* Disclosure In policies related to termination of employment, avoid using undefined, catch-all terms such as "just cause" which may open the door for wrongful termination lawsuits. Patients should never feel that they are being "victimized" by an office policy. Yet even in cases of justifiable excuses, the patient must be impressed with the necessity of maintaining the treatment schedule. The file is first divided by month. the office has been busy all day, with several interruptions calling the physician away. Return calls can then be made by the appropriate person. If one staff member attends to part of a letter before it is sent to someone else for further action, a paragraph that has had attention should be noted, dated, and initialed (eg, Did 6/17 JM). Small Business Regulations Referral procedures Protecting stocked materials from dust, moisture, and temperature extremes will greatly reduce damage. Soukhanov states that "Information is the basis of all decision making and planning. No system will run itself. * Only when necessary 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. Attachments. If this should occur, the issuing company should be notified immediately by telephone to avoid financial responsibility for unauthorized charges made against your account. Catalogs. When working capital deteriorates, the cause can usually be traced to accumulating operational losses, poor collections, excessive payroll expenses, or unusual disbursements (eg, unexpected legal expenses, repair costs). Some walk-in patients feel that while you may prefer appointments, they are not absolutely necessary --at least, not for them. * Headers Unit 1 is the last name in capitals, Unit 2 is the patient's title, Unit 3 is the first name, Unit 4 is the middle name or middle initial, and Unit 5 is the person's nickname or name by which the patient prefers to be called, enclosed by parentheses. When you are available but speaking on another line, your assistant should inform the caller of the fact and ask the caller if he or she would rather wait or have the call returned in a few moments. area within a "closed case" file. It is also here that returning patients gather their thoughts before they see you. A signed formal release is necessary before such confidential information can be discussed. Filing within this folder should be made alphabetically rather than by date. You can record all pertinent data on a small portable tape recorder after each housecall. Be alert to the fact that many people become quickly irritated when their call is answered by a machine. PROBLEMS WITH TRANSIENTS 3. Less than a 3-month supply is usually poor economy. No attempt to "pressure" a patient into a return visit should ever be made. The skill involved in their administration is an essential factor in a profitable operation. Your local telephone company will be happy to discuss with you all options that are available. You may ask an assistant to check on certain patients' progress after treatment or to verify that your instructions have been carried out. Are the reports illegitimate? I have Dr. Smith's appointment book here at my desk. 15.99 ounces post cards letters and small packages. 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. Clear, honest communication between patient and provider paves the way for accurate diagnoses and treatment decisions. Day Sheets Case History Procedures and Records Most offices plan that the notification is received by the patient about 3-4 days prior to the appointment. 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. Although professional printing houses have a large selection of case history forms to choose from, many doctors wish to design their own to meet their particular needs. If your assistant must make a number of outgoing calls such as for appointment verification, she should allow several minutes between each call so that a patient trying to reach the office has a chance to make the connection. Explain the importance of discussing general office policies to patients. Custom dictates the form in which a narrative report is developed, although there is some variation in framework depending upon the doctor's preference and specialty (if any). Most offices file strictly alphabetically by the patient's last name or subject of the topic to be filed. statements. What type of info would she need to bring for her son, New patient appointment Policy and Procedural Changes Each film should contain an identifying name or number, the patient's age and sex, the date of exposure, an indicator showing the direction of exposure, and something to designate the patient's right or left. Each procedure should briefly describe its purpose, support materials needed, technique (by steps) required by the assistant, and safety measures when applicable. Handling several progress reports or inquiries by telephone may dominate lines needed to receive and schedule appointments. (4) bank balance drops below forecasts, and 13. providers diagnosis and plan of care. Even taking advantage of the telephone company's discount time periods will make a difference. No system is any better than the manner in which it is used. An efficient filing system should provide for at least three general Learning to plan effectively is not difficult, but it is time consuming. There are two general filing systems popular in chiropractic offices: alphabetical indexing and numerical indexing. 1. patients should be and should expect to be treated professionally with respect at all times. Record Flow The "I Care" message must be conveyed. Consent forms * Print on stationary Dead leaves from plants should be removed, and the plants should be rotated for sunlight. Everything You Need to Know. It serves as a framework for planning the future. The total of all duty schedules comprise the office's Procedural Manual. Most doctors, however, prefer to have the incoming letter and its answer stapled together and filed under the name of the incoming letter's author or company. (Why not? The envelopes are generally filed alphabetically by the patient's name and cross-referenced by the x-ray film number. and so forth. One common procedure is for an assistant to sort the mail into three piles: (1) those letters that require the attention of someone outside the office staff; During the initial telephone contact, the assistant usually puts some information on a form when the appointment is scheduled. 2. THE UNSCHEDULED WALK-IN Time is always a problem. Either perform the necessary examinations and tests or telephone the patient's hometown doctor (at the patient's expense) and see what he suggests. 3.2). Has the patient sought help elsewhere for this particular disorder? specifies that when an agreement is made between the provider and a patient for payment in more than four installments, the provider is required to provide a detailed description of finance charges. Supply inventory control sheets 2. determine callers identity. Appointment schedules can be established accordingly, depending upon the clinical judgment of the doctor. THE GREETING Learning to plan effectively is not difficult, but it is time consuming. Each check should be reviewed to assure that the written amount and the figures match. Worker's Compensation (local office). A list of backup professional help should also be at hand. They also like to hear several "Thank you's." The accounting system must be prepared for the day. Coding. Whatever the reason is for failing to meet a scheduled appointment, communications must be maintained so that positive action can take place. Otherwise, it displays that the input is invalid. Nutritional supplements 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. Many of these callers are important to the operation of your practice. Have a labor or employment attorney review your policies and procedures for language and compliance issues. OFFICE POLICIES & PROCEDURES FOR OUR PATIENTS . In most practices, an administrative assistant takes full responsibility for housekeeping. This reaction is not a sometime thing. Return calls can then be made by the appropriate person. Both of these functions must be taken seriously as a large investmentis often involved. ADMINISTRATIVE RATIONALE Second, office policies must be adhered to whenever possible. The two most common types of case reports within a chiropractic office are personal reports and narrative reports. 3.16). Your office will receive many calls that do not require your personal attention. When you are available but speaking on another line, your assistant should inform the caller of the fact and ask the caller if he or she would rather wait or have the call returned in a few moments. 3.4). or "What seems to be the matter?" Your policies and procedures manual should address most major aspects of your practice operations. CLINICAL RATIONALE Cash disbursement reminders This implies that assistants should be familiar with all office policies, instruments, equipment, and clinical procedures used in the practice. An 869-page book, for example, may be reduced to ten 4-inch x 6-inch cards, occupying only 1/8-inch file space. All major equipment should have a maintenance checklist attached to assure that the manufacturers' recommendations have been followed. The patient can then be escorted to the consultation room. If a time slot is available and appropriate for the reason for visit, offer it to the patient, being polite but clear that this is not the usual practice. Duty Schedules and the Procedural Manual At the end of a personal report, it is customary that the patient be given an opportunity to ask any questions that remain unanswered to his or her satisfaction. Each time a patient returns to your office on subsequent visits or a housecall is made, the patient's condition should be recorded together with changes in treatment or to previous instructions. Whenever possible, patients on long-term appointment schedules should be given the same day and time to help establish a habit pattern. Follow-up Files In contrast to telephone reminders, most doctors do prefer the use of mailed reminders (Fig. Rather, it is better to respond, "There appears to be a poor connection. Roentgenographic procedures Determine your patient's readiness to learn. An "Appointment Control Record" is helpful in analyzing problem areas. Assistant: Dr. Smith will be happy to discuss fees with you. A record of out-of-office visits can be handled by a number of ways: When you return, your assistant can note on her copy of the routing list the services rendered, the fee involved, whether the fee was paid or charged, and other points necessary to record. Generally, the assistant's responsibility will be limited by her ability to parallel your desires, tone, and style. He also requires a CBC electrolyte panel and pan echocardiogram done prior ot the catheterization. From reducing the likelihood of client misunderstandings about matters like scheduling, payment and cancellations, to streamlining personnel management and setting clear expectations for your staff, your policies and procedures are one tool for managing the risk inherent in running a business. Sometimes policies and procedures help to achieve operational objectivessay, ways to develop a new product, or how to handle a customer service call. Copies of correspondence requesting reports, insurance statements, etc, that cannot be replied to immediately should be placed in a readily accessible holding file. her ob/gyn physician has determined that she needs to have a total abdominal hysterectomy. To recognize this is important in avoiding an unnecessary or unfavorable audit by the Internal Revenue Service or your state's Tax Commission. The patient must decide which course of action is preferred. First, the doctor who makes an appointment for a patient without informing the assistant is committing a definite breach of good communications and staff relations. Telephone transmission appears to be best when the mouthpiece is held about an inch directly in front of the lips. Your assistant should not feel that her function is to "screen" calls, as such an attitude appears to isolate you from the caller. Dr. Anderson will be glad to hear that because that is what he's been working toward. Third-class circulars In many cases, your assistant's quality of voice over the telephone may calm or reassure a nervous patient. If a mystery caller demands to speak directly with you, your assistant should ask for the caller's name and number so the call may be returned. X-ray ID cards. When a check is properly made out, the proper data should be entered within the daily record and patient's ledger. A list of such calls offers you an opportunity for a quick review (Fig. Practice policies relate to those nonpersonal policies such as office hours, billings, collections, inventory control, etc. If an opening is available, your assistant can explain office policy yet comply with the request if the patient can be worked into your schedule without causing confusion. SCHEDULING SYSTEMS 3.33) and transfer its information each month to a master list kept in the business office or the central storage area. * Attend to patient needs Film processing and filing procedures Deductively, you can start with long-range objectives and divide them into intermediate and short-term goals. If distressed callers are put off for several days, they will undoubtedly turn to another doctor who is more accommodating. For example, colored folders can be used to subdivide letters of the alphabet: A growing number of offices use elaborate color-coding systems to indicate subdivisions within a particular major category to differentiate cases (eg, Medicare, Medicaid, worker's compensation, Health Insurance, etc). Even when cleanliness standards are high, negative impressions can result when leaves and papers accumulate in exterior shrubs or when wall hangings and lamp shades become crooked. Assistant: If you wish to make an appointment or reserve time for a consultation, I can help you. This is to achieve consent for the examination. * Progress notes Its primary goal is to serve people in need. 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. The information in this article should not be used as a substitute for obtaining personal legal advice and consultation prior to making decisions regarding individual circumstances. 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; Why would a medical practice use social media? Postoperative lab, abdominal xray and pain medications should be anticipated. A major function of planning is to be able to visualize what your practice is at one stage and what it can be at another. Special assistance with clothing, walking, and seating should be offered to the elderly, the crippled, the painfully distressed. Pathology labs * confidentiality In addition, office correspondence can be opened and classified, case files should be pulled in the order of their appointments, and minor tasks left over from the previous day can be completed. Other common causes include expensive equipment purchases by cash and investments in unprofitable equipment. He offers professional health-care service. Thus, it's helpful to pitch the telephone voice slightly lower than normal. Make any changes necessary to keep your operations flowing smoothly and to comply with any legal or regulatory changes. When you are in the office, any emergency situation should be brought to your attention immediately. If you are in town but out of the office, your assistant can simply state, "Dr. Brown is out of the office and is scheduled to be back by 2 o'clock this afternoon." The basic information gathered from a patient new to the practice is often called statistical data or identifying information. Form letters Providers constantly research the wants and needs of consumers. On or near the doctor's desk and each assistant's desk should be trays to receive incoming and outgoing forms, reports, and correspondence. If the letter refers to a patient's account, it is efficient if the patient's financial ledger card is attached. Other common causes include expensive equipment purchases by cash and investments in unprofitable equipment. Ultimately, the most important reason to have policies and procedures is that they help to build a stronger corporate culture. MEETINGS Procedures tells employees how to deal with a situation and when. This can only be detrimental to a good doctor-patient relationship. In this type of file, patients who refer others to the practice are recorded so that appropriate thanks can be extended. Policies and procedures keep operations from devolving into complete chaos. Thus, prudence must be maintained. requires companies that make drugs, medical devices, and biological medicines to report payments and items of value given to physicians and teaching hospitals. Encourage your staff to ask questions, and have appropriate training literature on hand. Job descriptions should be included that specify requirements, responsibilities, regulations, normal working hours and station, and promotional guidelines. Explain general office policies 5. This advanced information will help your staff in preparing initial records and offer you a preview of the situation. This allows flexibility needed for patient care, makes fullest use of examining and treatment rooms, avoids delays for the doctor while patients are being prepared for examination or treatment, and helps handle the problem of the tardy patient (Fig. Kenneth JOnes, 50 yo. Similarly, clear, confidential communication between members of a care team (which often includes patients and multiple providers) results in swiftly and ethically delivered . Most patients who have not been in the office for several weeks or months usually do not mind such a suggestion. Whether or not the patient will receive the total service scheduled will depend on the type of service specified and how tight the appointment schedule is. Unworthiness indicates a profound lack of appreciation of the doctor and his services. Programs are becoming available that assist in diagnosis after inputting clinical data. Typical data include general office policies (eg, sick leave, absenteeism, tardiness), and employee benefits (eg, holidays, vacations, insurance). Welfare Department (local office) Preferably, this should be within another cabinet or at least another drawer. Coordinated efforts produce an atmosphere in which the doctor's concern for every patient can be expressed to its maximum. Newspapers what ramifications are possible if you are unable to handle the situation successfully? CANCELLED SERVICES The points made within this section will help you train your assistants in professional telephone procedures. Lack of respect may be the result of the patient's personality, negative environmental factors, or negative conditioning. Would you mind speaking a little louder and slower?" Periodic staff meetings should be regularly used to analyze the different phases, procedures, and control points involved in the services offered and to seek areas of improvement. 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