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Q
We see patients in the order they sign in. That means
that walk-ins sometimes are seen before patients with appointments.
That doesn’t seem fair. How can we make sure that doesn’t
happen?
A
Create a list of scheduled patients, then add on names of
walk-ins as they come in. The printed list will be your scheduled
patients, and the handwritten ones your add-ons. Or, if you
keep the schedule electronically, add an asterisk to the end
of the last names of the patients who walk in. You’ll
want to put someone in charge of managing this, such as your
front office receptionist. Call patients to the exam rooms
based on these lists, not in the order of sign-in.
Q
Our physicians sometimes cancel appointments at the
last minute because they need to attend CME courses or have
a vacation planned. How many such physician “bumps”
should we have? What can we do to reduce them?
A
Your goal should be to have no physician bumps. Cancelled
appointments create stress, have obvious negative consequences
for patient satisfaction and generate costs due to the internal
staff resources needed to reschedule appointments.
Moreover, the vast majority of physicians
need and want to see patients. For starters, physicians get
paid to see patients; bumps can reduce their income. Add the
cost of rescheduling the appointments and the loss of patient
loyalty, and bumps can have a significant financial impact.
To combat bumps, many practices set
windows for announcing CME and vacation schedules. Physicians
have to announce their absence at least six weeks before they
expect to be out (unless an emergency arises), so rescheduling
is kept to a minimum.
If you have a concern about yours,
track “bumps” by physician for at least a quarter.
Include the cost of rescheduling and any comments from disgruntled
patients or referring physicians. Put the data and comments
in a report, and present it at the next physicians’
meeting.
“Bumps” are just as important
as patient no-shows. Both mean that your practice bears the
cost of the appointment without any revenue to show for it.
Q
I have an EMR, but still have a lot
of paper. Lab results and other information come in on paper.
I’ve thought about scanning these documents and including
them in the EMR, but it seems so time-intensive. How can I
tell if the effort will pay off?
A
To determine if scanning is a cost-saver, you’ll want
to compare the price of the system and its administration
(that is, what you will have to spend on staff scanning the
documents) with the cost of having to maintain a manual filing
system. You’ll have to estimate the latter cost, but
be sure to consider the space that you will save as well as
the employees’ time.
Further, some practices have found
that a specific area in their practice — like the billing
office and the scanning of EOBs for submission of secondaries,
or the front office scanning patients’ insurance cards
— has really been cost-effective, but not a whole practice
solution.
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