Lecture Medical assisting: Administrative and clinical procedures with anatomy and physiology (4e) – Chapter 12

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

Scheduling

Appointments and

Maintaining the

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.

Learning Outcomes

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.

The Appointment Book

A well-managed appointment book

• Creates an efficient patient flow

• Shows respect for everyone’s time by preventing excessive wait time

Unexpected events that occur

• Early and late arrivals

• No-show patients

• Emergencies

• Physicians spend extra time with patients

The Appointment Book (cont.)

• Preparing the appointment

– Vacation and holidays – Scheduled meetings

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

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

15 min 15-20 min 15-30 min

30 min

30 min or >

Determining Standard Procedure Times (cont.)

A Legal Record

• Keep appointment books for at least 3 years

• Entries must be clear and easy to read

 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

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)

Apply Your Knowledge

S/RCPEFUCANP&P

suture removal 10–20 min.

complete physical examination 30–60 min.

follow-up appointment 5–10 min.

cancellation 0 min.

Pap smear and pelvic examination 15–30 min.

ANSWER:

GOOD JOB !

Appointment Scheduling Systems

• Goals

– Smooth flow of patients

– Minimal waiting time

Appointment Scheduling Systems (cont.)

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

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

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

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

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.

Arranging Appointments (cont.)

• New patients

– Those not established

at the medical office

– Obtain all necessary

– Have patient arrive 15–

30 minutes early to fill out forms

• Return appointments

– Ask patients if they need another

appointment before they leave

Appointment Reminders

appointment

Recall notices

 Form letter sent to remind patients to call for an

appointment

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.

TERRIFI

C!

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

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

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

• 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

Special Scheduling Situations: Patient (cont.)

• Walk-ins

– If it is an emergency, handle as such

– If no openings, offer to schedule an

• 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

J Jones 7890

Special Scheduling Situations: Patient (cont.)

if patient required special transportation or traveled

H Plummer 234-543-2345

P Lexar 098-765-4321

No show

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.

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.

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

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

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.

Maintaining the Physician’s Schedule

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

Maintaining the Physician’s Schedule (cont.)

• 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

Maintaining the Physician’s Schedule (cont.)

• Check with the physician before scheduling an appointment

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

cover practice while regular physician is away

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 agenda if

requested – Secure equipment such as

podium and microphones – Take minutes as needed

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

Apply Your Knowledge

When making travel arrangements for the physician, which of the following would be the responsibility of the medical assistant?

a) Locum tenens b) Itinerary

c) Agenda

ANSWER:

Right

!

In Summary

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 hours scheduling to computerized scheduling.

open-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 show

no-In Summary (cont.)

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

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)

End of Chapter 12