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MA: Chp 22 - Scheduling & Receiving > Scheduling & Receiving > Flashcards

Scheduling & Receiving Flashcards

1
Q

What can schedules be useful for besides the obvious?

A

accounting & legal proceedings

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2
Q

What does matrix refers to?

A

blocking off time slots

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3
Q

t/f: appointment schedules are legal documents

A

true

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4
Q

how long should appointment records be kept for?

A

vary by state law, but generally 3 years

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5
Q

What should be included when documenting appointments?

A
  • name of pt
  • parent’s name when appropriate
  • reason for visit
  • provider
  • date and time
  • pt’s current phone number
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6
Q

What info should be included in new pt registration packet?

A

insurance, demographic, employer

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7
Q

who is considered a new pt?

A

pt who hasn’t received services from provider within past 3 years

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8
Q

who is considered an established pt?

A

pt who received services from provider of same specialty/subspecialty belonging to same practice within 3 years

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9
Q

what are some aspects of the patient care partnership

A
  • high quality hospital care
  • clean & safe environment
  • involvement of own care
  • protection of privacy
  • help leaving hospital
  • help w/billing claims
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10
Q

what is not covered by general release of info form and requires it’s own special consent form?

A
  • genetic testing
  • mental health & therapy records
  • substance abuse records
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11
Q

t/f: pt should be notified when their PHI was given w/o consent bc of emergent situations/public health risk

A

true

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12
Q

benefits of using EHR w/billing and collections features

A

streamline workflow for submitting insurance claims & receiving payment for services

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13
Q

what can possibly happen to cost of emergency/urgent procedures w/o preauthorization bc of lack of time?

A

decreased/partial payment from insurance

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14
Q

what responsibility do patients have?

A
  • be honest & report all symptoms, injuries, any medications
  • treat staff w/courtesy & respect
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15
Q

what does the provider have the right to expect

A

pt to keep account in good standing to maintain businesses & pay expenses

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16
Q

descirbe the Federal Truth in Lending Act (TILA)

A
  • provider myst provide detailed description of finance charges when pt pay in more than 4 installments
  • prevent abuses in consumer credit cost disclosures
  • requires uniformity in disclosures throughout credit industry
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17
Q

define clustering scheduling

A

based on specific visits/procedures at specific time

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18
Q

give the pros of clustering scheduling

A
  • streamlines evaluations of pts w/similar complaints
  • paperwork can be done in batches in advance
  • unnecessary personnel can do other tasks
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19
Q

give the cons of the clustering schedules

A
  • off track/running late can throw flow offtrack
  • may not leave opportunities to individualize exams
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20
Q

define CLUSTERING SCHEDULING

A

schedule pts based on specific visit/procedure @ specific times

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21
Q

what are the pros of cluster scheduling

A
  • streamlines evaluations of pts w/similar complaints
  • visit paperwork can be done in batched in advance
  • unnecessary personnel can focus on other tasks
22
Q

what are the cons of cluster scheduling

A
  • off track/running late visit can throw appt off track
  • may not leave opportunities to individualize evaluations
23
Q

define DOUBLE BOOKING SCHEDULING

A

same appt time for at least 2 pts

24
Q

what are the pros of double booking

A

efficiency

25
Q

what are the cons of double booking

A

if problem w/one pt, can delay other causing rest of schedule to be behind

26
Q

define WALK-IN/OPEN HOURS SCHEDULING

A

no scheduled time and seen in order of arrival

27
Q

what are the pros of walk-in/open scheduling

A

good for complaints of unexpected onset

28
Q

what are the cons of walk-in/open scheduling

A

complex complaint/multiple ppl with same problem overwhelms staff & resources

29
Q

define SINGLE BOOKING

A

1 pt booked for specific amnt of time and done when appt will take longer

30
Q

what are the pros of single booking

A
  • focus on pt & thoroughly assess complaints
  • better for appts that take longer
31
Q

what are the cons of single booking

A

can leave gaps in schedule if problems easily addressed & straightforward

32
Q

define STREAMING SCHEDULING

A

appts scheduled for specific amnt of time based on need to keep continuous flow of pts

33
Q

what are the pros of streaming scheduling

A

most effective use of timeslots

34
Q

what are the cons of streaming scheduling

A

if insufficient time/unexpected problem it can cause other visits to be delayed

35
Q

define WAVE SCHEDULING

A

pts scheduled during first 30 min of each hour leaving last 30 min for same day appts

36
Q

what are pros of wave scheduling

A
  • give ample time for unexpected visits & staff to do tasks
  • effective in seasonal events
37
Q

what are the cons of wave scheduling

A
  • cause lag in schedule/workflow
  • excessive downtime when last half hour not needed
38
Q

define MODIFIED WAVE SCHEDULING

A

wave but schedules pts in last 30 min at 10-20 min intervals

39
Q

what are the pros of modified wave scheduling

A
  • same as wave (time for unexpected visits & tasks/good seasonally)
  • sees more pts in allotted time period
40
Q

what are the cons of modified wave scheduling

A
  • same as wave (lag in workflow & excessive downtime)
  • back up when pts late/providers delayed/unexpected events
41
Q

what should be documented when pts are making appts

A
  • pt name
  • parent of pt if appropriate
  • reason for visit
  • provider to be seen
  • date & time
  • pt current phone number
42
Q

for CPT purposes, what is considered a new pt?

A

person who has not received services within 3 years

43
Q

for CPT purposes, what is considered an established pt?

A

pt received services from provider of same specialty and subspecialty belonging to same practice within 3 years

44
Q

describe HEALTH MAINTENANCE ORGANIZATIONS (HMOs)

A

insurance plan requiring subscribers to use network providers

45
Q

describe EXCLUSIVE PROVIDER ORGANIZATION (EPO)

A

insurance plan similar to HMO but with exceptions; subscribers must use network providers

46
Q

describe PREFERRED PROVIDER ORGANIZATION (PPO)

A

insurance plan receiving more comprehensive benefits w/network providers & does not require PCP

47
Q

describe INDEMNITY PLANS

A

insurance plan where access is offered to any licensed physician/hospital but generally more expensive

48
Q

define TICKLER FILE

A

long-time standby filing system to augment regular calendar & scheduling system

49
Q

what info is required to schedule inpatient procedures?

A
  • full/birth name
  • DOB & age
  • gender and marital status
  • social security
  • address
  • phone number
  • designated/emergency contact
  • employer & work phone number of guarantor
  • hospital insurance coverage w/verification of preauthorization
  • name, address, phone number of referring provider
  • provider’s diagnosis & plan of care for committee review
  • expected date of surgery, name of surgery, length of procedure, type of planned anesthesia, estimated blood units (if applies)
  • time, date, name of lab/scans/type of pt prep (if applies)
50
Q

what info should be obtained when receiving a pt

A
  • full name of pt
  • DOB
  • SS #
  • marital status
  • current address & length of time at address
  • phone number & email
  • name & relationship of person responsible for charges
  • pt occupation
  • health insurance info
  • photo ID

MA: Chp 22 - Scheduling & Receiving (2 decks)

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