Your office will find it helpful to keep a file of form letters and model paragraphs that may be referred to in similar situations, thus saving time and thought whenever a letter need not be slanted toward a particular reader. You can divide patient records into three distinct categories: (1) active patients who are currently under care and patients who owe the office money whether they are under care or not; Policy impacts issues as fundamental as healthcare access, cost, delivery methods, and privacy. NOTE: The following topics are provided as examples only and neither apply to all practices, nor represent a comprehensive list of all policies that may be beneficial or required. These memos should be brief but include the necessary facts of who, what, when, where, and why. Such records must be referred to often during initial treatment and whenever the patient needs subsequent care. Subject Files. Psychology. If it was another doctor who suggested the call, it is customary that a report of findings and recommendations be sent immediately to the referring doctor. Excuse slips (Fig. * Speak clearly (2) It helps to transfer papers and records that should not be destroyed, yet are rarely referred to, to inactive storage facilities. Patient reminder and follow-up procedures If the case plan is being affected, you should take time to have a heart-to-heart talk with the patient on the importance of appointment regularity. A special notation should be made for items that require considerable time between order and receipt. During consultation, you should deeply investigate the information previously gathered, conduct a thorough systems review, and arrive at a judgment of what type examination procedures would be best suited for the particular complaints involved. It is important that the receptionist register each patient in the order of arrival for several reasons. Expense book or forms Office staff should be trained to keep personal calls most brief during office hours. Correspondence formats and styles Day Sheets To be efficient as a professional, delegate much of your authority and responsibility for many office details to assistants so that your time will be used optimally in doing that for which you have been specially prepared --helping the sick to get well and the healthy to stay well. The type of appointment cards typically used is a printed card with areas to indicate the patient's name and the date and time reserved (Fig. Doctor's calendar Every patient entering the reception area should be cheerfully greeted and properly registered. ENCLOSURES * Avoid monotone Allowance must also be given to the examination or treatment that takes a little longer than necessary, the emergency situation, special visitors, and other unexpected but necessary interruptions. Referral Calls * Old or new patient: pull chart if available, paperwork for new patients, * Minimize patient waiting A trained assistant can handle calls relating to making appointments, taking messages, answering routine questions about insurance claims, receiving a favorable progress report, answering requests for a housecall, answering complaints or misunderstandings over a bill, taking calls from sales people, and answering nuisance calls. Good planning is essentially a problem-solving adventure where certain questions must be answered. 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. This requires that your plan incorporate frequent control checks ("red flags") on patient volume, referral rate, cash-flow, working capital, net profits, collections, debt limit, etc. The chapter concludes with a description of optional equipment, office cleaning and repair services, periodic inspections, and how to make procedural changes. They set the stage for all else that follows in the office. Good policy is in the best interests of all patients. Any holding delay should be short. 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. Physicians mark charges for the day and indicate a diagnosis. 1. In addition, policies should address patient . explain the importance of discussing general office policies to patients? 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. Tax record procedures X-RAY FILES If the letter refers to a patient's account, it is efficient if the patient's financial ledger card is attached. Some large offices have a manual for business functions and another for clinical functions, while smaller offices just separate these functions by a divider in one book. Let's say a patient owes $5,000 or more for a deductible. Is there good balance between gross earnings and net income? 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. Assistant: How long have you had this problem? What is informed consent? the provider will be seeing patients in the afternoon, and the re are a couple of same-day appointments available on your schedule. Although clinical skills and quality services are the foundation in developing a successful practice, the psychologic impressions made upon patients in their association with the office are almost equally as important. Communication of sympathy, congratulations, and the like cannot be expressed if the facts are not known. explain that an appointment is necessary, and politely offer to schedule the soonest appt that is available and for the patients complaint, also you can suggest seeking treatment at urgent care if not severe. The date and quantity of the last order for each item should be recorded. Follow-up Files There are several companies that provided long-distance rates at a lower rate than that of the telephone company if more than 25 long-distance calls are made each month. The daily routines just discussed are a good example of task planning. Bribery Act, where policies and procedures are a significant theme. This will prevent numerous errors that would require many telephone calls and apologies to change scheduled appointments. In many offices, an assistant is delegated the responsibility of recording some of the case history data. Many attorneys who specialize in malpractice cases feel that accurate, comprehensive, and neatly prepared records are the doctor's best defense. Either the less than ideal must be adapted to or you must restrict service to only prophylactic care until the patient can be convinced it will be necessary to reside in your community for a longer period than originally desired by the patient. The services offered vary considerably, from simply relaying messages to electronic paging or two-way radio dispatching. Consider all the new anti-bribery and consumer privacy statutes we saw around the world in the 2010s, or the climate change disclosures were likely to see in the 2020s. A memorandum should be made immediately of every telephone call that needs your attention, needs a return call, or needs some type of action (Fig. When patients persist in demanding an immediate appointment and your schedule is full, they can be informed that the appointment schedule is full and you are running behind. Being polite and courteous can encourage patients to come back, while being rude can chase them away What components are included in a business letter? So clearly its important, but why do we have policies and procedures? To save your time, you may wish an assistant to directly process payments received, appointment requests and changes, routine insurance forms, and customary bills to be paid. Standard forms can be obtained at local office supply stores or from a number of mail-order catalogs. What else should we examine? As your practice matures, cabinets or storage boxes holding inactive and closed files can be placed in a distant storage room so that valuable active office space is not burdened. They take up considerable room depth, but not too much wall space. As health practice is not a business but a profession, any reference to "salesmanship" here might be in poor taste. Is there good balance between gross earnings and net income? Form letters Physicians have a legal and ethical responsibility to provide healthcare that is appropriate for the patient. A continuing patient or new patient to your practice who enters the office without an appointment and requests immediate service also requires tact. Some doctors have thriving practices in poor times, and some have meager practices in good times. We will cover this in more detail below. One of the most important duties as a receptionist is to prepare patient charts before the office opens. Patients scheduled ahead for a longer interval than a month have their folders placed in the appropriate monthly division. Front office staff are in a good position to begin the discussion. Statements and envelopes The various rooms can be prepared for patients, telephone answering service messages can be recorded, and equipment checks can be made. It's good policy to let the caller hang up first, else there is a risk of spoiling a pleasant conversation with a loud bang if the phone is not replaced gently. Telephone services and equipment have evolved rapidly during recent years. If the patient reports that he feels worse, is discouraged, and doesn't wish to continue treatment at present, your assistant might comment, "Mr. Smith, it's only human to get discouraged when response is not coming rapidly. Plans must be continually revised and updated. Most patients- both new and established- contact the office by phone. you offer her an appointment for later that day, but she insists that it must be now. Thus, prudence must be maintained. Because the telephone is a low-fi instrument, many overtones and undertones appreciated in direct conversation are lost. Explain the importance of discussing general office policies to patients. Personal calls of staff should be limited to emergencies and made as brief as possible. Consistent achievers stack the odds in their favor. A supplies purchasing control sheet is helpful in quickly reviewing the purchase history of an item and offering basic reorder information. * Signing in For example, if all expense reports are supposed to include itemized receipts (thats the policy), and all reports are to be submitted via a certain online system (thats the procedure) you can more quickly find those employees who arent submitting expense reports with itemized receipts. The Mystery Caller. Living in reality, the wise assistant will anticipate some appointment changes, tardy patients, broken appointments, last-minute cancellations, times when you will be late, as well as overly sensitive, irritable, and demanding patients. When an electronic device is used, an assistant should play back the tape and record the messages on a standard form along with each caller's name and phone number. In its simplest terms, the goal is to have the patient like the people associated with the practice. Sterile items should be protected while in storage, and appropriate instruments and supplies such as speculae, acupuncture needles, and specimen containers must be sterilized and kept aseptic prior to use. Aside from patient record files, additional card files that remind you and your assistants of important dates and matters to be taken up at a later date reduce burdening memories with sundry details. As a chiropractic office should maintain an image of efficiency and promptness, mail requiring an answer should be responded to within a day or two of receipt if possible. (2) when the average number of recall visits declines or plateaus, The telephone company is not above error; thus, your monthly toll statement should be reviewed carefully prior to payment. Worker's Compensation forms The only alternative is to place this patient on some type of temporary program that will allow the patient a maximum amount of comfort possible within the circumstances. Pathology labs * Place laboratory specimens for pick-up The cardiologist has asked you to schedule him for a cardiac catheterization with planned stent placement, which will require an overnight stay. A caller should never receive an indecipherable response like "DrJohnson'soffice; MissAndrewsspeaking. Personal Calls ultrasound US Thus, it is advisable that most all patients be given a specific day and time for the next appointment, even if the appointment is far in the future. Excessive stock means an unnecessarily high inventory investment. Increasing obligations can risk your practice's reputation and credit standing, leading the way to bankruptcy. It will be helpful to you if your assistant organizes call slips into categories. This record should contain the date, time of call, name of caller, caller's telephone number, the main points of the conversation, what your assistant did about the request, and other vital facts. OFFICE HOURS A narrative report is a written summation of findings and conclusions prepared for a referring physician or directed at the request of the patient to an insurance company, attorney, or some other third party. When a new patient is at the dismissal desk for the first time, an assistant should learn the most convenient days of the week and times of the day for each patient, and then try to accommodate the patient's desires as closely as possible when making future appointments. Record processing and maintenance Credit cards are a convenience to many doctors. - run account reports and balance the day sheet. Thus, control is necessary to maintain the quality effects of services and positive patient relations, and to safeguard the financial stability of your practice. If yes, explain _____ TOBACCO Never Current Former Age of Onset . Salespeople are not only an excellent source of information, they are also carriers of good will or ill will. 8. After your practice has been in operation for several years, it is possible to have your appointment schedule filled in advance 95% of the time. Thus, it can be appreciated that there are strong points for and against telephone reminders. Explain general office policies 5. Such cases usually warrant that the condition for which the patient is being referred is recorded when the appointment is made along with the length and type of treatment previously received. Caller: It's been getting worse over the last 2 weeks. LOW PATIENT VOLUME It is the chief way patients communicate with the provider. Include a disclaimer in your documentation that states the manual serves as a guide to the practices policies and procedures and does not explicitly or implicitly create a contractual relationship. It's not convenient for me to come in tomorrow. How will they fit with changing requirements? If vitamins or minerals have been dispensed or if rehabilitative equipment has been loaned, rented, or sold, entries should be made within the records. If behind schedule, why? Of the three, staples are the best unless the papers must be separated. However, if the writer only desires specific information regardless of source, the assistant is usually allowed to compose the letter over her or the doctor's signature. 1. review insurance coverage with patient. Even if the patient has a scheduled appointment, he or she should not be left sitting in the reception room "waiting a turn." Basic information is usually recorded on an index card and kept on file for administrative reference. Such a cold approach would be received by most patients as an indication of little concern for patients' best interests. She should realize that it's important not to interrupt the professional rapport or procedure between doctor and patient unless it's most vital. Depending upon the disorder involved and its seriousness, the age of the patient is sometimes quite important to record. input is valid. Step-by-step solution This problem hasn't been solved yet! Where should your practice be at this time? This is to achieve consent for therapy. However, except for form letters, it is good policy to at least quickly review all office letters that are mailed regardless of whose signature they contain. Because of the referring patient, the prospective patient will have a high regard for the doctor and high expectations for relief. hedge. Thus, it's helpful to pitch the telephone voice slightly lower than normal. 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. However, there may be some other correspondence that you wish your assistant to acknowledge receipt with a note that you will reply as soon as possible on your return. When using such a system to complete incomplete schedules, a patient's cooperativeness should be noted in the records. Telephone services and equipment have evolved rapidly during recent years. High sense of good conduct and hygiene. The patient should be made to realize that only first-aid service has been rendered and a more comprehensive service is available when the patient is ready. Would you mark us on your calendar too?" Insufficient stock may interfere with proper patient services. 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. Except with acute cases that require close surveillance, your assistant should have the authority to change the day you suggest either a day ahead or behind to meet scheduling demands. Subconsciously, many fear making specific plans. 3. have a patient sign a disclosure in presence of a witness. Reminder Calendars Shipment Errors. Employees working in factories whose employment requires a rotating shift pose a problem in maintaining a regular appointment schedule. * Note items on back order If mistakes have occurred while metering, the meter stamps not used will be refunded or credited at the post office. Insurance companies (patients) Before transfer, the date and number of the check made in payment should be noted on the invoice. Referral List Patient preparation Your assistant's good judgment is necessary to determine whether a patient's request for an immediate appointment is a true emergency or not. An important aspect of such control is your practice's appointment system. The objective is to see that each practice day represents a minimum of unproductive time. Folders can be color coded, forms and papers can be color coded, and stickers can be color coded to signify subdivisions. As your office will be judged by some by the appearance of its letters, the composition should be well spaced and composed accurately, neatly, and in accordance with an acceptable professional style. The office and the person receiving the call should be identified immediately. communicates the legal rights patients have while under the care of a practioner or facility. Health practice is a very human situation, and the initial contact with your practice will usually be via the telephone. If distressed callers are put off for several days, they will undoubtedly turn to another doctor who is more accommodating. I'll let you know when I can make another appointment." Employees should arrive in the morning well in advance of patients so that preparation can be made for arriving patients. 4. marital status. How many new patients you serve this week is not as important as how many satisfied patients you serve. A record can also be kept of office mailings if a separate advertising/public relations file is not maintained. Mail Sorting. The DOLs Office of Small Business Programs offers a variety of compliance resources for small businesses. Coils are better than sheets as they take up less space and are easier to tear apart at the perforations. Philosophy Warning signs are seen: Assistant: How long have you had this problem? Telephone practices While persistence in holding firm to your objectives is an asset in accomplishment, achievement strategies must frequently be amended to meet the unexpected. In most practices, an administrative assistant takes full responsibility for housekeeping. The cards are separated by tab dividers for each month and subdivided by 28--31 subtabs for each day of the current month. Your practice must have good equipment, supplies, and outside services to run efficiently and profitably. On the other hand, if a patient who is accustomed to a definite appointment time and day cannot be allotted that time, your assistant should inform the patient immediately of the change in routine. Appointment book sheets The follow-up system itself can be handled in either of two ways. It also helps to create a desire for more information. requires companies that make drugs, medical devices, and biological medicines to report payments and items of value given to physicians and teaching hospitals. * No personal emails You cannot score a touchdown if you do not know where the goal lines are. As there is always a degree of uncertainty when a change is made from established procedures, limit changes to those areas that distinctly warrant improvement. When the number of new referrals does not exceed the number of patients lost to the practice, your practice is diminishing quantitatively. has had a positive treatmill test that suggests an underlying cardiac condition. However, to maintain control, you should review all requisitions and initial your OK if the requisition is acceptable. 3.1) to run smoothly with less possibility of omitting necessary actions. To be tactful when the assistant makes a follow-up call, it should not be "to remind" the patient, but to "confirm" or "verify" the appointment. How Should HR Handle Political Discussions at Work? Full name, phone numbers at home and work (with extension number if necessary), reason for the visit, and dates and times of appointments are the important elements that should be recorded in a record book after they have been verified as correct. CROSS-REFERENCE SHEETS Daily financial control sheets Each check should be reviewed to assure that the written amount and the figures match. She should realize that it's important not to interrupt the professional rapport or procedure between doctor and patient unless it's most vital. Spelling should be clarified when necessary. This reaction is not a sometime thing. MICROFILM FILES Proper calculation of the time necessary for a patient's appointment greatly reduces reception room waiting time, prevents clinical care from being rushed, and con-tributes to positive human relations. Filing within this folder should be made alphabetically rather than by date. For example: The five-unit system allows a married woman to use her formal name (eg, Mrs. John J. Jones), which would distinguish her from another Mary J. Jones. There is a distinct difference between an office policy and an office procedure. Referral procedures When appropriate, entries are made for recall, thank you letters, etc, and entered either in the case record or another file. Touchdown if you do not know where the goal lines are _____ TOBACCO never Current Former Age of the patient! Positive treatmill test that suggests an underlying cardiac condition file for administrative reference does not exceed the number new... 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Than a month have their folders placed in the order of arrival for days... Office mailings if a separate advertising/public relations file is not a business but profession! Situation, and the like can not be expressed if the requisition is acceptable coded, and the receiving. Staff are in a good example of task planning professional rapport or procedure between doctor and patient it... An assistant is delegated the responsibility of recording some of the last order for each should... Initial treatment and whenever the patient needs subsequent care and credit standing leading! The Age of Onset of sympathy, congratulations, and the re are a couple of same-day appointments on. Rotating shift pose a problem in maintaining a regular appointment schedule, leading way...