness Fractures, possible fractures, dislocations, or large wounds Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

Individuals Who Are Not Patients Pharmaceutical representatives Salespeople Usually given specific appointment times Often during lunch or another time period that has been blocked from the schedule Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

Walk-in Patients 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 Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

Changing Appointments If using appointment book, erase original appointment and enter all information in new slot If using computer schedule, use “move appointment” feature Moves all information to new slot Deletes original appointment Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

Appointments may be changed because of change in physician’s schedule If physician must leave the office, offer to reschedule or indicate how long before physician likely to return If physician is running behind schedule, some patients may wish to reschedule Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

No-shows are patients who do not keep appointments and do not call to cancel 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 Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

Managing the Appointment Schedule
Late Patients Office usually has 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 Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

Managing the Appointment Schedule, cont.
Appointment Reminders Patients usually given appointment reminder cards for future appointments Most offices call 1 or 2 days ahead to remind patient of appointment Ask new patients for permission to leave a message May send letters or s to patients who need periodic examinations Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

Storing Appointment Books and Daily Schedules Some appointment books used as the office record of appointments Must be in ink Store in secure area Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

The official daily schedule should be updated and stored in a secure place Add all patients who receive appointments that day in ink Mark “no-shows” and cancellations from that day Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

Scheduling Referrals, Diagnostic Tests, Procedures, and Admissions
Referrals and Preauthorizations Referral is an authorization to another physician or health professional, usually a specialist Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

Scheduling Referrals, Diagnostic Tests, Procedures, and Admissions, cont.
Under managed care, a referral is made by the patient’s primary care physician It is an authorization for a specific number of visits Usually the primary care provider can initiate a referral to a physician who participates in the patient’s managed care plan without preauthorization Medicaid always preauthorizes all referrals Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

Preauthorization may be required for some treatments or providers Therapy (physical therapy, occupational therapy, speech therapy) Certain diagnostic tests or procedures Consultations by a physician who does not participate in the insurance plan Surgery and hospitalization Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

If preauthorization is required, medical assistant (MA) usually calls the insurance company and sends a written referral request to follow up Three common types of referrals Specialist physician for consultation Provider of therapy Provider of community-based services (visiting nurse, Meals on Wheels) Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

MA obtains information from the physician, patient, and medical record Completes the referral form Either makes the appointment or instructs the patient to make the appointment Referrals to community resources, such as Meals on Wheels or visiting nurse, may require additional specific information about the patient’s needs Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

Scheduling Diagnostic Procedures and Inpatient Admissions
Scheduling a Diagnostic Procedure Compile information about the patient before scheduling a diagnostic test Patient’s demographic and insurance information including a preauthorization number (if required) or written referral Type of test being performed and reason for the test (diagnosis) Time frame within which the test must be performed Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

Scheduling Diagnostic Procedures and Inpatient Admissions, cont.
Give patient instructions Inform patient when and where the test will be performed Provide directions to the testing facility Provide the facility’s instructions for preparing for the test Document instructions and follow-up Document that patients informed of results of diagnostic tests to avoid lawsuits for malpractice or abandonment Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

Scheduling Diagnostic Procedures and Inpatient Admissions, cont.
Scheduling an Inpatient Admission Obtain preauthorization from patient’s insurance Arrange admission with hospital admitting department Provide patient information Patient’s name, address, telephone number, and date of birth Admitting diagnosis Patient’s insurance information and preauthorization number Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

Say when MD will visit the patient (within first 24 hours) Arrange to send or fax admitting orders If patient is admitted through the emergency department, hospital obtains the information from the patient Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

Scheduling Surgery Information necessary for scheduling surgery
Patient’s name, address, telephone number, and date of birth Type of surgery to be performed Time frame within which the surgery is to be performed Name of surgeon and any assistant surgeons Name of anesthesiologist Name of hospital or day surgery center at which surgery will be performed Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

Scheduling Surgery, cont.
Preauthorization is necessary before scheduling surgery Call the patient’s insurance company to obtain this prior approval Give preauthorization number when scheduling surgery Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

Schedule preadmission testing (PAT) Will include blood tests, ECG, and chest x-ray May be done at hospital or surgeon’s office, or by patient’s primary care physician Patient may be scheduled to donate one or more units of his or her own blood If a transfusion is necessary, using patient's own blood is safer Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

Giving a Patient Instructions before Surgery If surgery will be done under general anesthesia, patient must be NPO Usually after midnight Surgeon may allow morning medication with a sip of water Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

Patient may need to wash with antibiotic soap before surgery Instruct patient not to bring along valuables to the hospital For day surgery, patient should arrange to have someone pick up him or her afterward Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

Documenting an Appointment for Surgery Document all interactions with surgical team members and facilities Document all instructions to the patient in the medical record Document any additional interactions with the patient about the surgery Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

Posttest True or False A written appointment book must be kept to provide a legal record of appointments. If a patient fails to call or keep an appointment, the appointment is crossed out in red on the official daily schedule. In wave scheduling, several patients are given the same appointment time. The method of scheduling appointments with the least waiting time for patients is open hours. 5. Categorization refers to the practice of scheduling patients with similar problems back to back. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

Posttest, cont. True or False
Most medical offices set up the appointment matrix for only the next 2-3 months. If a patient makes an appointment while in the office, he or she should be given a written appointment reminder card. The primary care physician must always obtain insurance preauthorization before providing a referral for a patient. If a medical assistant schedules a diagnostic test for a patient, he or she should also provide any written instructions about preparation for the test. A patient must almost always be scheduled to have an ECG and blood work before he or she can have inpatient or outpatient surgery. Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

Scheduling Appointments

Similar presentations

Presentation on theme: "Scheduling Appointments"— Presentation transcript:

Similar presentations

About project

Feedback

Log in

Auth with social network:

Scheduling Appointments

Similar presentations

Presentation on theme: "Scheduling Appointments"— Presentation transcript:

Similar presentations

About project

Feedback