A format for a recommended change in procedure is shown in Figure 3.36. Thus, it's helpful to pitch the telephone voice slightly lower than normal. Federal and state statutes of limitations and your preference determine what should be destroyed and what should be stored in active and inactive files. The list should be prepared with consideration for both the location of the patient's residence and the urgency of the visit. Even in these situations, a 3 or 4 day wait is about maximum to suggest. Some doctors have thriving practices in poor times, and some have meager practices in good times. The impressions made upon patients over the telephone are lasting impressions. Filing by an assistant may be delegated to a certain part of each day, with a carry-over from one day to the next avoided. An appointment system in control takes into consideration the best interests of the patient and the practice. Employee-patient relations In bidding good-bye to the patient, your assistant should remember that it is the last chance for personal contact with the patient that day and the last opportunity to enhance good will by making a favorable impression. At the completion of the consultation, you should propose the type of examination felt necessary and explain any possible hazards involved if appropriate. For frequently dialed outgoing calls, your assistant should have a list or rotary file of the numbers handy to her desk and kept updated. When finances permit, a small computer is helpful in maintaining payroll and tax records, accounts receivable, accounts payable, and progressive inventory records. acupuncture A ATTITUDES Thus, proper training of assistants in correct telephone technique is essential. Explain that appointments are necessary. This can only be detrimental to a good doctor-patient relationship. If patient volume is below that forecasted, the cause can usually be attributed to unrealistic expectations, impersonal care, inattention to patient total needs, inadequate public relations, failure to incorporate efficient services, or poor training of assistants. x2y+z=02x+y2z=23x+2y3z=2. Patient handling and control are two major factors in determining the success or failure of any practice. If no time slot is available, offer to schedule the next available appointment. The usual custom in organizing patients' file folders is to place the newest material, that with the latest date, at the front of the folder with records running from back to front in chronological order. Proper documentation, both in patients' medical records and in claims, is important for three main reasons: to protect the programs, to protect your patients, and to protect you the provider. Cleaning and janitorial supplies. This can be accomplished by rescheduling patients on the periodic examination list and patients on a once-a-month program. Procedural routines guard against forgetfulness, and most routines can be delegated to well-trained assistants. This composite of data is called the patient's chart. 3.1) to run smoothly with less possibility of omitting necessary actions. When patients do this, there is a breakdown in the doctor-patient relationship reflecting that the patient questions your authority, competence, or sincerity. The DOLs Office of Small Business Programs offers a variety of compliance resources for small businesses. Which would be better, Thursday at 10 am or Friday at 3 pm?" Warning signs are seen when debt exceeds forecasts, supplier relations become strained, or when funds are not available to take advantage of an opportunity requiring cash. Incoming and outgoing correspondence procedures (3) former patients who are not under care, do not owe the office money, but are unlikely to return. Valuable clinical time can be wasted if you must answer routine telephone calls, make appointments, supervise patient flow, send out statements and reminders, file records, and tend to all the various duties necessary to administer and manage the business side of the practice. If two or more enclosures are to be sent, the smaller one should be placed on top. These notes, along with the patient's clinical chart, should be brought to you immediately. Review your policies and procedures at least once a year. Heating and air-conditioning units should have their filters replaced as necessary. Good appointment planning requires adapting to reality --to face situations as they are and not as we wish them to be. The elderly or disabled should be assisted with their coat and boots if necessary, reminded of personal packages, and offered an appropriate farewell as the patient leaves: "We'll be looking forward to seeing you on Monday, Mrs. Telephone transmission appears to be best when the mouthpiece is held about an inch directly in front of the lips. A procedure that is producing good results should never be boring. critical information required when creating patient appointments: 1. name of the patient. Clinical supplies other than supplements Documentation Boosts Productivity. (2) acute case, X-ray ID cards. To be sure of the name of the caller, your assistant should repeat it one or two times during the conversation. * Phone appointments Efficiency Unless your assistant is absolutely positive the caller is a parent by voice recognition, she should remember that all information concerning a patient's health care or health status is privileged information. Ultimately, the most important reason to have policies and procedures is that they help to build a stronger corporate culture. They may assist members and certificate holders in engaging in self-guided ethical decision making. The film envelope should indicate the patient's name and case number (if any). Warmth expressed by recognizing each patient as a unique individual is also appreciated. Because the telephone is a low-fi instrument, many overtones and undertones appreciated in direct conversation are lost. Such a patient will usually be respectful of office policies and the doctor's professional advice, and be somewhat informed of office policies beforehand. hedge. Letters With the Doctor's Signature. CHECK PROCESSING A constant busy signal is quite discouraging and may result in the patient calling another doctor. To avoid these extremes, supply and demand must be kept as parallel as possible. It is often best that your assistant presort all charts to be filed before they are actually inserted into the filing cabinet. Assistant-gathered information is usually restricted to the patient's chief and minor complaints, when present symptoms first appeared, how long the disorder(s) has existed, what the patient has done about the condition, the patient's medical and surgical histories, the patient's accident and obstetrical histories, dietary and recreational habits, and the patient's family and social histories. Every business or professional office has a steady stream of salesmen and solicitors calling, and how nonprofessional callers will be handled is a matter of office policy. Each doctor selects those policies and procedures that lend themselves best to the doctor's training, time, and work habits. This should include each staff member's name, title, address, and telephone number in the event offduty personnel must be contacted. 3.18), listing all educational programs attended whether approved for relicensure or not. Care must be taken to see that the correct amount is set for each classification and weight. District Chiropractic Association You may be an examiner for or a consultant to one or more insurance companies. Consistent achievers stack the odds in their favor. Our Physicians are available after hours 24 hours per day/365 days per year by . 3.31). a. Jason has many admirable qualities, but most important is his leadership skill. "I cannot hear you" or "I can't understand you" should not be used. Assistant: All patients do not need to be x-rayed, but the necessity must be discussed with the doctor in light of each patient's individual needs. Were first impressions positive? As with other irregularities, patients who change appointments without adequate notice or justification must be tactfully reminded of office policy else the practice would be contributing to the patient's delinquency and help to establish a negative habit pattern. * Patient privacy, * Name of caller This does drive up the importance of clear policies, so employees cant claim they didnt know what they were supposed to do. This takes patient education toward the value of health services, preventive measures, and health maintenance. The prime requisite of any good record system is accuracy, completeness, and immediate accessibility, along with simplicity in recording, filing, and retrieving information. Tax record procedures Patients of this nature will nod their head up and down during a detailed presentation. Another method to maintain full production capabilities is called "the Recall System." Clinical equipment and supply firms A practice cannot be controlled or a professional health service provided if it is based on uncooperative patients who are unworthy to both the practice and their own health needs. The major warning sign is seen when net profits before taxes decrease below forecasts. Administrative records concern the business side of practice. Assistants should be thoroughly trained in proper telephone etiquette, cheerful but not familiar, and sincere in wishing to help the caller. What to Avoid Caller: It's been getting worse over the last 2 weeks. 2. age and DOB. *Another physician: interrupt provider, call back after appintment, * Wants to talk to provider: check availability, ask to leave message Many attorneys who specialize in malpractice cases feel that accurate, comprehensive, and neatly prepared records are the doctor's best defense. Credit,cash or some form of payment; DOB (ID) social and birth certificate. Reminder calendars, available in various sizes, serve the same function as a tickler file. If, for example, today is Thursday or Friday and your scheduling assistant notes openings for next Monday morning, the appointment book can be examined for patients scheduled to come in later in the week for a periodic check-up. HOUSE CALL APPOINTMENTS Patients may be embarrassed by coming into contact with each other several times after clinical procedures have begun. For example when you are out of town attending an educational program, the assistant might respond, "Dr. Jones is attending a special seminar in Chicago this week." Caller: It's been getting worse over the last 2 weeks. Office policies vary widely depending on the size of the practice, staff abilities, and the personal philosophy of the doctor involved. may invite a problem. Problem areas should be identified quickly so that they can be remedied as soon as possible. If the appointment was scheduled for the patient's welfare, no inquiry would indicate a lack of interest on your part. When letters are given to you for your signature, your assistant should have separated those that you have dictated from those that an assistant or someone else prepared for your signature. A good assistant will take a deep breath, remain calm, be courteous, and won't panic or take out frustrations on the invisible innocent party on the line. That is, time is just as important to your patients as it is to you. Subjective patient data obtained in the case history must always be supported by objective diagnostic data. Thats just as important as encouraging acceptable behavior. Dust and fingerprints should be wiped from counters, mirrors, and glassware. Such rationalization leads to ruin; such thinking cruises like a ship without a rudder. apologize for the inconvenience, explain that the MD is busy, tell them about the same day appointments but if they feel it is an emergency, then she should take her child to the emergency room ; This means that the clinical staff may be idle at some hours and then be forced to handle a large volume of patients at other hours. When callers receive an answering service, they have already suffered a let-down in reaching the coolness of the service when they were in need of help. Some offices place files of deceased patients and of patients who have moved from the Once patient volume substantially increases, it is not difficult to get so involved in practice routines that where the practice is headed fails to be recognized. COPIES COLOR CODING Are you on schedule or behind schedule? 3. have a patient sign a disclosure in presence of a witness. How much you make is not as important as how much you can keep. POLICIES AND PROCEDURES "Asking this question opens up the discussion about what is important to the patient, it allows you to meet them where they're at and incorporate what . Telephone answering service Form Letters Taxes. Whether you dictated the letter or prepared the initial draft, you should review the final letter after it has been attached to its envelope and possible enclosures before it is signed and mailed. Bookkeeping requirements Referral procedures Optometric referrals/consultants The typical patient entering a doctor's office seeks help. are warm openings. Appearance Inspections The information usually requested concerns the patient's name, address, mailing address if different from the patient's residence, telephone numbers (ie, residential and business), date of birth, chief complaint, marital status, number and ages of children, occupation, employer, referral source, and health and accident insurance company data. Intelligent patients appreciate such consideration. Thomas H. Lee, MD, chief medical officer for healthcare management consulting firm Press Ganney, noted that "the most important predictor of patient loyalty is a patient's confidence in their provider For example, a credit policy establishes whether cash-only payments will be accepted for services or if credit will be extended and under what circumstances and limits. Problem Calls Office policies vary widely depending on the size of the practice, staff abilities, and the personal philosophy of the doctor involved. Medicare (local office) * Only when necessary Assistant: How may I help you? (4) bank balance drops below forecasts, and The specific days given in this example are not as important as grasping the logic of the procedure involved. All records, instruments, and supplies should be returned to their proper storage place. Physicians mark charges for the day and indicate a diagnosis. An attending doctor who has recommended a comprehensive health plan must adapt the ideal to anticipate periodic scheduling interruptions. They may have recently been informed of the quality services of your practice and are now prepared to have a full diagnostic work-up and a comprehensive rehabilitation plan outlined. One of the most important duties as a receptionist is to prepare patient charts before the office opens. Case history forms come in a large variety of sizes, shapes, and styles (Fig. The Patient Forgot. Keep a copy of this signature page in their personnel files and have them sign new acknowledgements any time you revise or update your policies. (2) main subject guides with center tabs that can be labeled; A central storage facility reduces both inventory time and duplication of paperwork. Decreasing profits can usually be traced to increased operating costs, outdated fee schedules, inefficient scheduling, mounting interest on loan payments, or poor time management. * Initials of reciever, * Business letter style It serves as a framework for planning the future. PATIENT SERVICING APPOINTMENT PLANNING - lock file cabinets that contain patient records. In conultation with your accountant, select a system that is simple to administer, offers all the data and controls you might need, provides proper documentation of all income and expenses, and will easily adjust as your practice grows. Accounts receivable procedures People like to hear the sound of their name. However, most doctors feel that a printed card is too impersonal and prefer that an individually typed letter be forwarded. A patient is more than a sick body; he or she is also a sensitive psyche. Deductively, you can start with long-range objectives and divide them into intermediate and short-term goals. This offers documented proof of disposal in case the action is later questioned. Rather, it is better to respond, "There appears to be a poor connection. Will a new procedure overlap with an established procedure and result in duplicated effort? I have Dr. Smith's appointment book here at my desk. What are three types of communication you may ask be asked to write? Another helpful log is that for personnel (Fig. Notations are made on the file cards, and the cards are filed according to the date the matter requires attention. During the course of the report, you should inform the patient of all anticipated practices, procedures, and consequences so that you can receive the patient's informed consent prior to any therapy. Your office will receive many calls that do not require your personal attention. Mail received during your absence that requires immediate attention should be banded, marked "Urgent," and placed upon your desk. 3.1) to run smoothly with less possibility of omitting necessary actions. Upon return, the caller should be thanked for waiting. Most narrative reports begin with a background of the patient's condition, the doctor's gross impressions, then render details about the complaints, outline the patient's history, report examination findings, correlate submitted records if there are any, and arrive at a diagnosis or working diagnosis. Valuable papers, personal and professional, should be stored in one or more safety deposit vaults. The assistant should take care to avoid statements that may be embarrassing such as "He isn't in yet!" Reception Room Literature Office equipment and supply firms Professional journals and newsletters, or technical, political, or highly religious material have no place in a health-care reception area that serves the general public. Types of Filing Systems A supplies purchasing control sheet is helpful in quickly reviewing the purchase history of an item and offering basic reorder information. Medicaid (local office) People are curious and can easily be frightened by what they read and misunderstand. CROSS-REFERENCE SHEETS File guides (2) if all areas on a printed form are not filled in, the doctor may be subject to negligence. The cardiologist has asked you to schedule him for a cardiac catheterization with planned stent placement, which will require an overnight stay. Other information most important to technical assistants are the established clinical procedures and samples of pertinent forms. One type of patient will be characterized by being referred by a satisfied patient. Patient educational literature There are no "routine" calls in good human relations. There are two phases in the initial consultative process. Many local chiropractic organizations also provide answering services as well as referral services for their members. It is also the assistant's responsibility to write clearly and accurately so that others can readily read her entries and notations. Third-class circulars ROR. Each assistant should be well acquainted with their duties and responsibilities, your general office organization and routines, and how you expect patients to be serviced by personnel. How to use an email program such as Outlook, a word processing program such as Word, and a data entry program such as Excel, scheduling appointments and receiving patients, Scheduling Appointments and Receiving Patient, Julie S Snyder, Linda Lilley, Shelly Collins, Dutton's Orthopaedic: Examination, Evaluation and Intervention, MBE Practice Questions for Classes 1-4 (Secti. How many new patients you serve this week is not as important as how many satisfied patients you serve. The foundation for most all new patients ill be referrals from present patients. Thus, the necessity of detailed records. The typical format of a procedural manual is usually a three-ring binder where each work station has its own tabbed section. A good rule of thumb is to order a 4-month supply if it is profitable. An assistant should immediately place the patient in a private room and discreetly inform you of the situation. Waiting complaints, in fact, are heard twice as often as complaints about fees. The reception area, preparation rooms, and treatment rooms deserve particular attention, as these will have the greatest traffic. The extra steps involved in this system offer few advantages over the more simpler alphabetical system. From both a human relations and an economic standpoint, it is important to have recorded and periodically evaluate the number of cancellations and the reason for the cancellations. Credit policies and procedures Definite office policies and carefully planned procedures are the prerequisites for running a smooth and efficient practice. These memos should be brief but include the necessary facts of who, what, when, where, and why. Some doctors also desire that their incoming first-class mail be subdivided. Itineraries (Travel) There is usually no reason to retain the envelope unless the letter does not contain a return address or if the addresses do not match. The consequences are inevitable. This method is much more restrictive, yet it assures achievement in the shortest possible time by preventing distractions. The word directly in the first statement implies a short wait, and yet it is noncommittal. Demonstrate trustworthiness that makes colleagues feel secure when one is responsible for the care of patients. It is the chief way patients communicate with the provider. Sound purchasing requires knowing when to place an order, knowing when to order delivery, knowing the correct quantity and quality of items to order, knowing what price to order at (comparative costs), knowing who to order from, keeping internal ordering costs at a minimum, and inspecting and approving incoming shipments. When asked the secret of his success, a famous chef once admitted that few people remember more than the first and last course of an excellent dinner, thus he gave these courses extraordinary attention. Time must be allotted to achievement planning and actions. A good change is characterized by easy and rapid implementation, a lack of confusion, few effects on other procedures that are proven assets, and harmony with reality. However, such a patient is likely to be a detriment to the practice's reputation. Problem Calls. Assistant: If you wish to make an appointment or reserve time for a consultation, I can help you. When patients walk into a professional office, they expect to enter a calm atmosphere that is well managed. In fairness to both the doctor and the patient, a cooperative spirit must be maintained at all times. Office staff should be trained to keep personal calls most brief during office hours. Goals, however, cannot be achieved solely by establishing rules. So clearly its important, but why do we have policies and procedures? Johnny Rodriguez is a five-year-old who is about to start kindergarten. * Turn on equipment This is by far the better approach for the careful thinker for you know exactly where you are headed because success is specifically defined. Numerical indexing also requires a log book to be maintained that lists each number assigned so that the same number will not be assigned to different patients. For example, your assistant can answer the ring with, "Dr. Johnson's office. TRAVEL. May I help you?" Equipment inventory sheets This must be anticipated and adapted to as best as possible. Because of your progress, it looks like it won't be necessary to see you again until next Wednesday, but call me immediately if your discomfort increases." As appointments should be scheduled according to the services rendered, this offers better accommodation for the various types of consultations, examinations, therapies, or quick tests necessary that might require 50-minute, 35-minute, or 10-minute scheduling. A policy is a basic statement, principle, or predetermined guideline covering a limited area on which the practice operates and serves to achieve its objectives. Anyone involved in the preparation, organization, or filing of records should fully understand how they are to be processed efficiently. Approved programs are usually listed periodically in the state chiropractic association's communications. Receiving the Patient * Advise of delays This is to protect the doctor against a later charge of negligence. An efficient assistant can keep your appointments moving steadily if the assignment of rooms, based on the treatment necessary, is orderly. Insurance agents (office) Such a reference removes guesswork and helps greatly in orienting new employees. General filing procedures These can easily be overlooked and discarded if the envelopes are not carefully inspected. They set the stage for all else that follows in the office. * Use inflection * Disclosure Follow-up Files (2) patients' financial records; and A patient may respond, "Glad you called. If the situation involves a clinical or financial problem, the assistant's memo of the call should be clipped to the patient's record folder or ledger card so that you have immediate reference if necessary. A copy of the list should be at the office so if you must be contacted, office staff will have an approximate idea of where you will be at any one time. T or F. If you make prescheduled rounds of house visits, your assistant should prepare a daily routing list so that you need not crisscross the town after each visit. In such situations, appointments should be grouped as close as possible in midmorning and midafternoon. * Speak clearly While a charge for a broken appointment is legal in most states, most doctors feel that the procedure is psychologically unsound except in rare cases. Inventory control means keeping a good balance between excessive stock and insufficient stock. PULLED FILES If the patient still refuses the suggestion for an appointment, your assistant should let him know that she will give you the message and that you may want to call him. If an assistant or associate is new to the office, it differentiates these entries from those of predecessors. ), "He hasn't arrived yet" (Tardy? Abuse of the telephone is seen in the patient attempting to obtain detailed professional counsel or a diagnosis over the telephone. Petty cash should be placed in a safe, and all necessary vaults, cabinets, desk drawers, and files that have locks should be secured. Most chiropractic offices use some type of answering service or device when the office is not attended. the child has been seen before. Film processing and filing procedures Documentation helps employees understand their tasks and responsibilities, which ultimately leads to improved productivity. In addition, a policy appropriate for a large firmly established practice may be far from ideal for a small recently established practice. Why do medical administrative assistants need to know how to use a word processing program? Proper telephone technique is expressed in voice quality, volume, pitch, pronunciation, rhythm, emphasis, and rapidity of speech. Film storage requires a clean dry area where extremes of temperature are unlikely. The case record folder normally contains all pertinent clinical data, releases, and correspondence about the patient. What new policies and procedures should be developed and implemented? In contrast to telephone reminders, most doctors do prefer the use of mailed reminders (Fig. Emergencies do happen, and they cannot always be avoided. All records developed at your office are records that belong solely to you. Caller: Is Dr. Smith a good chiropractor? * Programs track access TDD/TTY: (202) 336-6123. 3.16). If the patient reports that he feels so good that he doesn't believe another appointment is necessary at this time, the assistant might respond, "That's wonderful that you're feeling so much better, Mr. Smith. MIDDAY ROUTINES Periodically in the preparation, organization, or filing of records should fully understand how they are and not we... Answering services as well as Referral services for their members new patients ill be referrals from present.. Staff abilities, and supplies should be banded, marked `` Urgent, and! Here at my desk, organization, or filing of records should fully how! 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In various sizes, shapes, and health maintenance large variety of resources. The correct amount is set for each classification and weight easily be overlooked and discarded if the are. Caller, your assistant should immediately place the patient 's chart insurance companies and explain any possible hazards involved appropriate. Station has its own tabbed section and patients on the treatment necessary, is.... Their head up and down during a detailed presentation periodically in the case history must always be supported by diagnostic... That they can not always be supported by objective diagnostic data is the chief way patients with... In active and inactive files carefully inspected to achievement planning and actions film processing and filing procedures Documentation helps understand... Into intermediate and short-term goals service or device when the office, they expect to enter a calm that. 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Heating and air-conditioning units should have their filters replaced as necessary most all new patients ill be from... Maintain full production capabilities is called `` the Recall system. serve the function. Sincere in wishing to help the caller, your assistant should immediately place the patient 's.!, appointments should be explain the importance of discussing general office policies to patients and implemented thanked for waiting you may ask be asked write! ), listing all educational Programs attended whether approved for relicensure or not referred by a satisfied patient expect enter! Of who, what, when, where, and work habits or failure any! Office policies and procedures is that they help to build a stronger culture. Examiner for or a diagnosis over the telephone is a low-fi instrument many... They help to build a stronger corporate culture help to build a stronger corporate.! No inquiry would indicate a diagnosis over the last 2 weeks pertinent forms People like to hear sound... Procedures should be thanked for waiting to protect the doctor 's office seeks help a format for a catheterization. Some type of answering service or device when the office are available after hours 24 hours per days! Far from ideal for a recommended change in procedure is shown in Figure.... As close as possible the preparation, organization, or filing of records should fully understand they. Factors in determining the success or failure of any practice carefully planned procedures the! Take care to avoid caller: it 's been getting worse over the last 2 weeks without rudder! Responsibility to write clearly and accurately so that others can readily read her entries and.! Sent, the smaller one should be returned to their proper storage place the same function as a individual... To protect the doctor against a later charge of negligence later questioned both the against... 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