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Scheduling Appointments and Maintaining the Physician’s Schedule

12. Scheduling Appointments and Maintaining the Physician’s Schedule. Learning Outcomes. 12.1 Explain the importance of the appointment book in maintaining the schedule in the medical office. 12.2 Identify common scheduling abbreviations.

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Scheduling Appointments and Maintaining the Physician’s Schedule

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  1. 12 Scheduling Appointments and Maintaining the Physician’s Schedule

  2. Learning Outcomes 12.1 Explain the importance of the appointment book in maintaining the schedule in the medical office. 12.2 Identify common scheduling abbreviations. 12.3 Identify different types of appointment scheduling systems. 12.4 Discuss ways to arrange appointments for patients.

  3. Learning Outcomes (cont.) 12.5 Explain how to handle special scheduling situations. 12.6 Explain how to properly document no-shows and late patients. 12.7 Describe how to schedule appointments that are outside the medical office. 12.8 Discuss ways to keep an accurate and efficient physician schedule.

  4. Introduction • Scheduling systems • Types • How each is used • Scheduling situations • Appointment book • Legal aspects • Documentation

  5. The Appointment Book A well-managed appointment book Unexpected events that occur • Early and late arrivals • No-show patients • Emergencies • Physicians spend extra time with patients • Creates an efficient patient flow • Shows respect for everyone’s time by preventing excessive wait time

  6. The Appointment Book (cont.) • Preparing the appointment book • Create thematrix,or basic format • Block off times the doctor is unavailable • Examples of when time should be blocked off • Hospital rounds • Surgery • Vacation and holidays • Scheduled meetings

  7. The Appointment Book (cont.) • Computer or traditional paper appointment book • Obtain patient information • Patient’s full name • Home and work telephone numbers • Purpose of the visit • Use only approved abbreviations

  8. Determining Standard Procedure Times • Create a standard list of procedure times • Indicate how much time to allow for the tests • Use only as a guide • Helps identify appointment openings appropriate for the patient visit

  9. Determining Standard Procedure Times(cont.) How Long Will Each Take? 5-10 min 30–60 min Complete physical examination 10-20 min 30 min Minor in-office surgery 15 min 15–20 min Emergency office visit 15-20 min 30 min or > New patient visit 10–20 min 15-30 min Suture removal Prenatal examination 30 min 15 min 30 min or > Follow-up office visit 5–10 min Pap smear and pelvic exam 15–30 min 30-60 min

  10. A Legal Record • Keep appointment books for at least 3 years • Entries must be clear and easy to read General Tips... • Never erase a name or use liquid paper • Use blue ink and never pencil • Draw a single line through the name • Write the date, time, and reason for cancellations • Document cancellations and no-shows in patient’s record

  11. Apply Your Knowledge Use your knowledge of abbreviations and scheduling to order these from least time required to most time required. (1= least time required and 5= most time required) 3 5 2 1 4 S/R CPE FU CAN P&P suture removal10–20 min. ANSWER: complete physical examination30–60 min. GOODJOB! follow-up appointment5–10 min. cancellation0 min. Pap smear and pelvic examination15–30 min.

  12. Appointment Scheduling Systems • Goals • Smooth flow of patients • Minimal waiting time • Open-hours scheduling • No appointments • Patients arrive at their own convenience • Seen on a first-come, first-served basis • Rural practices and urgent care centers

  13. Appointment Scheduling Systems(cont.) • Time-specified scheduling • Stream scheduling • Patients are scheduled for specific times • At regular intervals • Time based on reason for the appointment

  14. Appointment Scheduling Systems (cont.) • Wave scheduling • Large offices • See several patients at the same time • Seen in the order of their actual arrival • Flexibility for appointments that run longer than planned • Uses an hourly target • Number of patients to be seen hourly determined by dividing 60 minutes by the average estimated length of visits • Multiple patients at the same time can result in • Patient dissatisfaction • Annoyance

  15. Appointment Scheduling Systems (cont.) • Modified-wave scheduling • Options • Patients scheduled in 15-minute increments • Four patients scheduled during the first half hour and the second half hour is left free for catch-up • Double-booking • Two or more patients scheduled for the same time • Both patients will see the doctor within the scheduled period • One may be seen by NP or PA • Used when patient with no appointment needs to be seen

  16. Appointment Scheduling Systems (cont.) • Cluster scheduling (categorization) • Groups similar appointments together • Useful if specialized equipment has limited availability • Advance scheduling • Scheduling patients weeks or months in advance, such as with annual exams • Leave a few slots open for patients with unexpected problems • Combination scheduling – Using two scheduling methods

  17. Appointment Scheduling Systems (cont.) • Computerized scheduling – advantages • Can “lock out” selected appointment times • Information can be accessed from all office terminals • Help identify patients who are late, miss appointments, cancel, or require more time with the physician • Reports to help improve efficiency • Online scheduling – patients make own appointments via the Internet

  18. Apply Your Knowledge A large pediatrician office commonly must “squeeze in” patients in that have become ill, so this new office plans to offer immunizations only twice per week. Which scheduling system(s) would you recommend for this medical practice? ANSWER: Combination scheduling consisting of cluster and a form of wave scheduling would be recommended to allow for the needed flexibility. Right!

  19. Arranging Appointments • Offer choices • Dates • Times • Accommodate patient’s needs whenever possible • Confirm choice with patient

  20. New patients Those not established at the medical office Obtain all necessary information Name Address and phone number Date of birth Insurance information Have patient arrive 15–30 minutes early to fill out forms Return appointments Ask patients if they need another appointment before they leave Arranging Appointments (cont.)

  21. Appointmentcards Reminder mailings • A postcard addressed to the patient that is mailed one week before theappointment • After appointment time is entered in the book, it is recorded and given to the patient Reminder calls Recall notices • Form letter sent toremind patients to call for an appointment • 1–2 days before the scheduled appointment, the office calls the patient Arranging Appointments (cont.) Appointment Reminders

  22. Apply Your Knowledge The doctor wants Mr. Lincoln to return to the office for a follow-up appointment in two weeks. What should the medical assistant do? ANSWER: The medical assistant should offer Mr. Lincoln a choice of dates and times available to accommodate Mr. Lincoln’s needs. After entering the appointment in the book or into the computer, confirm the date and time with the patient and give him a appointment card. TERRIFIC!

  23. Special Scheduling Situations:Patient • Emergencies • Seen immediately upon arrival at the office • Explain to waiting patients without details • Provide opportunity to reschedule • Referrals • Referred patients should be seen as soon as possible • When arranging referrals for a patient • Provide choices • Be sure the facility accepts the patient’s insurance • Document in patient record

  24. Special Scheduling Situations: Patient(cont.) • Fasting patients • Refrain from eating or drinking – usually beginning the night before the appointment • Schedule as early as possible in the day • Instruct patient about the need to fast and when to start

  25. Special Scheduling Situations: Patient (cont.) • Patients with diabetes • Require regular meals and snacks to regulate blood glucose • Consider avoiding late morning slots that are close to lunchtime • Keep appropriate snacks on hand in the event a patient develops a low blood sugar

  26. Special Scheduling Situations: Patient (cont.) • Repeat visits • Schedule regular appointments on same day and time • Late arrivals • Schedule chronically late patients toward the end of the day • Prevents disruption in the office schedule • Document late arrivals or missed appointments in patient record

  27. Special Scheduling Situations: Patient (cont.) • Walk-ins • If it is an emergency, handle as such • If no openings, offer to schedule an appointment • Post a sign in the office if no walk-ins are allowed

  28. Special Scheduling Situations: Patient (cont.) • Cancellations • Thank patient for calling to cancel • Appropriately mark appointment as canceled • Attempt to reschedule while the patient is on the phone • Document cancellation in the patient’s medical record S Smith 098-765-4321 R Hansen 456-789-0123 M Fitz 321-456-0987 J. Jones 123-456-7890 cancelled

  29. Special Scheduling Situations: Patient (cont.) • Missed appointments • Document no-shows in the appointment book and patient medical record • Inform the physician of no-shows • Wrong day • Reschedule if patient lives locally • Attempt to accommodate if patient required special transportation or traveled far H Plummer 234-543-2345 P. Lexar 098-765-4321 No show

  30. Physician Scheduling Situations • Physicians may throw the schedule off by • Arriving late to the office • Returning late from lunch or meetings • Being called away for emergencies • Being delayed at the hospital If a physician is late repeatedly, you may want to add some buffer time to the schedule and slot patients accordingly.

  31. Apply Your Knowledge Mr. Washington needs a follow-up appointment in a week for a fasting blood sugar after the physician changed his medicine for diabetes. How should you handle this appointment? ANSWER: The appointment should be made for the first or second appointment for that day. Mr. Washington should be reminded he should not eat or drink after midnight, and that he should not take his diabetes medicine prior to the appointment but should bring it with him. SUPER!

  32. Scheduling Outside Appointments • Common outside appointments include • Consults with other physicians • Laboratory work • X-rays and other diagnostic tests • Hospitalizations and surgeries • Be sure to have a doctor’s order specifying • Procedure • When results are needed

  33. Scheduling Outside Appointments (cont.) • Validate the patient’s insurance prior to selecting the outside physician or facility • HMOs often arrange referrals and notify office when approved • Discuss possible appointment times with patient or give patient information to make appointment • Give pre-appointment instructions if necessary

  34. Apply Your Knowledge Mr. Anderson calls at 0830 and cancels his 0900 but calls the office again at 1230 c/o redness and discomfort at his surgical site. What should the medical assistant do? ANSWER: The medical assistant should tell the patient to come right in due his complaints of incision redness and discomfort. However, Mr. Anderson should also be told that he will be “worked in” around other patients’ appointments. Very Good!

  35. Do Not Overbook Do Not Underbook Maintaining the Physician’s Schedule Maintain a Balance

  36. Maintaining the Physician’s Schedule(cont.) • Overbooking • Scheduling too many patients • Office schedule falls behind • Stressful for staff • Underbooking • Gaps in schedule • Try to schedule another appointment in cancelled time slot

  37. Emergencies or delays Apologize to waiting patients and give an estimated waiting time Offer choice Leave and return at agreed-upon time Reschedule appointment for another day Reserving operating rooms Give preferred days and times Provide type and approximate length of procedure Maintaining the Physician’s Schedule(cont.)

  38. Maintaining the Physician’s Schedule(cont.) • Scheduling pharmaceutical sales representatives • Block time for this purpose • New representatives • Request a business card • Check with the physician before scheduling an appointment

  39. Maintaining the Physician’s Schedule(cont.) • Making travel arrangements for out-of-town meetings or events • Medical assistant may be responsible for • Airline arrangements (get itinerary) • Car rentals and lodging • Get confirmations for all reservations • A locum tenensor substitute physician may cover practice while regular physician is away

  40. Maintaining the Physician’s Schedule(cont.) • Planning meetings • Find out number of people, length and purpose of meeting • Secure location with adequate room and parking • Prepare an agendaif requested • Secure equipment such as podium and microphones • Take minutes as needed

  41. Maintaining the Physician’s Schedule(cont.) • Schedule regular time with the physician • Review schedule • Other items • State medical license • Drug Enforcement Agency registration • Documentation of continuing medical education (CME) requirements

  42. Apply Your Knowledge ANSWER: When making travel arrangements for the physician, which of the following would be the responsibility of the medical assistant? • Locum tenens • Itinerary • Agenda Right!

  43. 12.1 The appointment book is important in a medical office because it shows respect for the physician’s time and creates an orderly and efficient patient flow. 12.2 Commonly used abbreviations save space and time when entering information into an appointment book. 12.3 There are several different types of appointment scheduling systems. They range from open-hours scheduling to computerized scheduling. In Summary

  44. In Summary (cont.) 12.4 When arranging appointments for patients, be courteous and polite. Offer different dates and times; always confirm the appointment by repeating it to the patient. 12.5 Special scheduling requires creativity and flexibility. 12.6 Document late arrivals and no-show patients. Call to discuss reasons for lateness or no-show.

  45. 12.7 Before scheduling outside appointments, ask the doctor for exact procedures that need to be performed, and which results will be needed. 12.8 Your job as a medical assistant is to keep the physician’s schedule accurate and efficient. Do not overbook or underbook. In Summary (cont.)

  46. End of Chapter 12 Taking a few extra minutes, going that extra mile, and giving that added special touch can make a world of difference in a very difficult situation. ~ Lisa Lockhart (From A Daybook for Nurses: Making a Difference Each Day)

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