Download Chapter 9 - Mackay Education

Chapter 9
Learning Objectives









Define, spell, & pronounce the terms listed in the vocabulary.
Describe guidelines to establishing an appointment schedule & creating an appointment matrix
Discuss the advantages of computerized appointment scheduling & explain how self-scheduling can reduce
the number of calls to the healthcare facility.
Discuss the legality of appointment scheduling system.
Discuss pros & cons of various types of appointment management systems
Discuss telephone scheduling & identify critical information required for scheduling appointments for new
patients.
Discuss scheduling appointments for established patients.
Discuss how the MA should handle scheduling other types of appointments.
Do the following related to special circumstances in scheduling:









Discuss several methods of dealing with patients who consistently arrive late
Recognize office policies & protocols for rescheduling appointments.
Discuss how to deal with emergencies, provider referrals, & patients without appointments.
Discuss how to handle failed appointments & no-shows, as well as methods to increase appointment show
rates.
Discuss how to handle cancellations & delays
Discuss patient processing, including the importance of the reception area.
Describe how to prepare for patient arrival, including patient check-in procedures.
Explain why using the patient’s name as often as possible is important, as well as how the MA can make
patients feel at ease.
Describe registration procedures, including obtaining a patient history.
Scheduling
Appointments &
Patient
Processing
Page 131 – 160
Page 133
Scheduling Appointments
& Patient Processing
The person responsible for scheduling must
understand the practice, be familiar with the working
habits & preferences of the provider (or providers), &
have clear guidelines for time management in the
practice.
 Appointment scheduling is the process that
determines which patients the provider sees, the dates
& times of appointments, & how much time is
allotted to each patient based on the complaint & the
provider’s availability.

Page 133
Scheduling Appointments
& Patient Processing: Cont.
Time management involves the realization that
unforeseen interruptions & delays always occur &
must be handled appropriately.
 You must assign the appropriate appointment time
length for the complaint along with ensuring that the
appointments are scheduled so that there are minimal
gaps in the schedule.
 Most healthcare providers find that efficient
appointment scheduling is one of the most important
factors in the success of the practice.

Page 133
Establishing the Appointment Schedule
Patient Needs
 Consider the demographics of the patients that are
being served when determining office hours &
appointment times.
 Knowing when the providers need to be available
for patients is one of the factors in creating the
patient schedule.
Page 133
Establishing the Appointment Schedule: Cont.
Provider Preferences & Habits
 Consider the preferences & habits of the
providers in the practice before establishing &
implementing a scheduling plan.
 Keep in mind that the provider cannot spend
every moment of the day with patients. The
provider also has telephone calls to make &
receive, reports to examine & dictate, meetings to
attend, mail to answer, & many other business
responsibilities. An experienced staff can handle
many but not all of these tasks.
Page 133
Establishing the Appointment Schedule: Cont.
 Next the office hours & the length of appointment
time intervals need to be determined. Keeping in
mind patients’ needs & provider’s preference &
habits, decide what would be the shortest time
possible for an appointment. Most healthcare
facilities use 10- or 15 minute time intervals for
the appointment schedule. If an appointment
needs longer than 15 minutes, multiple time slots
are used to cover that appointment. Once the
minimum time period has been set, then the
appointment matrix can be established.
Page 133
Creating the Appointment Matrix
 Setting
up the appointment matrix involves
blocking out the times when the provider is not
available to see patients, such as lunch time,
hospital rounds, conferences, & vacation.
•
In a paper-based appointment book the matrix is
usually established for 6 months at a time.
•
In a computerized system the matrix can be set
up indefinitely.
Pages 133 – 134
Creating the Appointment Matrix: Cont.
Establishing Guidelines for Appointment
Scheduling
 If it is decided that a complete physical
examination should be scheduled for 30 minutes,
yet the provider routinely spends 45 minutes with
the patient for a complete physical, then the
scheduling guidelines need to be adjusted.
 Well-planned scheduling & adherence to that
schedule allow the provider to do more than run
in & out of examination rooms with little time for
the patient to talk with provider.
Pages 133 – 134
Creating the Appointment Matrix: Cont.
 Some
providers need prompting to end the patient
visit & move to the next patient.
•
If there is you are in the examination room, you
can help the provider remain on schedule by
letting the provider know that the end of the
appointment time is near. You may work out some
type of signal, such as a hand gesture or phrase.
•
A pager may be used when you are not in the room
with the provider. When the provider’s pager
vibrates they will know that it is time to wind
things up with that patient.
Page 135
Creating the Appointment Matrix: Cont.
Available Facilities
 Another factor to keep in mind when scheduling
appointments is the availability of facilities needed
for the particular appointment type. Getting a patient
into the office at a time when no facilities are
available for the services needed is pointless.
 As you gain proficiency in scheduling, it becomes
easier to pair patient needs with the available
facilities according to the provider’s preference.
Major equipment frequently used or a certain room
with such equipment may need its own scheduling
column in the appointment book or software system.
Page 135
Methods of Scheduling Appointments
 The
two most common methods of appointment
scheduling are computerized scheduling &
appointment book or paper-based scheduling.
 Each has advantages & disadvantages, & the
healthcare facility should weigh the benefits &
choose the method that best suits the provider &
the staff.
Pages 135 – 136
Methods of Scheduling Appointments: Cont.
Computerized Scheduling
 Practice management software programs can:
 display such information as the length & type of
appointment required & the patient’s day or time
preferences. The computer then can select the best
appointment time based on the information entered
into the computer.
 search for future appointments
 multiple users can access the appointment schedule
at the same time, minimizing the wait time for
patients.
 generate reports
Page 136
Methods of Scheduling Appointments: Cont.
Appointment Book Scheduling
 Office
suppliers carry a variety of appointment
book styles.
•
Some appointment books show an entire week
at a glance; many are color coded, with a
special color used for each day of the week.
•
Multiple columns may be available to
correspond with the number of doctors in a
group practice, & the time can be divided
according to their preferences.
Page 136
Methods of Scheduling Appointments: Cont.
Self-Scheduling
 Allowing patients to schedule their own
appointments using the Internet & the healthcare
facility’s Web site is becoming much more
common. The patient is given limited access to
the schedule, seeing only the available
appointment times, not the other patients who are
scheduled, thus protecting patient confidentiality.
Other patients’ names should never be visible on
an online system.
Page 136
Legality of the Appointment Scheduling System
 Paper-based appointment book is a legal record.
 It must be accurate & maintained so that it
provides correct information.
 Patients are expected to follow the provider’s
orders; this includes keeping appointments.
• If a patient does not show up for an
appointment or cancels it & does not
reschedule, a notation should be placed in the
patient’s health record.
• If a patient reschedules an appointment &
subsequently keeps it, there is no need to
document that it was rescheduled.
Page 137
Legality of the Appointment Scheduling System
 Computerized scheduling systems can also be
used to track patient appointments.
 Most
computerized scheduling systems will allow
the user to indicate if the patient has checked in,
canceled, or missed the scheduled appointment.
 When
a patient misses or cancels an appointment
it should be documented in the electronic patient
record for legal purposes.
Page 137
Types of Appointment Scheduling
 Different
types of appointment scheduling are
used to meet the various needs of the medical
facility, the providers, & the patients.
 Some
offices use a combination of methods to
create the right mix of activity during the day &
to ensure that the day runs smoothly & efficiently.
 You
need to become proficient at managing
appointments.
Page 137
Types of Appointment Scheduling: Cont.
Time-Specified (Stream) Scheduling
 When
each patient is given a specific time for
their appointment, this is referred to as timespecified or stream scheduling as it keeps a steady
flow of patients moving through the office.
•
If you use this method to schedule patient you
should know the amount of time needed for
each appointment type & keep time slots
available for urgent visits.
Page 137
Types of Appointment Scheduling: Cont.
Wave Scheduling
 Wave scheduling is an attempt to create shortterm flexibility within each hour. Wave
scheduling assumes that the actual time needed
for all the patients seen will average out over the
course of the day. Instead of scheduling patients
at each 15-minute interval, wave scheduling
places three patients in the office at the same
time, & they are seen in the other of their arrival.
This way, one person’s late arrival does not
disrupt the entire schedule.
Page 137
Types of Appointment Scheduling: Cont.
Modified Wave Scheduling
 The wave schedule can be modified in several
ways. For example, one method is to have two
patients scheduled to come in at 10 am & a third
at 10:30 am. This hourly cycle is repeated
throughout the day. In another version, patients
are scheduled to arrive at given intervals during
the first half of the hour, & none are scheduled to
arrive during the second half of the hour. This
would allow time for urgent or walk-in patients to
be seen.
Page 137
Types of Appointment Scheduling: Cont.
Double-Booking
 Booking two patients to come in at the same time
is sometimes used to work in a patient with an
acute illness or injury when there are no open
appointments. This works out best if one of the
patients needs laboratory work or another
procedure done before seeing the provider. The
provider can see one of the patients while the
other one is being prepared.
Page 137
Types of Appointment Scheduling: Cont.
Open Office Hours
 With the open office hours method, the facility is
open at given hours of the day or evening, & the
patients are told that they can come in at any
time.
 This type of system is often used in an urgent care
setting.
 Patients are then seen in the order in which they
arrive, although a patient with an urgent condition
may be seen ahead of those who arrived before
them.
Page 137
Types of Appointment Scheduling: Cont.
 This
•
•
hours system can have many disadvantages.
The office may already be crowded when the
provider arrives, resulting in an extremely long
wait for some patients.
Patients may arrive in waves throughout the
day, which causes parts of the day to be very
busy & other parts to be slow. This makes
accomplishing other office duties difficult.
Without planning, the facilities & staff can be
overburdened.
Page 137
Types of Appointment Scheduling: Cont.
Grouping Procedures
 This method appeals to many practitioners
 A surgeon might devote 1 day each week to seeing
only referral patients. Obstetricians often schedule
pregnant patients on different days from gynecology
patients.
 The providers & staff can experiment with different
groupings until the plan that works best for the
practice becomes evident.
 In applying a grouping scheduling system, you may
find it helpful to color-code the appointment book for
designated procedures.
Page 137
Types of Appointment Scheduling: Cont.
Advance Booking
 Often appointments are made months in advance.
When any appointments is made, an appointment
card should be completed & given to the patient.
All appointment cards should mention that
patients must give 24 hours’ notice if they are
unable to keep the time reserved. Most offices
have some type of confirmation procedure by
which patients are notified the day before to
verify that they intend to keep the appointment.
Pages 137 – 138
Time Patterns
When booking appointments, you should make it a
policy to leave some open time during each day’s
schedule so that if a patient calls with a special
problem that is not an immediate emergency, time
will be available to book the patient for at least a
brief visit. A busy provider always fills these open
slots, & having them in the schedule causes the least
disruption during the day.
 If possible, set aside time in the morning & afternoon
for a break. Even 15 minutes can give the provider
time to return calls from patients, verify prescription
calls, & answer questions.

Page 138
Telephone Scheduling
Often the manner in which you book an appointment
makes more of an effect than the convenience of the
appointment time.
 Be especially considerate if the time requested for an
appointment must be refused. Briefly explain why the
time is not available & offer a substitute date & time.
Comply with the patient’s desires as much as
possible, & do not show annoyance if the patient does
not understand the scheduling process. Most people,
however, understand the need for a well-managed
office & are willing to cooperate.
 Many offices offer the patient a choice when
scheduling the appointment & let the patient decide
which option is best for them.

Page 138
Telephone Scheduling: Cont.
 Always
repeat the information to reinforce the
appointment & do not hesitate to ask the patient if
they have a pen ready to jot it down.
 While repeating the information to the patient,
check the appointment book or computer screen
to ensure that it was posted correctly.
 When scheduling appointments over the
telephone it is not possible to give the patient a
reminder card for the appointment. Be sure to ask
if they would like a telephone, e-mail, or text
message reminder of the appointment.
Page 138
Telephone Scheduling: Cont.
 Form
the habit of entering the patient’s daytime
telephone number after every entry.
 The
appointment may need to be canceled or the
schedule rearranged in a hurry, & many precious
minutes can be saved in the telephone number is
handy.
 Cell
phone numbers also are quite useful for
tracking down a patient quickly.
Page 138
Scheduling Appointments for New Patients

Arranging the first appointment for a new patient
requires time & attention to detail. 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.
 You may also be expected to give general instructions
to patients seeking care for specific complaints.
Patient demographic information should be collected
during this conversation, including the type of
insurance the patient has. Some insurance carriers
restrict which providers can be used.
Page 138
Scheduling Appointments for New Patients: Cont.

After the necessary information has been collected,
offer the patient the first available appointment.
Whenever possible, offer a choice between two dates &
times.
• Ask them to arrive 15 minutes before their scheduled
appointment to complete any paperwork.
• Ask whether they know how to get to the facility
• Tell them about any special parking conveniences
that are available.
• Discuss their options for the first payment. If
payment is expected immediately, inform them.
• Before ending the conversation, repeat the
appointment date & time & thank them for calling
Page 138
Scheduling Appointments for New Patients: Cont.
 Some healthcare facilities mail information
packet/brochure to new patients, especially if the
appointment is several days away. With the
patient’s permission & 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.
 In addition to the brochure, the packet could
include a health history form, the Notice of
Privacy Practices (NPP), & release of information
form (to obtain records from their previous
provider).
Page 139
Scheduling Appointments for New Patients: Cont.
 If another provider has referred the patient, you
may need to call the referring provider’s office to
obtain additional information before the patient’s
appointment.
 This information should be printed out & 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.
Page 141
Scheduling Appointments For
Established Patients
In Person
 Most return appointment for established patient 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.
 The patient’s health record can be reviewed to see
whether the provider ordered any laboratory tests or
procedures, & these can be scheduled & discussed with
the patient.
 Always give the patient an appointment card & any
necessary instructions at this time & remember to smile
Page 143
Scheduling Appointments For
Established Patients: Cont.
By Phone
 Usually you only need to determine when the
patient must return & to find a suitable time in the
schedule.
 The patient’s address, telephone number, &
insurance should always be verified & any
changes documented in the health record.
 If an e-mail address &/or cell number is not on
file, obtain one so as to have a quick, easy way to
notify the patient of appointments & other events.
Page 143
Scheduling Other Types of
Appointments
 You
may also schedule services other than
appointments at the healthcare facility, & these
will appear on the appointment schedule. This
includes surgeries the provider will perform at a
hospital or other facility, consolations, outside
appointments & meetings, & even house calls if
the providers 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.
Page 143
Scheduling Other Types of
Appointments: Cont.
Inpatient Surgeries
 When scheduling a surgery, call the facility where the
procedure will be preformed as soon as the operation
is planned. Provide all necessary information & 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 & 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.
Page 143
Scheduling Other Types of
Appointments: Cont.
Outpatient & Inpatient Procedure Appointments
 You are often asked to arrange laboratory or
radiography appointment for patients. Before
calling the facility to schedule the appointment,
be sure all necessary information is available.
 Inform the patient of the time & place of the
appointment, relay any special instructions, &
then note these arrangements in the patient’s
health record. Some offices make a reminder call
to the patient or send a reminder e-mail or text
message.
Page 143
Scheduling Other Types of
Appointments: Cont.
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 you may be responsible for scheduling
inpatient admissions or inpatient surgical procedures.
This is similar to scheduling outpatient testing, but
you coordinate with a hospital rather than an outside
facility & this should also be documented in the
patient’s health record.

Page 143
Scheduling Other Types of
Appointments: Cont.
It is often your responsibility to provide the patient
with any special instructions for the procedure or test
that is going to be preformed.
 The patient should be provided with written
instructions as well.
 The patient should also be instructed to leave
valuables at home.
 If it is an outpatient procedure & the patient will be
sedated in any way, they should be instructed to have
someone drive them home.

Page 145
Scheduling Other Types of
Appointments: Cont.
Outside Visits
 If the provider regularly makes house calls or visits
patients in skilled nursing facilities, a special black of
time must be reserved in the appointment schedule.
The provider needs demographic information, such as
addresses, room numbers & 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 & courtesy.
Page 145
Scheduling Other Types of
Appointments: Cont.
Providers
 Another provider dropping into the facility should
be ushered in to see the provider, regardless of the
appointment schedule. If the provider is seeing a
patient, explain the situation &, if possible, take
the 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 & don’t appreciably
affect the schedule.
Page 145
Scheduling Other Types of
Appointments: Cont.
Pharmaceutical Representatives
 Representatives from pharmaceutical companies
are frequent visitors to healthcare facilities &
generally are welcomed when the schedule permits.
You are often expected to screen such visitors &
turn away those whose products would not be used
in the practice. If the representative or the
pharmaceutical company is unknown to the office,
ask for a business card & then check with the
provider, who will decide whether to see them.
Page 145
Scheduling Other Types of
Appointments: Cont.
 Pharmaceutical
representatives will often bring
samples of the medications that they are going to
talk to the provider about.
 It is important for you to understand the policies
& procedures for the handling & dispensing of
the samples.
 Most healthcare facilities will require that these
samples be stored in a locked cabinet or closet &
are given to patients only with provider approval.
Page 145
Scheduling Other Types of
Appointments: Cont.
Sales People
 Salespeople from medical, surgical, & office supply
houses call regularly at healthcare facilities.
Sometimes they want to see the provider, but the
office manager or, if you are in charge of ordering
supplies, you can handle these calls.
 Unsolicited salespeople can present a problem. If the
provider does not want to see such callers, you must
firmly but tactfully send them away. Suggest that
they leave their literature & cards for the provider to
study & say that the provider will contact them.
Page 146
Special Circumstances
Late Patients
 Every medical practice has a few patients who are
habitually late for appointments. This seems to be a
problem for which no cure has been found.
 Such patients can be booked as the last appointment
of the day. Then, if closing time arrives before the
patient does, the staff has no obligation to wait &
other patients have not been inconvenienced.
 Make an attempt to work with patients who have
occasional difficulties arriving on time, but do not
allow the schedule to be constantly disrupted by late
patients.
Page 146
Special Circumstances: Cont.
Rescheduling Appointments
 Sometimes
changes must be in the appointment
schedule. When rescheduling an appointment,
make sure the first appointment is removed from
the appointment book, & then set the new
appointment.
 Otherwise,
the patient will be expected in the
office on 2 days, & time will be wasted with calls
& follow-up, only to discover that the
appointment was rescheduled.
Page 146
Special Circumstances: Cont.
Emergency Situations
 Patients with emergencies & those who are
acutely ill should be seen the same day. The
urgency of the call initially can be determined by
having a list of questions prepared for reference.
 The patient may need to be referred directly to a
hospital emergency department, or the provider
may want to see the patient that day in the office.
 If patients are unable to get themselves to the
hospital you may need to contact the emergency
medical services in your area.
Page 146
Special Circumstances: Cont.
Provider Referrals
 If another provider telephones & requests that a
patient be seen on the same day, most offices
honor that request if at all possible.
 It is important to keep a schedule that is not
intolerant of this type of request.
Page 146
Special Circumstances: Cont.
Patients Without Appointments
 The provider & scheduling team should come up
with a policy for patients without appointments,
or “walk-in patients.”
 A patient who requires immediate attention most
likely will be accommodated in the schedule
somehow.
 If the patient does not need immediate care, a
scheduled appointment at a later time may be the
answer.
Page 146
Failed Appointments

It is important to determine the reason for failed
appointments & to do whatever is possible to remedy
the situation.
• Telephone the patient to make sure no
misunderstanding has occurred.
• If the patient’s health is such that medical care must
continue, the provider may write a letter explaining
this to the patient.
 Documented failed appointments in the patient’s health
record & the appointment schedule for legal purposes.
A patient may try to claim abandonment, when they
have actually been the one to miss the appointments.
Pages 146 – 147
No-Show Policy
 Some
patients may not realize the importance of
keeping their appointment. The patient who does
not arrive for a scheduled appointment or
reschedule it is called a no-show. A busy practice
must have a very specific policy on appointment
no-shows & must enforce it effectively.
 The provider may wish to charge patients for not
showing up for the appointment. Be
understanding whenever possible, but do not let a
patient take advantage of the provider’s time.
Page 147
Increasing Appointment Show Rates
Automated Call Routing
 Automated call reminders can contact patients
scheduled for appointment.
• The patient is asked to press a key on the phone to
confirm the appointment or a different key to
cancel
• Can be used to send messages to patients, to
introduce a new provider at the office, or
announce the availability of a new procedure.
 These systems can also be set up to send text
messages
Page 147
Increasing Appointment Show Rates: Cont.
Appointment Cards
 Most healthcare facilities use appointment cards
to remind patients of scheduled appointments &
to eliminate misunderstandings about dates &
times.
• Make a habit of reaching for an appointment
card while writing an entry in the appointment
book or scheduling it on the computer.
• After the date & time have been written on the
card, double-check with the book/computer to
make sure the entries agree.
Page 147
Increasing Appointment Show Rates: Cont.
Confirmation Calls
 Patients who have made appointments in advance
may appreciate a confirmation call to remind them
they have a time set aside to see the provider.
• Always note the phone number the patient
prefers the office to use for such calls.
• The office must use caution in making calls to
patients because of the significance of privacy
guidelines & standards. It is a good idea to have
an established policy on leaving messages that
does not breach the patient’s confidentiality.
Page 147
Increasing Appointment Show Rates: Cont.
E-Mail Reminders
 Many computer scheduling programs can send an
e-mail to patients the day before an appointment
to remind them of it.
• This is a great timesaver for the office staff,
because no time is taken to perform this duty
other than the original scheduling of the
appointment.
Page 147
Increasing Appointment Show Rates: Cont.
Mailed Reminders
 The office staff may mail reminder letters to
patients.
• This method is time-consuming with a paperbased appointment system but worth the effort if
the patients show up for their appointments.
• Computer scheduling systems can be set up to
generate reminder letters for scheduled
appointments & also to remind patients that they
are due for their annual physical or influenza
vaccination.
Page 147
Handling Cancellations & Delay
When the Patient Cancels
 Inevitably,
•
cancellations occur.
Keep a list of patients with appointments who
would like to come in sooner, then begin calling
to try to fill the available opening
 Each
cancellation should be noted in the medical
record, along with a reason for the cancellation if
that information is available.
Page 147
Handling Cancellations & Delay: Cont.
When the Provider is Delayed
 Some days the provider will be delayed in reaching
the office. If advance notice of the delay is received,
start calling patients with early appointments &
suggest that they come later. If some patients arrive
before the office learns of the delay, explain that an
emergency has detained the provider.
 Show concern for the patient, but do not be overly
apologetic, which might imply some degree of guilt.
 If this kind of situation occurs frequently, however,
consider devising a different scheduling system.
Pages 147 – 148
Handling Cancellations & Delay: Cont.
When the Provider is Called to an Emergency
 Providers have responsibilities for responding to
medical emergencies, & most patients understand if
you take time to explain.
• You may say, “Dr. Wright has been called away due
to an emergency. She asked me to tell you she is
very sorry to keep you waiting. There will be at
least 1-hour delay.” Then ask the patient, “Would
you like to wait? If not, I’ll be glad to give you the
first available appointment on another day.”
 It’s possible that another provider may be able to see
them.
Page 148
Handling Cancellations & Delay: Cont.
When the Provider is Ill or Out of Town
 Providers get ill & patients schedule to be seen
during the course of the provider’s recovery must be
informed of this & their appointments rescheduled.
 When the provider is called out of town for personal
or professional reasons, appointments must be
canceled or rescheduled.
• Customarily, the patient is given the name of
another provider to see during such absences.
• For security reasons, merely state that the doctor is
unavailable.
Page 149
Patient Processing
 Visits
to the provider can be times of great stress,
& the staff must do everything possible to make
the experience pleasant for patients.
 A patient usually has a choice of healthcare
providers & should be given excellent customer
service.
 Good patient relationships result in referrals to
the provider, & this helps the practice grow.
When patients have a good experience with a
provider, they are likely to tell others.
Page 149
The Reception Area
A first impression is a lasting one. Nowhere is this
more important than in the healthcare facility. The
appearance of the reception room & the front desk, as
well as a cordial greeting from you, influences
patient’s perception of the entire facility & of the care
they will receive.
 The reception room should be as attractive & cheerful
as possible & kept clean & uncluttered. Most
providers’ offices are well supplied with recent
magazines, & some have various books. Any reading
material placed the reception room should be of
interest to the general public.

Page 149
The Reception Area: Cont.

Nice things to have in a reception area:
• A writing desk with writing paper
• A selection of tea & coffee
• Music from a concealed speaker
• A lighted aquarium or an educational display
enhances the attractiveness & individuality.
• health-related brochures
• A television/DVD player plus DVDs or healthcare
book library that allows patients to check out items.
• A telephone
• A children’s corner equipped with small-scale
furniture & some playthings works well.
Page 149
The Reception Area: Cont.
 Periodically,
take an objective look around the
reception room.
 Could it use a little brightening or freshening up?
 Try to look at the room as if seeing it for the first
time. You are responsible for the appearance of
the area by making sure the room remains neat &
orderly throughout the day.
 Check the temperature & lighting for comfort.
 Scan the room at intervals during the day to
ensure that it is in good order.
Pages 149 – 151
The Reception Area: Cont.
 If
your desk is in the reception area or in open
view of patients, it should be free of clutter.
 In particular, patients’ medical & financial
records should not be in sight.
 To protect patient confidentiality, keep computer
monitors turned so that those waiting cannot view
them.
 Some healthcare facilities use privacy screens that
allow only the user to see the monitor, or they use
a screen savor that activates after being idle for a
few minutes.
Page 151
Preparing for Patient Arrival
 Advanced
preparation helps make the day go
smoothly & contributes to a more relaxed
atmosphere for all.
 Some
healthcare facilities prepare for the next
day on the evening before, whereas others prepare
each morning.
 The
healthcare facility should consistent, & the
same routine should always be performed so that
no important preparations are left undone.
Page 151
Preparing for Patient Arrival: Cont.
Preparing Health Records
 Review a list of patients who will visit the
provider during the next appointment period.
• electronic health record: this task could be as
simple as pulling up & printing a report.
• paper-based appointment book: pull the medical
records for the day & check off the patient’s
name on a copy of the appointment schedule;
this helps ensure that all the records have been
located & are ready.
Page 151
Preparing for Patient Arrival: Cont.
 Review
each record to verify that any recently
received information (e.g., laboratory reports,
radiograph readings) has been entered correctly &
permanently attached to the record; if a document
is missing, attempt to obtain it before the patient’s
arrival using a fax or other electronic means.
 Arrange the medical records sequentially in the
order in which the patients are scheduled. Make
sure enough space is available on the progress
notes for the provider to write in the record. If
not, place additional notes pages in the record.
Pages 151 – 152
Preparing for Patient Arrival: Cont.
Patient Check-in
 The reception desk should be in clear view of all
visitors who come into the office.
 Make sure no patient medical records are on the
reception desk & that the computer monitor is
positioned so that it cannot be viewed by patients at
the desk.
 You should check the reception room each time you
have been away from the desk to see whether more
patients have arrived. Greet these patients by name; if
you do not know the person who has entered the
reception area, ask the individual’s name. Use a signin register that promotes patients’ privacy.
Pages 151 – 152
Preparing for Patient Arrival: Cont.

During patient check-in it is vital that you take steps
to protect the other patients in the reception area.
• One of the first questions that must be asked is
whether in the last 21 days, the patient has traveled
to a country with widespread transmission of Ebola
or had contact with someone with Ebola. If the
patient answers yes, they should be isolated
immediately.
• During flu season the healthcare facility should
make masks available for patients in the reception
area. Tissues, trash cans along with hand sanitizer,
should be available to patients
Pages 152 – 153
Greeting the Patient
A personal touch, such as greeting the patient by
name, is an easy way to develop patient rapport. Use
the patient’s last name & title unless the patient
insists on the use of their first name or prefers a
nickname.
 Some EHR systems allow for a patient’s picture to be
added so you can be assured that they have the
correct patient record opened during check-in.
Requesting a photo identification card or having the
patient’s picture on file also ensures that the person
requesting benefits is actually the person covered by
the insurance policy.

Page 153
Greeting the Patient: Cont.
Patient Interaction
 Cultivate the habit of greeting each patient
immediately in a friendly, self-assured manner.
Establish eye contact & smile while introducing
yourself to the patient. Remember to ask about
why the patient is here before asking about
insurance converge; no patient wants to feel that
the provider’s main interest is the collection of an
insurance check.
 Make notes of life events in the patients chart so
you can visit with them in the reception area.
Pages 153 – 154
Registration Procedures
Most providers use a patient information or
registration form to gather demographic information
about the patient. The form may be attached to a
clipboard & handed to the patient with instructions to
complete sections. Be ready & willing to answer any
questions that they may have about the forms.
 When the completed form is returned, check carefully
to verify that all the necessary information has been
provided.
 At this time you should scan or obtain a copy of both
sides of the patient’s insurance card, verify the
subscriber’s date of birth, & collect copayments.

Page 154
Registration Procedures: Cont.
Obtaining a Patient’s History
 The patient’s personal history, medical history, &
family history may be obtained by asking them to
complete a questionnaire.
 The provider can augment this information during
the patient interview.
 Once you are more experienced you can conduct
the interview to obtain the patient’s personal &
medical history, family history, & chief
complaint.
Page 154
Showing Consideration For Patients’ Time
 The
patient expects to see the provider or
practitioner at the appointed time. You should
bring the patient to the examination room for
treatment or consultation as close to the appointed
time as possible or explain delays.
 All patients want to be kept informed about how
long they should expect to wait to see the
provider. Any delay longer than 10 to 15 minutes
should be explained. You can also offer to
reschedule the appointment for the patient.
Page 155
Showing Consideration For Patients’
Time: Cont.
Patients with Special Needs
 Find out how the patient is feeling before suggesting
that they be seated to wait for the provider. They may
need to lie down in a cool room or perhaps be seen as
an emergency case. Patients with disabilities may need
extra attention. Some patients may need help disrobing
even if a disability is not obvious. Always ask if the
patient needs assistance & how you can help them. If
there is a language barrier, have translation assistance
available. In all special needs cases it is important to
remain professional & treat everyone with respect.
Page 155
Escorting & Instructing the Patient
 While
in the healthcare facility, most patients
prefer to be escorted rather than simply told
where to go.
 Pronounce
the patient’s name correctly when
calling the person to the clinical area.
 If
unsure of the pronunciation, ask the patient.
 Write
the name phonetically on the health record
for quick retrieval at the next appointment.
Page 155
Health Record Care
 Often
file holders are located on the doors of the
examination rooms, & the health record can be
placed in the holder horizontally when the patient
is ready to be seen.
 The provider can then leave the file in the vertical
position to indicate that the patient is ready for
you.
 Never leave health records in examination rooms.
Page 155
Challenging Situations
Talkative Patients
 Any professional office has problem patients.
Talkative patients, for example, take up far more
of the provider’s time than is justified. You can
usually spot this tendency during the initial
interview. The patient’s history can be flagged
with a symbol to alert the provider. You can then
buzz the provider’s intercom & remind them that
the next patient is ready. Once you have learned
which patients take extra time, they can be
booked for the end of the day, or more time can
be allowed for them.
Page 156
Challenging Situations: Cont.
Children
 Parents are responsible for their children’s
behavior while at the healthcare facility. If
children are doing something that could harm
themselves, or other patients, quietly speak to the
parents & allow them to handle the situation.
 Do not discipline the child
 You can try to distract them with books or toys
Page 156
Challenging Situations: Cont.
Angry Patients in the Reception Area
 Usually the best course of action is to let the
patient talk out their anger. Present a calm attitude
& speak in a low tone of voice.
 Never return the anger or become argumentative.
 Use good listening skills & remain empathetic.
 If there is a room free, you can also invite them
into another room so that they aren’t in the
reception area.
Page 156
Challenging Situations: Cont.
Patient’s Relative & Friends
 Patients are sometimes accompanied by a relative or
well-meaning friend who may become restless
waiting for the patient & attempt to discuss the
patient’s illness. You should sidestep any discussion
of a patient’s medical care, except by direction of the
provider. Avoid a “too casual” attitude, such as, “I’m
sure there’s nothing to worry about.” A show of
moderate concern & reassurance that “the patient is
in good hands” usually takes care of the situation.
Remember that health information cannot be released
to anyone, including concerned friends & relatives,
without the patient’s consent.
Page 156
The Friendly Farewell
 You
can help convey a sense of caring by
terminating the visit cordially. If the patient will
return for another visit, you can say something
like, “We will see you next week.” If the patient
will not be returning soon, a pleasant “I hope
you’ll be feeling better soon” is appropriate.
Whatever words of goodbye are chosen, all
patients should leave the facility feeling that they
have received top-quality care & were treated
with friendliness, respect, & courtesy.
Page 156
Patient Checkout
 When
the patient returns to the front office for
checkout, greet them with a friendly smile & call
the individual by name. Form the habit of asking
patients whether they have any questions. Check
the health record to determine when the provider
wants the patients to return. Most providers not
this information on the encounter form. Make the
return appointment, remembering the technique
of giving the patient choices for days, morning or
afternoon, & specific times.
 Be sure to thank the patient for coming & wish
the person well as they leave the facility.
Page 156
Planning for the Next Day
 As
the day is winding down, look over the
appointments scheduled for the next day. Review
the health records for scheduled patients. If
laboratory tests or other procedures were
scheduled on the patients last visit, determine
whether the reports are available in the health
record. If the patient is scheduled for specific
procedures on this visit, make sure everything
needed for the procedure is on hand & available.
Planning can save many precious moments at the
time of the patient visit.
Pages 156 – 157
Closing Comments
 A friendly,
helpful attitude is a prerequisite for
cordial interaction with patients, as is the ability
to make compromises that benefit both the
provider & patient.
 Make sure to play a part in having each patient
feel a sense of satisfaction as they leave the
office.
 People tend to tell everyone when they have a bad
experience make sure that it’s not because of you.