TEACH Lesson Plan Manual for Kinn’s
The Medical Assistant: An Applied
Learning Approach
12th edition
Chapter 10
Scheduling Appointments
Copyright © 2014 by Saunders, an imprint of Elsevier Inc. All rights reserved.
1
Lesson 10.1
Appointment Scheduling Methods
1.
2.
3.
4.
5.
7.
6.
Define, spell, and pronounce the terms listed in the
vocabulary.
Describe scheduling guidelines.
Discuss the advantages of computerized appointment
scheduling.
Explain the features that should be considered when
choosing an appointment book.
Explain how self-scheduling can reduce the number of
calls to the medical office.
Explain the importance of legible writing in the
appointment book.
Discuss pros and cons of various types of appointment
management systems.
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2
Using Established Priorities for
Appointment Scheduling
Effective scheduling allows physicians to
spend adequate time with patients
Four factors for scheduling:
Patient’s needs
Physician’s preferences and habits
Facilities available
Duration of office visits
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3
Patient Needs
Determining office hours and appointment
times requires consideration of the
socioeconomic status of the area being
served
Scheduler must allot visit time based on
patient’s needs for each individual visit
Balance between meeting patient’s needs
and physician’s preferences and available
facilities
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4
Physician Preferences and Habits
All preferences and habits are important to
scheduling
Physicians also make phone calls, examine
and dictate reports, attend meetings, answer
mail, and other responsibilities
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5
Available Facilities
Medical assistant must know how to pair
patient needs with available facilities when
scheduling
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6
Duration of Office Visits
Scheduler must know how long various office
visits and procedures take
Use office policies and procedures manual for
procedure times
Physician’s reimbursement from insurance
companies is partly based on time
requirements for procedure or visit
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7
Methods of Scheduling Appointments
Two most common methods:
Computerized scheduling
Appointment book scheduling
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8
Computer Scheduling
Software programs vary from simple to more
sophisticated ones that can select the best
appointment time based on information
entered
Also keeps track of future appointments
Printouts of schedules help staff and
physicians stay on schedule
More than one person can access the
schedule, so everyone is informed
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9
Appointment Book Scheduling
Many styles of appointment book; some color
coded
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10
Self-Scheduling
Allows patient to use Internet to view a
facility’s schedule and select his/her own
appointment time
Reduce call volume to the office; available to
patient 24/7
Can also send e-mail reminders the day
before an appointment to request
confirmation
Phoned-in appointments must still be offered
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11
Advance Preparation
Block out time when physician is not available
to see patients
Note reason for time blocked off
Most electronic scheduling systems use a
template where you can block time slots
automatically, such as lunch hours
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12
Legality of the Appointment Book
Appointment book must be accurate because
it can be used as a legal record
Missed appointments should be noted in the
medical record
Pencil is used so that changes can be easily
made
Include patient’s name and phone number
Book should be kept for state’s statute of
limitations and then shredded when
discarded for privacy reasons
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13
Types of Appointment Scheduling
Different types of appointment scheduling to
meet needs of facility, providers, and patients
Some offices combine methods to make the
right mix of activity during the day and to
ensure the day runs smoothly
Must be proficient at managing appointments
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14
Open Office Hours
Facility is open at given hours when patients are
told to return “in a couple of weeks” for follow-up
Patients can come in at intermittent times, seen
in order of arrival
Eliminates broken appointments and prevents
from running behind schedule
Most commonly used at labs, imaging facilities,
urgent care clinics, and emergency departments
Disadvantages include crowding and long waits,
waves of busy times and waves of slow times,
potential overburdening of staff
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15
Scheduled Appointments
Scheduled appointments allow practitioners
to see more patients with less pressure
Requires a person who is good at
multitasking and being efficient
Critical to understand how long each
procedure requires and time for pre-visit
paperwork
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16
Flexible Office Hours
Because many families often have two
working parents, many providers are using
extended day and flexible office hours
Flexibility is advantageous to both patients
and staff at physician’s office
Evening and weekend hours can increase
size of practice because of convenience
offered
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17
Wave Scheduling
Attempt to create short-term flexibility within
each hour
Assumes time needed for all patients seen
will average out over the day
Rather than scheduling at intervals, several
patients will be at office at once and seen in
order of arrival
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18
Modified Wave Scheduling
Example: Have two patients come in at 10 AM
and one at 10:30, repeating cycle throughout
day
Example: Patients are scheduled to arrive at
given intervals during first half of hour, then
none are scheduled during second half of
hour
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19
Double-Booking
Booking two patients at once to see same
physician is poor practice
Exception: one patient will only take 5
minutes
Double-booking should be avoided or
reflected in the schedule
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20
Grouping Procedures
Grouping (categorizing) procedures is
another way to approach scheduling
Medical offices may try several ways of
grouping before finding the best way
Medical assistant may find it helpful to colorcode sections for grouped appointments
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21
Advance Booking
Appointments are often made months in
advance
Appointment card should be given to patient
and should require 24 hours’ notice for
cancellation
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22
Lesson 10.2
Special Considerations When
Scheduling Appointments
8.
9.
10.
11.
12.
13.
Explain the basic procedure to follow when the
office is behind schedule.
Discuss the benefits of offering choices to patients
when scheduling appointments.
Identify critical information required for scheduling
patient admissions and/or procedures.
Discuss several methods of dealing with patients
who consistently arrive late.
Name several reasons for failed appointments.
Recognize office policies and protocols for handling
appointments.
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23
Time Patterns
Special problems arise daily, and some time
should be open daily for a physician to deal
with minor emergencies
These schedule slots reduce disruption
during the day
If possible, block out 15 minutes each
morning and afternoon for a break for
physician to return calls, verify prescription
calls, or answer questions
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24
Patient Wait Time
Patient wait time should be minimized
because it adds to anxiety, stress, and
frustration
Patient should go to exam room at scheduled
appointment time, but not wait too long in
there to see physician
If a patient has been waiting more than 15
minutes, explain the delay and offer to
reschedule
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25
Telephone Scheduling
Be pleasant and helpful when scheduling
over the phone
Try to accommodate a patient’s requested
appointment time, if possible
If not, be considerate offering alternative
times and dates
Offering two choices for a time slot is
encouraged so that the patient feels s/he is in
control of her/his time
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26
Telephone Scheduling, cont’d
Always repeat time and date of appointment
at end of call and ask if patient has pen/paper
to write it down
Check appointment book or computer screen
to be sure it is entered correctly
Write legibly in appointment book and obtain
a daytime phone number for each patient
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27
Scheduling Appointments for
New Patients
New patient scheduling requires time and
attention to detail
Tact, courtesy, and professionalism are very
important
Request preliminary information so that you
know how much time to allot
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28
Scheduling Appointments for
New Patients, cont’d
Offer patient first available appointment,
giving a choice between two dates and times
Offer directions or physical address to office
Provide parking information if needed
Options for first payment should be discussed
Repeat appointment date and time and thank
the patient for calling
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29
Scheduling Appointments for
New Patients, cont’d
Some medical offices mail or e-mail an
information packet to new patients
If patient is a referral, you may need to call
referring physician’s office for additional
information before appointment
Print and give referral information to attending
physician before patient arrives
Send a thank-you note to anyone who refers
a patient to medical office
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30
Confirming Appointments
Many offices call patients the day before
appointments
Can eliminate last-minute cancellations
E-mail and automatic dialers can also be
used to send reminders
May need to conduct preauthorization or
precertification to determine patient eligibility
for certain procedures
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31
Scheduling for Established Patients:
In Person
Most return appointments are arranged when
patient is leaving office
Have all patients stop by front desk before
leaving in case information is needed or
outside scheduling must be done
Ordered tests or procedures can be
discussed and scheduled
Offer patient two choices for time and date
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32
Scheduling for Established Patients:
By Telephone
To find a suitable time in the schedule, only
need to know when patient must return
No need for directions or parking information
Recheck information with patient if it has
been awhile since last visit
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33
Scheduling Other Types
of Appointments
Other types of appointments to schedule:
Surgeries performed by physician at other facility
Hospital rounds and consultations
Outside appointments and meetings
Possibly house calls
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34
Scheduling Admission or
Treatments in Other Facilities
Provide scheduler with patient’s name,
address, phone numbers, SSN, insurance
information, patient allergies, and procedures
to be performed
Send admitting diagnosis and orders to
healthcare facility before patient’s
appointment
Patient will need to bring picture ID and
insurance card
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35
Scheduling Inpatient Surgeries
When scheduling surgery, call facility where
procedure will take place as soon as it is
planned
Provide all necessary information and state
any special requests physician may have
May need to provide insurance information
and certainly phone numbers
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36
Scheduling Outpatient and
Inpatient Procedures
Arrange laboratory or radiography
appointments for patients
Have all necessary information handy before
calling facility to schedule
Relay time and place of appointment, special
instructions (also note in medical record) to
patient
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37
Scheduling Outpatient and
Inpatient Procedures, cont’d
Magnetic resonance imaging (MRI),
computed tomography (CT) scans, x-ray
evaluations, ultrasonography, and simple
blood tests
Provide patient with name, address, and
phone number of facility where tests will be
done
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38
Scheduling Outpatient and
Inpatient Procedures, cont’d
Some patients require a series of
appointments
Try to set these up at the same time/day of
week to reduce risk of patient forgetting
May be responsible for scheduling inpatient
admissions or inpatient surgical procedures
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39
Scheduling Outside Visits
If physician makes house calls or visits
patients in skilled nursing facilities, block out
regular time in appointment schedule
Physician needs demographic information,
and allow for travel time
Physician’s medical bag should always be
prepared and well stocked for outside visits
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40
Late Patients
For habitually late patients, scheduling them
last for the day means if they arrive after
closing time there is no obligation to wait
Some tell habitually late patients to arrive 30
minutes before appointment time
Make an attempt to work with patients who
have occasional difficulties arriving on time
Do not let schedule be disrupted by
constantly late patients
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41
Rescheduling Canceled
Appointments
Unexpected conflicts cause patients to
reschedule
Remember to remove first appointment day
and time from schedule and then set new
appointment
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42
Emergency Calls
Calls go through a screening process,
prioritizing so that emergencies see physician
first
Screening is very important and requires
experience and tact
Emergencies can be emotional, as well as
physical, crises
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43
Emergency Calls, cont’d
Patients who are acutely ill should be seen
same day
Urgency of calls determined by a list of
questions prepared for reference
Patient may need to be directly referred to
hospital emergency department
Never place emergency call on hold and stay
on line until EMTs or other help arrives
Obtain name, phone number, and location at
start of call
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44
Physician Referrals
Most offices honor requests from referring
physicians who ask that a patient be seen
same day
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45
Patients Without Appointments
Physician must agree to a policy for patients
with no appointments and medical assistants
must follow through
Patient requiring immediate attention should
be accommodated somehow
If immediate care is not needed, a brief visit
with physician and scheduled appointment for
later on can solve the problem
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46
Failed Appointments
Why do patients fail to keep appointments?
Forgetfulness
Owing money
Denial about condition
Important to determine reason for failed
appointments to remedy the situation
If patient’s health is in jeopardy, send a letter
by certified mail to explain this and keep a
copy for medical record
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47
No-Show Policy
Some patients do not realize importance of
keeping appointments
Patient who does not arrive is a “no-show”
Policy must exist and be enforced
Note first-time no-show on patient’s medical
record and/or ledger card
Second no-show, warn patient; third time,
consider dropping the patient
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48
No-Show Policy, cont’d
Physician may wish to charge patients for noshows or rescheduling appointments
Office policy manual must state patients are
charged for not showing up, especially if time
slot could not be filled
Be understanding when possible, but do not
let a patient take advantage of physician’s
time
Make a notation in patient’s medical record
and in appointment book or database
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49
Automated Call Routing
Automated call reminders can contact
patients scheduled for appointments
Patient is asked to press a certain key on
phone to confirm appointment and a different
key to cancel appointment
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50
Appointment Cards
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51
Confirmation Calls
Indicate in records the patient’s preferred
phone number for reminders
Privacy guidelines and standards require care
when leaving messages for reminders
Patient can sign a release form so that office
staff may contact someone else to leave
messages or reminders
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52
E-mail and Mailed Reminders
Many computer scheduling programs can
send an e-mail to patients the day before an
appointment as a reminder
Office staff may mail reminder cards to
patients
Patient who is due for an appointment but
has not yet arranged a date and time may be
sent a reminder
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53
When the Patient Cancels
Keep a list of patients with advance
appointments who would come in sooner if an
appointment opens up due to cancellation
Note each cancellation in patient’s medical
record, with reason if possible
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54
Physician Is Delayed
Call patients and suggest they come later if
advance notice of delay is known
If patients have arrived, let them know of
delay and explain it was an emergency
If delays happen often, consider a different
scheduling system
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55
Physician Is Called to an Emergency
Physicians frequently have emergencies, and
most patients are understanding
Tell patients they can wait or reschedule for
another day
Quickly call patients scheduled for later, if the
schedule is affected, to cancel before arrival
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56
Physician Is Ill or Out of Town
Inform patients scheduled of physician’s
illness
If physician is called out of town,
appointments must be canceled or
rescheduled
Typically, other physicians will proved care
during absences
For security reasons, state the doctor is
unavailable, not that s/he is out of town
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57
Other Types of Appointments:
Physicians
Another physician dropping by should be
allowed to see the physician as soon as
possible
If physician is in with a patient, allow visitor to
wait in a private room
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58
Pharmaceutical Representatives
Also called “detail persons” or “reps” and are
generally welcomed, schedule permitting
Screen reps and turn away those whose
products would not be used in the practice
Prepare a list with physician of reps who may
visit
When rep calls, give times of physician’s
availability and give an estimate of wait time
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59
Other Types of Appointments:
Salespeople
Salespeople from medical, surgical, and
office supply houses regularly call physicians’
offices
Usually, office manager or medical assistant
in charge of ordering supplies can deal with
calls
Unsolicited salespeople should be firmly, but
tactfully, sent away
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60
Planning for the Next Day
Before leaving, look over next day’s
appointments
Review medical records for scheduled
patients
If tests were scheduled at last visit, check for
reports in medical record
Prepare supplies for specific procedures
scheduled
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61
Closing Comments
Person in charge of scheduling has a huge
impact on overall office efficiency
Friendly, helpful attitude and ability to make
compromises are key
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62
Patient Education
Information booklet about office policies and
procedures should be given to patients
If facility offers Internet-based appointment
scheduling, patients must be taught how to
use the system
Choose a simple, user-friendly program, and
have a special phone number for patients to
call with questions about the program
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63
Legal and Ethical Issues
Appointment schedule can be subpoenaed to
court as a legal record
Be sure all handwriting is legible and
information collected is consistent
Note all no-shows in appointment book and
medical record
Keep old appointment schedules equal to
statute of limitations for your state
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64
Questions?
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