Electronic Record Procedures

Key components of medical information

Demographics, medical history, and social history

What is medical information vital for?

Informed decision-making, continuity of care, and legal compliance

What are the key aspects of insurance management?

Verification of coverage, types of insurance plans, and financial responsibilities

What is insurance management vital for?

Preventing claim denials, enhancing patient experience, and streamlining billing processes

HMO in insurance management

Requires patients to use a network of providers and obtaining referrals for specialists

PPO in insurance management

Offer more flexibility in choosing providers, but could come with higher out-of-pocket costs

EPO in insurance management

Combine features of HMOs and PPOs, limiting coverage to network providers, except in emergencies

What are financial responsibilities?

Copayments, deductibles, and coinsurance

Scheduling considerations

Appointment types, time allocation, provider availability, and patient communication/reminders

MA standard procedure to schedule an appointment

Check provider availability, offer options to the patient, confirm and record the appointment, set a reminder, and provide additional instructions

Appointment types

Routine visiting, urgent consultations, procedural appointments, telemedicine appointments, and specialist referrals

Types of scheduling

Wave scheduling, modified wave scheduling, and cluster scheduling

Wave scheduling

Multiple patients are scheduled at the top of the hour and seen in the order they arrive, allowing flexibility for late appointments or varying appointment lengths

Modified wave scheduling

A combination of wave and time-specific scheduling. Some patients are booked at the top of the hour, and others are spaced throughout the hour to reduce wait times

Cluster scheduling

Also called block scheduling. Similar types of appointments are grouped together during set times

Double booking

Strategically booking multiple patients with the same provider if one is expected to be brief

How long is a standard routine visit?

15 to 30 minutes

How long is a standard new patient consultation?

30 to 45 minutes

How long is a standard physical exam?

45 to 60 minutes

How long are standard minor procedures?

30 to 60 minutes

Staggered scheduling

Providers can start at different times or appointments can alternate from long and short ones to maintain balance

When should you set automated reminders?

24 to 48 hours prior

Ways to manage cancellations

Communicate clear policies and keep a list of patients willing to be waitlisted

MA standard procedure to reschedule follow-up appointments

Gather information, review the schedule, offer alternatives, update records, and confirm with the patient

How can you utilize data?

Generate and analyze reports; adjust strategies based on feedback