Scheduling appointments for new patients

New patient appointments

Arranging the first appointment for a new patient requires time and attention to detail. This encounter provides the first impression of the healthcare facility and may set the tone for all subsequent visits. Tact, courtesy, and professionalism are extremely important. During the conversation with the new patient, request preliminary information to help determine how much time to allow for the visit on the appointment schedule. The provider may also expect the medical assistant to give general instructions to patients seeking care for specific complaints. For example, the patient may be required to be fasting for certain laboratory tests. Patient demographic information should be collected during the conversation, including the type of insurance the patient has. Some insurance carriers restrict which providers can be used.

After the necessary information has been collected, offer the patient the first available appointment. Whenever possible, offer a choice between two dates and times. Ask the patient to arrive 15 minutes before their scheduled appointment time to complete any paperwork necessary. Also ask whether he or she knows the directions to the healthcare facility or offer the physical address for those who use a GPS or want to obtain exact directions from one of the many Internet direction sites, such as MapQuest. Tell the patient whether any special parking conveniences are available and whether the healthcare facility provides a token or parking validation. The patient’s options for the first payment should also be discussed. If payment is expected immediately, inform the patient. The staff should expect patient concerns about the amount of the first bill and should address this issue before the appointment so that there are no surprises or misunderstandings. Before ending the conversation, repeat the appointment date and time and then thank the patient for calling.

Some healthcare facilities mail an information packet/brochure to new patients, especially if the appointment is several days away. With the patient’s permission and e-mail address, such information can also be sent via the Internet. An ideal tool to use to deliver this information is a new patient brochure (Procedure 10-3). This brochure can be printed with graphics and images to promote a professional impression of the healthcare facility. This brochure should include the following:

• Description of the practice
• Location or a map
• Telephone numbers
• E-mail and Web site addresses
• Staff names and credentials
• Services offered
• Hours of operation
• How appointments can be scheduled

In addition to the brochure, the packet could include a health history form, the Notice of Privacy Practices (NPP), and release of information form (to obtain records from their previous provider).

If another provider has referred the patient, the medical assistant may need to call the referring provider’s office to obtain additional information before the patient’s appointment. This information should be printed out and given to the attending provider before the patient arrives. Remember to send a thank you note to anyone who refers a patient to the facility.

Often, the medical assistant will need to conduct preauthorization or pre-certification to determine whether a patient is eligible for treatment or for certain procedures. The office manager must make certain that these procedures are being done and assign these duties to a specific person(s).

Established patient appointments

Most return appointments for established patients are arranged when the patient is leaving the office. A good policy is to have all patients stop by the front desk to check out before leaving in case any information is needed from the patient or any outside scheduling must be done. The patient’s health record can be reviewed to see whether the provider ordered any laboratory tests or procedures, and these can be scheduled and discussed with the patient. When making a return appointment, follow the same procedures as for scheduling any appointment by phone, offering the patient choices in the day and time slots. If a certain time the patient specifically requests is not available, offer two alternatives. Always give the patient an appointment card and any necessary instructions at this time, along with a bright smile. Never forget to provide excellent customer service.

By telephone

Usually the medical assistant needs only to determine when the patient must return and to find a suitable time in the schedule. Established patients do not usually need directions and parking information unless the office has recently moved. The patient’s address, telephone number, and insurance should always be verified and any changes documented in the health record. If an email address and/or cell phone number is not on file, obtain one so as to have a quick, easy way to notify the patient of appointments and other events.

Scheduling other types of appointments

The medical assistant may also schedule services other than appointments at the healthcare facility, and these will appear on the appointment schedule. This includes surgeries the provider will perform at a hospital or other facility, consultations, outside appointments and meetings, and even house calls if the provider makes them. The provider also must have time to get from one location to another, so driving time must be considered when arranging all appointments.

Some critical information is required when scheduling admission or treatments in other facilities. Always provide the facility with the patient’s name, address, phone numbers (both home and cell), Social Security number, and insurance information and relay the procedures that are to be performed. Patient allergies should be mentioned if the patient is being admitted. Additionally, the facility may have forms that the patient needs to complete, so an email address is helpful in such cases. Always provide the admitting diagnosis and orders to the healthcare facility before admission time. Some facilities require a history form before admission. The patient will be required to bring a form of picture identification, such as a state driver’s license, and his or her insurance card.

Inpatient surgeries

When scheduling a surgery, call the facility where the procedure will be performed as soon as the operation is planned. Provide all necessary information and state any special requests the provider may have, such as the amount of blood to have available for the patient. The facility may want the patient’s insurance information and certainly will want a phone number so that the patient can be contacted before the surgery if necessary. Make sure all this information is available before placing the call.

Outpatient and inpatient procedure appointments

A medical assistant often is asked to arrange laboratory or radiography appointments for patients. Before calling the facility to schedule the appointment, be sure all necessary information is available. Inform the patient of the time and place of the appointment, relay any special instructions, and then note these arrangements in the patient’s health record. Some offices make a reminder call to the patient or send a reminder email or text message.

Outpatient testing is common because most providers do not have extensive x-ray or laboratory equipment in their offices. Magnetic resonance imaging (MRI), computed tomography (CT) scans, numerous x-ray evaluations, ultrasonography, and simple blood tests all may need to be scheduled. Provide the patient with the name, address, and phone number of the facility where the tests will be done.

Some patients may require a series of appointments (e.g., at weekly intervals). Try to set up these appointments on the same day each week at the same time of day. This considerably reduces the risk of the patient forgetting an appointment.

In some cases the medical assistant may be responsible for scheduling inpatient admissions or inpatient surgical procedures. This is similar to scheduling outpatient testing, but the medical assistant coordinates with a hospital rather than an outside facility and should also be documented in the patient’s health record.

It is often the medical assistant’s responsibility to provide the patient with any special instructions for the procedure or test that is going to be performed. The patient should be provided with written instructions as well. A patient undergoing general anesthesia will need to fast for approximately 12 hours before the procedure. If medications are to be taken the morning of the procedure the patient may take them with a small sip of water. The provider will instruct the patient about which medications to take. The patient should also be instructed to leave valuables at home. If it is an outpatient procedure and the patient will be sedated in any way, he or she should be instructed to have someone drive them home.

Outside visits

If the provider regularly makes house calls or visits patients in skilled nursing facilities, a special block of time must be reserved in the appointment schedule. There has been an increase in the number of providers who are making house calls again, especially if they have an elderly patient base that are still living independently. The provider needs demographic information, such as addresses, room numbers, and the best route to each home or facility. Remember to allow for travel time.

There are a number of other situations that may have to be added to the schedule, sometimes without much advance warning. Handle all of these situations with care and courtesy.

Providers

Another provider dropping into the facility should be ushered in to see the provider as soon as possible, regardless of the appointment schedule. If the provider is seeing a patient, explain the situation and, if possible, take the visiting provider into a private room, such as the provider’s office, to wait. Then notify the provider as soon as possible. Visits from other providers are usually brief and do not appreciably affect the schedule.

Pharmaceutical representatives

Representatives from pharmaceutical companies are frequent visitors to healthcare facilities and generally are welcomed when the schedule permits. They are well trained and bring the provider valuable information on new drugs. The medical assistant often is expected to screen such visitors and turn away those whose products would not be used in that practice. If the representative or the pharmaceutical company is unknown to the office, ask for a business card and then check with the provider, who will decide whether to see the caller.

Pharmaceutical representatives will often bring samples of the medications that they are going to talk to the provider about. It is important for the medical assistant to understand the policies and procedures for the handling and dispensing of the samples. Most healthcare facilities will require that these samples be stored in a locked cabinet or closet and are given to patients only with provider approval.

Specialists usually limit their conferences with pharmaceutical representatives to their line of practice. The medical assistant, together with the provider, can prepare a list of the representatives with whom the provider is willing to spend time; the list is the determining factor in future conferences. The medical assistant can say whether the provider will be available that day and give an estimate of the waiting time or suggest a later time at which the representative may return. The representative then can decide whether to wait or return later. The pharmaceutical representative usually is quite understanding and cooperative and willing to wait patiently for a long time for just a brief visit with the provider. In turn, the medical assistant should treat the representative with courtesy, showing as much cooperation as possible.

Salespeople

Salespeople from medical, surgical, and office supply houses call regularly at healthcare facilities. Sometimes they want to see the provider, but the office manager or the medical assistant in charge of ordering supplies usually can handle these calls.

Unsolicited salespeople sometimes can present a problem in the professional office. If the provider does not want to see such callers, the medical assistant must firmly but tactfully send them away. Suggest that they leave their literature and cards for the provider to study and say that the provider will contact them if further information is needed.