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

Scheduling & Receiving Flashcards

(50 cards)

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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

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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

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

define DOUBLE BOOKING SCHEDULING

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A

same appt time for at least 2 pts

24
Q

what are the pros of double booking

25
what are the cons of double booking
if problem w/one pt, can delay other causing rest of schedule to be behind
26
define WALK-IN/OPEN HOURS SCHEDULING
no scheduled time and seen in order of arrival
27
what are the pros of walk-in/open scheduling
good for complaints of unexpected onset
28
what are the cons of walk-in/open scheduling
complex complaint/multiple ppl with same problem overwhelms staff & resources
29
define SINGLE BOOKING
1 pt booked for specific amnt of time and done when appt will take longer
30
what are the pros of single booking
- focus on pt & thoroughly assess complaints - better for appts that take longer
31
what are the cons of single booking
can leave gaps in schedule if problems easily addressed & straightforward
32
define STREAMING SCHEDULING
appts scheduled for specific amnt of time based on need to keep continuous flow of pts
33
what are the pros of streaming scheduling
most effective use of timeslots
34
what are the cons of streaming scheduling
if insufficient time/unexpected problem it can cause other visits to be delayed
35
define WAVE SCHEDULING
pts scheduled during first 30 min of each hour leaving last 30 min for same day appts
36
what are pros of wave scheduling
- give ample time for unexpected visits & staff to do tasks - effective in seasonal events
37
what are the cons of wave scheduling
- cause lag in schedule/workflow - excessive downtime when last half hour not needed
38
define MODIFIED WAVE SCHEDULING
wave but schedules pts in last 30 min at 10-20 min intervals
39
what are the pros of modified wave scheduling
- same as wave (time for unexpected visits & tasks/good seasonally) - sees more pts in allotted time period
40
what are the cons of modified wave scheduling
- same as wave (lag in workflow & excessive downtime) - back up when pts late/providers delayed/unexpected events
41
what should be documented when pts are making appts
- pt name - parent of pt if appropriate - reason for visit - provider to be seen - date & time - pt current phone number
42
for CPT purposes, what is considered a new pt?
person who has not received services within 3 years
43
for CPT purposes, what is considered an established pt?
pt received services from provider of same specialty and subspecialty belonging to same practice within 3 years
44
describe HEALTH MAINTENANCE ORGANIZATIONS (HMOs)
insurance plan requiring subscribers to use network providers
45
describe EXCLUSIVE PROVIDER ORGANIZATION (EPO)
insurance plan similar to HMO but with exceptions; subscribers must use network providers
46
describe PREFERRED PROVIDER ORGANIZATION (PPO)
insurance plan receiving more comprehensive benefits w/network providers & does not require PCP
47
describe INDEMNITY PLANS
insurance plan where access is offered to any licensed physician/hospital but generally more expensive
48
define TICKLER FILE
long-time standby filing system to augment regular calendar & scheduling system
49
what info is required to schedule inpatient procedures?
- 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
what info should be obtained when receiving a pt
- 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
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