Comprehensive
Medical Assisting, 3rd Ed
Unit Two: Fundamentals of
Administrative Medical Assisting
Chapter 6 – Managing Appointments
Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins
Appointment Scheduling Systems
Manual Appointment Scheduling
• The appointment book should have space for
– Each provider’s appointments
– Appointment info, including patients’ name, phone
numbers, and reasons for visits
• Establish the matrix; cross out unavailable times
– Meetings, vacations, rounds, “buffers”
• Review carefully and communicate with staff
• Document all cancellations and reschedules
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Sample Page
From a Manual
Appointment
Book
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Appointment Scheduling Systems
Computerized Appointment Scheduling
• Main advantage: Convenience
– One-time entry of repeating schedule components
– Easy search for available appointment times
– Many useful printout formats
– Interface with account information
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Types of Scheduling
Structured Appointments – Each patient is allotted
a fixed time and duration
• Advantages
– Optimum use of time and facility
– Opportunity for advance preparation
• Disadvantage – Patients may need more time than
expected
– Pin down time needs
– Incorporate “buffer” time
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Types of Scheduling
Structured Appointments – Methods
• Clustering patients with similar needs
• Wave or modified wave – Multiple patients scheduled
in blocks
• Fixed – Each patient assigned a specific time and
duration
• Streaming – Time is allotted according to anticipated
need
• Double booking – Two patients for each time slot
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Types of Scheduling
Flexible Hours – Different times on different days
• Accommodate patients and providers with varied
schedules
Open hours – First come, first serve
• Eliminates some patient complaints
• Effective time management is difficult
• Can raise confidentiality issues
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Factors that Affect Scheduling
Patients’ Needs
• Reason for appointment
• Staff to be seen
• Duration of symptoms
• Third-party payer
constraints
• Acute or chronic condition
• Most convenient time
• Documentation
requirements
• Transportation constraints
You control the schedule; don’t let it control you!
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Factors that Affect Scheduling
Providers’ Preferences and Needs
• Adjust to each provider’s punctuality habits
• Allow each provider time for other duties
– Receive and return calls
– Review reports
– Dictate notes
– Outside duties
• Establish protocols for unscheduled visitors
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Factors that Affect Scheduling
Physical Facilities
• Number of users
• Amount of space
• Quantity and availability of equipment
Understand the space and equipment required.
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Scheduling Guidelines
General Guidelines
• Always write the patient’s phone number on the
schedule
• Leave open time slots every day to accommodate
problems
Be pleasant and helpful
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Scheduling Guidelines
New Patients
• Get patient contact, referrer, and payer information
• Explain payment policy and paperwork needs
• Give directions, establish a message protocol, and
confirm the date and time
• Check your own work
• Contact the referring physician
The first encounter is critical.
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Scheduling Guidelines
New Patients
• Check the schedule for possible conflicts
• Offer a specific date and time
• Put the patient’s name and phone number on the
schedule
• Provide the patient with an appointment card
• Check your work
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Patient Reminders
Appointment Cards
• Include the patient’s name, date and time of
appointment, and physician’s name and phone number
• Try to keep series on the same day and time
• Provide a card for the next appointment only
• Write in ink
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An Appointment
Card Will Help
the Patient
Remember His or
Her Appointment
and Reduce No
Shows
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Patient Reminders
Telephone Reminders
– Call the day before using the phone number agreed
– Keep it simple, including your name, your office,
and the appointment date and time
– Check the move-up list and document the call
Mailed Reminder Cards
– Send at least a week before
– Maintain stock postcards and a tickler file for
annual examination reminders
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Sample Reminder Postcard
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Adapting the Schedule
Emergencies
• Have policies to determine can the emergency be
treated in the office?
• Have questionnaires to evaluate for a constellation
of symptoms
Patients Who Are Acutely Ill
• Obtain the information the physician needs to decide
when the patient should be seen
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Adapting the Schedule
Walk-In Patients
• See emergencies ASAP; refer decisions to physician
– Work in or reschedule
Late Patients
• The patient must wait until the physician is free
• Establish an office rescheduling policy
• Schedule habitually late patients at the end of the day
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Adapting the Schedule
Physician Delays
• Call patients as soon as possible to reschedule
• Inform patients in the waiting room at once
Missed Appointments
• Determine the reason and reschedule
• Notify the physician of habitual no-shows
Document, document, document!
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Cancellations
By the Office
• Notify patients ASAP; ask the patients to call to reschedule
• Apologize to patients in the office
By the Patient
• Determine the reason
• Make sure patient understands the need for follow-up
• Check the move-up list to fill the vacancy
• Notify the physician of habitual no-shows
Document, document, document!
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Making Appointments for Patients
in Other Facilities
Referrals and Consultations
• Check insurance requirements, including precertification and
paperwork. Is the physician on the preferred list?
• Provide physician and patient contact info, including the reason and
urgency and whether it is a consultation or referral
• Record the call
• Ask for notice of no-show
• Provide written notice to the patient
• If patient makes an appointment, ask for notice
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Making Appointments for Patients
in Other Facilities
Diagnostic Testing
• Get instructions – What test(s), how soon
• Get patient conflicts
• Provide the laboratory with patient info, patient lab and
appointment info
• Provide the patient with verbal and written explanation
of any required preparation
• Document the appointment and post the target date for
results in your tickler file
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Making Appointments for Patients
in Other Facilities
Surgery
• Determine and follow precertification requirements
• Call the facility with the physician’s requirements – Patient
info and insurance info and precertification number
• Provide the patient with any preadmission forms or
instructions
• Write down dates, times, and locations for the patient
• Document the appointment
• If necessary, arrange for hospital admission
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When the Appointment Schedule Does
Not Work
If problems are frequent
• Evaluate 2 to 3 months of the schedule
• Involve all staff in your study
• Identify persistent problems
– Habitual lateness
– Insufficient time allotted
– Too many staff make appointments
• Adjust routines to address the problem
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End of Presentation
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