Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Chapter 37 Patient...

Elsevier items and derived items © 2009 by Saunders,

an imprint of Elsevier Inc.

Chapter 37Chapter 37Patient Reception

2Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc.

PretestPretest

1. The first thing the medical assistant does when opening the office is to unlock the file cabinets, medical record files, and medicine cabinets.

2. After opening the office, the medical assistant should be sure that the telephones are switched to the day message or call the answering service.

3. An electronic task system consists of a folder for each month and a folder for each day.

4. Medical records are usually pulled the evening before the appointment.

5. A radio, CD player, television, or DVD player is usually turned on in the morning before patients arrive.

True or False


Pretest, cont.Pretest, cont.

6. The autoclave is often run just before closing the medical office so that instruments can dry overnight.

7. Only one person should be permitted to stand at the reception desk at a time.

8. A new patient must sign a form acknowledging receipt of HIPAA privacy practices.

9. Only the top side of the insurance card must be photocopied.

10. If a patient has managed care insurance, a referral form may be required to see a physician other than the primary care provider.

True or False


Preparing for PatientsPreparing for Patients

1. Duties of first person in the office:a. Disarm the alarm systemb. Turn on the lightsc. Unlock the door through which patients

enterd. Unlock file cabinets, medical records files,

and medicine cabinetse. Turn on all of the office equipment that will

be used

Opening and Closing the Medical Office


Checking for Messages and/or Faxes1. Duties to prepare telephone system for the

day’s activities:a. Switch from the night/weekend message to the

day message on the voice mail systemb. If office uses an answering service, need to

notify service that office is open

Preparing for Patients, cont.Preparing for Patients, cont.



2. Checking for faxes that have arrived overnighta. Route to the appropriate personb. Make sure fax machine has adequate amount

of paper

3. Retrieve messages from a separate prescription request mailbox



Preparing for the Day’s Activities1. Review the day’s tasks2. Note any deviations from normal routine3. Prepare manual day sheet if it will be used4. Review electronic task system or tickler file

a. Tickler file is set of 12 folders (one for each month) plus 31 additional folders (one for each day of the month

b. Contains notes, bills to be paid, other items for the day when it must be handled



Making Sure Patient Charts Are Prepared1. Patient charts are usually pulled the evening

before the appointment2. Charts are arranged with an appointment

schedule for each physician3. A charge slip is printed for each person and

placed with the recorda. May be printed when charts are pulledb. May be printed when the patient arrives



4. Appointment schedules are updated as patients are added

5. Appointment schedule printed for each physician and placed throughout the office

6. Charts are usually kept at the front desk until the patient arrives



Checking the Office and Waiting Room1. Waiting room should be checked for:

a. Cleanlinessb. Neatnessc. Correct temperature



Neat and Tidy Waiting Room



2. Television, radio, and/or DVD player in waiting room should be turned on

3. Any toys in children’s play area are cleaned regularly

4. Holders for patient information brochures are tidied and restocked



Checking Equipment and Supplies1. Office should be checked visually for safety2. Fill paper trays of copier and printer3. Check examination rooms and restock as

needed4. Turn on equipment in laboratory as needed

and run controls5. Unload autoclave if it was used the night

before



1. Autoclave may be run and medical records pulled at the end of the day a. Allows instruments to dry overnightb. Gives more time in the morning

2. Make backup copy of main computer hard drive as needed

Closing the Medical Office



3. Other duties are reverse of opening the office:a. Turn off all equipment except fax machine and

telephonesb. Change telephone system to night message and/or

call answering servicec. Lock the door through which patients enterd. Lock file cabinets, medical record files, and

medication cabinetse. Make sure kitchen equipment is turned offf. Turn off lights

4. Alarm system is set as the last person leaves


Patient Check-InPatient Check-In

1. Important to acknowledge each person who enters the office as soon as possible

a. Prevents person from feeling awkwardb. Sign-in sheet should have adhesive peel-off

strips to preserve confidentiality


Patient Check-In, cont.Patient Check-In, cont.

1. Sliding glass window prevents people in the waiting room from hearing telephone conversations, etc., in the reception area

2. If open desk, medical assistant (MA) avoids conversation with patient when another patient is at the desk

3. Only one patient at the reception desk at a time

4. If information provided is sensitive, patient is taken to private area

Maintaining Confidentiality



1. Forms completed and/or signed by a new patient

a. Personal and insurance information (if not already recorded)

b. Consent for treatment/release of information form

c. Form authorizing assignment of benefits• Payment will go directly to the office

New Patients



Sample New Patient Information Form



Acknowledgement of Receipt of HIPAA Privacy Practices

1. New patient is given a copy of the notice of office privacy practices

2. New patient signs a form acknowledging receipt of notice of privacy practices

3. If office policy, new patient signs a general form consenting to release of information



Sample Acknowledgement of Receipt of HIPAA Privacy Practice



Optional Consent for Disclosure of Protected Health Information



Patient History Form1. New patient fills out a history form before

seeing the physician2. May be mailed to the patient or given before

the first visit



Verifying Insurance and Obtaining Authorizations

1. Photocopy both sides of the insurance card2. Some insurance companies require

authorizations every time the patient sees the primary care physiciana. Medicaid patients usually have to be verified

and/or receive prior authorization for each visit• Medicaid is an insurance program established by the

federal government• Medicaid pays for low-income patients’ medical needs• Medicaid patients can be verified by card reader,

telephone, or fax



Card Reader to Verify Insurance



b. Other types of insurance may necessitate calling the patient’s insurance company to obtain authorization for treatment

c. Call if there is a question about whether the insurance will cover the visit before patient is seen



Verifying a Managed Care Referral1. For physician other than primary care

provider, a paper or electronic referral form may be required

2. Referral form will state how many visits are allowed



3. Referral form will state problem for which the patient is being referred

4. If a referral, must accept what insurance pays

5. If not covered by insurance or no referral form, patient must be informed of responsibility for bill



1. Verify that billing information is correct each time patient visits the office

2. Update information when there are any changes

Established Patients



1. Copayment is a fixed amount of money that the patient is required to pay each time he or she receives medical treatment

2. Amount is usually printed on the patient’s insurance card

3. Copayment may be collected before the visit because it is a fixed fee

4. Patient is given a receipt for copayment and amount is recorded on patient’s charge slip

Accepting Copayments



Indicating That the Patient Is in the Waiting Room

1. After patient has been checked in, medical record is placed in designated space

2. Patient placed in examination room when one is free

3. Forms are inserted in the medical record or scanned into an electronic medical record



4. Charge slip is usually attached to front of medical record or routing slip

5. Physician will complete the charge slip6. Patient information is checked and/or

added in the computer


Orienting Patients to theMedical Office

Orienting Patients to theMedical Office

1. Brief description of the physicians and information about them

2. How long each physician has been in practice

3. Each physician’s credentials4. Which physicians are accepting new

patients

Information for New or Prospective Patients


Orienting Patients to theMedical Office, cont.


5. Specialties of each physician in the office

6. Information about languages spoken7. Location of the main office and satellite

officesa. Directions to office(s)b. Information about parkingc. Information about access to public

transportation, if applicable




8. Types of insurance that the practice accepts

9. Payment policy10. How far in advance to make appointments

and policy on canceling appointments11. “Call-in” times or when the physician will

return calls12. What hospitals and/or nursing homes the

physician is affiliated with13. How medication refills are handled




1. Some doctors may not be accepting patients

a. They already have as many patients as they can handle

b. They have been out on leavec. They are planning to retire

If Physicians Aren’t Accepting New Patients




1. Tell patients how much time to allow for the visit

2. Remind patients to bring all medications to an initial visit

Instructions for First Appointment




Case Study for DiscussionDonna Pohl calls the office to ask about the medical practice. An acquaintance has recommended Dr. Sylvia Lawrence. She says that she prefers a female physician. She asks for information about her and her specialty. Dr. Lawrence specializes in general internal medicine. At the current time she is pregnant, and her due date is 1 month away.




Although Dr. Lawrence is still seeing established patients, she has instructed Keisha not to make any appointments for her with new patients for the next 3 months. The other physician in the practice, Dr. William Rudner, also specializes in general internal medicine.




1. Many offices have an information booklet or brochure

2. Important to keep booklet up to date3. Patient information booklets are very

successful marketing tools

Patient Information Booklet




1. HIPAA regulations are not specific about sign-in lists

a. If possible, other patients should not know who is in the waiting room

b. Sign-in lists with peel-off labels are recommended to minimize time that name is visible

c. When staff calls the patient, name is removed from the list

Protecting Patient Confidentiality during Check-in




d. Silent wireless paging systems are availablee. Patients may indicate seat position on a chart at

the desk to avoid having to call their name

2. Computer screens should be turned so that patients at the reception desk cannot see them

3. Shredder should be located at front desk to destroy any notes with patient names that are not saved


PosttestPosttest

1. As soon as the medical assistant has opened the office, he or she usually runs the autoclave.

2. After opening the office, the medical assistant should check the fax machine for faxes that may have arrived overnight.

3. A tickler file is used to remind the medical assistant of tasks to be done on a specific day.

4. The first major task for the medical assistant in the morning is to pull the medical records for all patients to be seen that day.

5. Holders for patient information brochures are often located in the waiting room.

True or False


Posttest, cont.Posttest, cont.

6. The medical assistant turns off all equipment as the last thing when closing the office.

7. A sliding glass window between the waiting room and reception desk helps maintain patient confidentiality.

8. A new patient must sign a form providing consent for treatment and release of information.

9. Insurance companies usually require authorization every time the patient sees the primary care physician.

10. If the patient has a copayment, it is usually collected before the patient sees the physician.

True or False

Elsevier items and derived items © 2009 by Saunders, an imprint of Elsevier Inc. Chapter 37 Patient...

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