Chapter 7: Patient Scheduling, Reception, & Related Communication

practice management system

software that assists in the administrative management of a medical office; may be separate or integrated with a medical facility’s EHR system

things to know for managing patient scheduling

advantages/disadvantages of manual and computerized scheduling systems; types of information found in an appointment book or system besides scheduled patient visits; factors that determine the length of a new appointment

information to collect when scheduling appointments

correct spelling of full name; date of birth; contact phone number; reason for visit; insurance information

factors that determine the length of an appointment

whether the patient is new or returning; the complexity of the care the patient will receive

scheduling methods

timed; open hours; wave/modified wave; double-booking; cluster

timed

appointments scheduled at a specific; keeps office running smoothly; reduces patient wait times

open hours

patients do not need an appointment

wave/modified wave

set number of patients scheduled for same time period; patients are soon in order of arrival; allows for more time to “work in” patients

double booking

two patients booked for same timeslot

cluster

appointments scheduled based on disease, condition, or illness

use of timed

most commonly used in medical offices

use of open hour scheduling

most commonly used in urgent care clinics

use of wave/modified wave scheduling

most commonly used in practices when patients are likely to arrive early or late, or where many patients have urgent needs

use of cluster scheduling

most commonly used in practices where it is important to control possible exposure to contagious illnesses

subscriber

in the insurance industry, the person who holds an insurance policy

patient portal

an electronic tool used by many healthcare facilities to communicate with patients and give them access to information about their healthcare

points about new patients

new patients have never seen the provider or have not been seen at the practice for 3 years or more; longer appointments may be necessary for new patients; insurance information must be collected, including the patient’s relationship to the subscriber; the MA must confirm that the practice takes the patient’s insurance; the MA should explain payment procedures to the patient at the time the appointment is scheduled

information in a new patient packet

welcome letter; patient registration; statement of general consent to receive services; appointment policy; notice of privacy practices; notice of patient rights and responsibilities; emergency contact information/acknowledgments; authorization to disclose, use, or release protected health information

patient contact methods

online portal; email; mail; text; phone call

guidelines about scheduling returning patients

patient information verified including reason for visit; update the patient’s information as necessary; print/write appointment cards if the patient is present; monitor and approve online appointment request according to facility policy; follow up with appointment reminders and confirmations according to facility policy

triage

the sorting of patients for treatment based on the urgency of their condition

scheduling disruptions

emergencies; cancellations; missed appointments; late arrivals; walk-ins; provider schedule changes; sales representatives

responding to emergencies

advise a patient calling due to an emergency to hang up and call 911; notify the provider immediately for in-office patient emergencies; follow the facility’s policies regarding working patients with urgent needs into the schedule

responding to cancellations

regularly review the schedule for gaps caused by cancellations; ask patients cancelling appointments to reschedule; note the cancelation in the appointment book and in the patient’s medical record; fill appointment gaps by asking the next patient to come in early or by scheduling someone new in the slot

responding to missed appointments

record a missed appointment in the appointment book and the patient’s medical record as NS; follow provider’s instructions regarding contacting the patient about the missed appointment; follow office policy regarding whether to bill for a no-show or late cancellation

responding to late arrivals

Late arrivals are disruptive to the schedule; follow office policy regarding any grace period or cutoff time that qualifies a late arrival as a no-show; encourage patients to arrive at least 15 minutes early; wave scheduling can minimize disruptions due to late arrivals

responding to walk-ins

patients may choose to walk-in or may arrive on the wrong day unintentionally; attempt to find space for the patient as facility policy allows

responding to provider schedule changes

notify patient if provider will be more than 20-30 minutes late and offer to reschedule them if they are unable to wait; schedule the patient with another provider, if available; follow facility policy for rescheduling patients due to provider schedule changes; some medical offices will have a substitute provider for planned absences

locum tenens

latin word that means a substitute provider will stand in for planned absences

responding to sales representatives

medical equipment and pharmaceutical salespersons sometimes visit during lunchtime or at the end of the day; follow facility policy regarding blocking off time for sales representative visits

notice of privacy practices

a legal document describing how a medical office keeps patient information private

information in patient sign in sheet

name; appointment; provider name

guidelines for checking in a patient

request to scan and/or photocopy the patient’s identification and insurance information; verify that the insurance coverage is current; verify and update address and contact number as needed; have the patient sign a notice of privacy practices; accept payment at check-in if it is facility policy to do so

when patients should sign a notice of privacy practices

all new patients; annually for established patients

patient checkout tasks

collect payment if it was not collected at check-in; provide a receipt of payment to the patient; provide a visit summary, if available; schedule any necessary follow-up appointments; provide the patient with an appointment reminder card; give the patient copies of educational materials related to their diagnosis if requested/assigned to do so

referral

a formal order from a primary care provider for a patient to see a medical specialist or receive medical services

precertification

the process of providing justification for a referral to an insurance provider and assuring that the services are covered by the patient’s policy

preauthorization

approval from an insurance provider confirming that a referral or procedure is agreed to be necessary and will be covered by the patient’s insurance policy

guidelines for patient education related to outpatient rests and surgical procedures

may be delegated to MA by the provider; most offices have instructional materials prepared for common test/procedures'; the MA should review materials with the patient and answer questions within scope of practice

empathy

identifying with the feelings of others

guidelines for communicating with empahty

maintain eye contact; practice active listening; ask questions to clarify the message and get feedback; allow the patient time to express their thoughts/feelings; acknowledge the patient’s feelings and experience

parts of a professional business letter

date; sender’s address; recipient’s address; reference line; salutation; body of letter; closing phrase; signature line

guidelines for business writing

write clearly; use fewer words; use proper grammar and punctuation; have full understanding of terminology; sign and date all letters; keep a professional tone; do not use medical terminology; follow HIPAA guidelines and facility policy to keep electronic communications private

business letter formating

keep a 1-inch margin around all edges; single-space addresses and paragraphs; double-space between the different parts of the letter and between paragraphs; provide four blank lines for sender’s signature; include sender’s name below signature; follow facility policy when typing a provider’s name and credentials

common business letter formats

black, modified block, modified black with indentions, and simplified

block letter

everything lined with the left margin, including date address lines, closing phrase, and signature line

modified block letter

left margin: addresses, salutation, and body of the letter; center or right margin: date, closing phrase, and signature line

modified block letter with indentions

left margin: addresses, salutation, and body of the letter; center or right margin: date, closing phrase, and signature line; indentions at the first line of each paragraph

simplified letter

least formal format; all elements are in line with the left margin; subject line is included in all caps; salutation, closing phrase, and sender’s signature are not included; sender’s name and title are included in all caps

points about medical office communications

are legal documents (can be used in court); letters should be signed by the provider if they are written in their name; copies should be placed in the patient’s medical record

guidelines for terminating a provider-patient relationship

relationship may be terminated if either party is dissatisfied; patient may terminate by not returning to the practice; provider must legally continue to provide care until legal termination; must notify the patient of termination formally in writing; termination letter should state the end date of the relationship; the patient must be given time to find a new provider; termination letter must be sent by certified mail with return receipt requested; copy of the termination letter and return receipt should be placed in the patient’s medical record

amount of time a patient takes to find a new provider

30 days