Admin & Finance - Section 2: Scheduling, Front Office, & Patient Registration Flashcards
What are the 3 scheduling types?
1) Open access (same day appts)
2) Appointment only
3) Portal (self-scheduled)
Open access (same day appts), appt only, and portal (self-scheduled) are examples of what?
Scheduling types
What should determine how you and your RHC customize a schedule?
The needs of your community
What are 2 reasons to review patient scheduling and in-take processes?
1) To ensure accruacy
2) To ensure patient satisfaction
Open access is a “fancy” term for what kind of appointment?
Walk-ins
TRUE or FALSE: It is better to advertise your clinic as an “Urgent Care Center” rather than as an RHC that provides “Urgent Care Services”.
FALSE.
What appointment type is this an example of: open times available throughout the day
Open access
What appointment type is this an example of: open time in blocks (i.e., designated time blocks from walk-in appointments)
Open access
What appointment type is this an example of: designated days/time for same day appointments
Open access
What appointment type is this an example of: walks-ins worked in same day for acute needs
Open access
What are the 3 components of open access appointments?
1) Open times in blocks
2) Designated days/times for same day appointments
3) Walk-ins worked in same day for acute needs
What appointment type has this advantage: increases patient satisfaction.
Open access
What appointment type has this advantage: primary care specialists have regular demand.
Open access
What appointment type has this disadvantage: challenging to match time slots to demand
Open access
What appointment type has this disadvantage: unused slots
Open access
What appointment type has this disadvantage: patient has unrealistic expectations and the schedule over runs
Open access
What appointment type has this advantage: multi-provider efficiency when the clinic has multiple providers
Appointment only
What appointment type has this advantage: multi-location efficiency if the RHC has more than one location
Appointment only
What appointment type has this advantage: customization of appointment
Appointment only
Why are appointment only appointment types less flexible?
Providers can use the same appointment intervals and consistent lengths for different types of visits (i.e., providers may not pay attention to time and go over with some patients).
What appointment type has this disadvantage: matching appointment types to demand by provider.
Appointment only
What appointment type has this advantage: boosts patient engagement/meaningful use
Patient portal scheduling
What appointment type has this advantage: reduces phone calls and action needed in scheduling by staff
Patient portal scheduling
What appointment type has this disadvantage: chief complaints do not fit appointment slot
Patient portal scheduling
What appointment type has this disadvantage: patient expectation doesn’t match provider/clinic expectation or availability
Patient portal scheduling
What appointment type has this disadvantage: lack of effective communication between patients and staff
Patient portal scheduling
What appointment type has this disadvantage: technology dependent
Patient portal scheduling
What appointment type has this disadvantage: lack of patient broadband, computer, technical savvy.
Patient portal scheduling
What formula in regards to scheduling helps ensure/increase patient satisfaction?
Scheduling plan + scheduling flexibility + patient access = patient satisfaction
How do you calculate no-show rate?
Missed appointments / Total appointments
How do you calculate utilization rate?
Kept appointments / Total appointments
What does the revenue cycle start with?
Scheduling
When should patient eligibility be checked?
Prior to seeing the patient
When should payment terms (collection, co-pay, deductibles, etc) be communicated?
Prior to seeing the patient/up front
What patient demographics are subject to constant change?
Address and phone number
What types of questions should front desk staff ask to determine current information?
Open questions
Which question wording is correct to verify patient demographics: 1) What is your current address, or 2) Are you still at 123 Oak St?
1) What is your current address? This is an open question. 2) Are you still at 123 Oak St allows for a monosyllabic answer of yes or no
When should patient balances be checked?
At every visit
At what 2 times must patient balances be communicated?
When the appointment is made AND when the patient is checking in
What percent of revenue do patient balances represent?
20%
What is a significant source of missed revenue?
Uncollected patient balances
When should patient eligibility be checked when using appointment only scheduling?
Prior to the appointment
What is required to determine patient eligibility for walk-in appointments?
On-demand eligibility verification since it cannot be done before the appointment
What is the most common denial reason in the revenue cycle?
Transposed ID numbers
How often must benefits be verified?
At every visit
What is a critical component of data entry when entering insurance and patient information?
Accuracy
What are the 3 components of the patient experience?
1) First impression
2) Patient registration
3) Financial responsibility
What 4 things should be completed by the front office during patient registration?
1) Verify information input during scheduling
2) Add remaining demographic and chart information
3) Scan/copy identification and insurance card(s)
4) Complete any additional forms
What 3 things should be completed by the front office relating to financial responsibility?
1) Verify insurance eligibility and benefits
2) Collect co-pay/deductible
3) Discuss sliding scale or other financial discounts if applicable
What 7 documents/forms should the front office ensure all patients are reviewing and signing?
1) Legal consents
2) Assignment of insurance
3) HIPAA Privacy Notice
4) Medicare secondary payer form
5) Healthcare power of attorney
6) Verbal release of authorization
7) Patient portal enrollment
What 3 ways can staff ensure an effective patient workflow?
1) Follow quality of care standards (assesing urgency of medical needs)
2) Know when to get medical staff involved (phone triage)
3) Have staff work within their scope of practice within their clinical team (CNA, CMA, LPN, RN)
What are 2 ways to ensure that staff is working within their scope of practice within their medical team?
1) Work up to their license to maximize efficiency
2) Create an organizational chart
What demographic information is recommended to verify patient identity?
Name and DOB
