By enlightening the patient of the need for a complete rehabilitation program, the chiropractic physician has fulfilled his or her obligation. If your assistant has an urgent question, message, or special caller on the phone, there are a number of methods that can be used to communicate this to you such as a chime, a light system, or a polite knock on the door. Telephone services and equipment have evolved rapidly during recent years. Examination Records District Chiropractic Association 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. Your scheduling assistant should never enter an appointment unless there is reasonable assurance that the appointment will be kept. Current case records, inactive case records, subject files, correspondence files, tickler files, public relations files, and financial records, for example, may be filed in separate cabinets or within the same cabinet as space permits. Traits like those can provide an invaluable strategic edge over your competitors. All of these tasks typically are done on the computer. If there are too many exceptions, satisfying the needs of a few may be detrimental to the needs of the majority. * Talk naturally Job descriptions should be included that specify requirements, responsibilities, regulations, normal working hours and station, and promotional guidelines. ADVERSE TRAVELING CONDITIONS Patient preparation A list of such calls offers you an opportunity for a quick review (Fig. Appointment book sheets Policies and Procedures * Avoid jargon As a popular alternative, you can separate patient records into current, active, and inactive categories. They concern the time wasted waiting in the reception room when the doctor is behind schedule. Bills PayablePersonnel While several doctors in different areas who practice closely alike may cooperate on a case of a commuting patient, it is most difficult to do so. This information is held in a "future appointment," to be reconfirmed by the assistant on the patient's arrival when more detailed data are recorded. Was the patient adequately educated of office policies, and were appointment policies emphasized? Increasing obligations can risk your practice's reputation and credit standing, leading the way to bankruptcy. * Patient privacy, * Name of caller Caller: How much does the doctor charge? Typical letters written over an assistant's signature are those that acknowledge routine correspondence received in the doctor's absence, follow-up letters, replies to meeting notices, requests for refunds, hotel and automobile reservations, letters arranging appointments, collection letters, letters calling attention to account errors, service complaints, and letters of a routine business nature. Why is it important to have good phone etiquette? If the new patient was not referred by another individual but solely by location of the practice, an advertisement or publicity release of some sort, etc, this should be recorded so later evaluation of your practice's public relations program can be evaluated. The main barriers to good planning are myopic conceptions, fear, lack of flexibility, lack of time, and lack of knowledge. PPO-you do not need to select a primary care physician "I cannot hear you" or "I can't understand you" should not be used. Are the reports illegitimate? What are two tasks that need to be done to get ready for the day? Be alert to the fact that many people become quickly irritated when their call is answered by a machine. Before revealing a new diagnosis,. She should tactfully find out if the subject is important enough to be called to your immediate attention. These guidelines ("the office bible") become the basis for all routine task planning and employee training. Topics are commonly of varying interests in good taste and directed to various reading levels. Rather, it is better to respond, "There appears to be a poor connection. On the first offense, the late patient only needs to be reminded that he is late and that the doctor will see him as soon as possible. It is good policy to have a simple daily record kept of all important mail sent out of the office each day that requires action by another person. It is more appropriate for businesses that have thousands of active accounts. A kindly smile, never forced, will do much to tell the patient in distress that he or she will be served with consideration. Roentgenography record forms It involves the rules and regulations set forth by lawmakers on a local, state, and national level. While reminder calendars and memo books are helpful, they limit the number of possible entries as compared to a tickler file. 3.1) to run smoothly with less possibility of omitting necessary actions. How the activities are broken down is a matter of personal preference. Your scheduling assistant will frequently have to respond to some unusual requests that will test her efficiency and tact. The goal for both you and your assistant should be a smooth flow of patients with as little loss of time and effort as possible. To recognize this is important in avoiding an unnecessary or unfavorable audit by the Internal Revenue Service or your state's Tax Commission. Insufficient stock may interfere with proper patient services. Practice objectives provide overall direction for making decisions, and office policies and procedures serve as mechanisms for their accomplishment. Why is the telephone important to the medical office? 1. greet patients promply and courteously. what kind of paperwork must be completed, and what information will the hospital require prior to admission? Depositing such a check may make it impossible to collect the full balance due. What will happen if no changes are made? 7. telephone #'s DELEGATION CONSIDERATIONS * Reports You must have the opportunity of keeping abreast with the latest developments in clinical technology. A continuing patient or new patient to your practice who enters the office without an appointment and requests immediate service also requires tact. The typical basis used in chiropractic offices is the item's cost rather than the market value, which is used in some businesses. Each call should be answered promptly by an assistant. (1) lack of respect for the doctor, A combination of factors rather than a single factor is usually involved. If a patient has to wait more than 15 min, the courteous thing to do is to let the patient know. An objective analysis should be made of your practice objectives, financial position, management capability, supervisory expertise, and personnel practices. 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. * Redirect phone to office traction T Many practitioners feel strongly that no patient of the practice should leave the office without a specific appointment unless the case has been formally dismissed. This again reassures the patient of personalized interest and enhances office good will --the essence of practice security. When they are printed on a bright-color paper, they are quickly noticed and speed retrieval. 2. discuss in advance how payments will be made if paying alot out of pocket. 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. To appreciate this, the person answering the telephone must consider the outlook of the caller. Supply inventory control sheets 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. * Develop spreadsheets, * Microsoft outlook If patient contact cannot be made, the only thing left to do is for the assistant to apologize to patients when they arrive for their appointment. Everything You Need to Know. Progress records Some large offices have a manual for business functions and another for clinical functions, while smaller offices just separate these functions by a divider in one book. Following are some essential attributes the front office staff must have . Most successful professionals are quality conscious. 3. call patients by their full name. The Office Computer Warning signs are seen when: What else should we examine? Determine your patient's readiness to learn. For example, evening hours may be a benefit to the new practice even if few doctors in the community provide such a service. 1. You answer it, glance at the appointment book, and schedule a patient in the apparently open 3 pm spot of next Monday. one way to ease fears and maintain good report with patients is to communicate clearly what is expected from patients of the practice as well as what patients can expect from the office staff. * Confidentiality THE APPOINTMENT CONTROL RECORD Miscellaneous Problem Resolution Inventory control When necessary, an outside service should dryclean or shampoo upholstered furniture. Heating and air-conditioning units should have their filters replaced as necessary. No system will run itself. The typical subjects covered are: Many local chiropractic organizations also provide answering services as well as referral services for their members. Voice tone should reflect a friendly, alert, professional attitude. This chapter describes fundamental office policies, procedures, and systems, and their role in practice planning and conduct. MICROFILM FILES STATUS ASSESSMENT A patient may respond, "Glad you called. Any valuation policy must be supported by sound accounting practices and physical inventories taken at reasonable intervals. Lalla puts it this way: "If you encounter patients who want to be the doctor, then they should be freed to go to a doctor who doesn't want to be the doctor --and it's just that simple." Any holding delay should be short. If your practice is growing, it is not the same today as it was last year nor will it be the same next year. If no time slot is available, offer to schedule the next available appointment. The report usually concludes with a statement of the doctor's clinical judgment of the case, recommendations for therapy, and prognosis based upon the recommendations. Practice policies relate to those nonpersonal policies such as office hours, billings, collections, inventory control, etc. It is the rare patient who enjoys a long wait in a reception room. Make any changes necessary to keep your operations flowing smoothly and to comply with any legal or regulatory changes. Thus, it is advisable that most all patients be given a specific day and time for the next appointment, even if the appointment is far in the future. 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. As professional competence should be taken for granted, patient satisfaction makes the difference between success or failure. No practice can survive if it depends solely upon referrals from location, the yellow pages, or other influences. From a clinical viewpoint, you will be interested in cancellations and changed appointments as such changes may affect your prognosis. If you will be out of town or unavailable for emergency needs, you should make arrangements with another doctor to attend to patient needs and alert your staff who this doctor is and where he can be located. Credit,cash or some form of payment; DOB (ID) social and birth certificate. 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. Even taking advantage of the telephone company's discount time periods will make a difference. how much time is required to see this patient? A continuing patient not in distress or a new patient with a chronic condition will not usually mind if an appointment cannot be arranged for a few days. When an electronic device is used, an assistant should play back the tape and record the messages on a standard form along with each caller's name and phone number. This may be because the caller is just normally a skeptic, recently mistreated by another practitioner, or "shopping." Case history forms come in a large variety of sizes, shapes, and styles (Fig. 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). Good planning is essentially a problem-solving adventure where certain questions must be answered. When the patient makes such a decision, you are no longer in authority in the case. Office philosophy should always consider patient handling, patient control, and patient satisfaction. Another type problem is seen with the patient who becomes free of pain but requires further care to prevent a recurrence and calls to cancel an appointment in the erroneous belief that further treatment is not necessary. To assure efficiency, each phase of your practice should be planned in detail and the phases coordinated with your overall objectives (Fig. Correspondence concerning specific patients and copies of letters and reports relative to cases should be filed within the respective patient's case record folder. However, certain precautions must be taken when a postage meter is used. A doctor should never be required to do an unlicensed procedure in the office that an assistant can do as well or better. Efficient purchasing, comparative shopping, good storage procedures, and alert inventory control offer distinct savings to any office. Record processing and maintenance Preprinted cross-reference sheets are available at most office supply stores. This will give you an opportunity to differentiate between reasons and excuses. These are also tasks that are usually delegated to an assistant. It begins with the first contact, which is usually the initial telephone conversation for an appointment. Practice Objectives and Philosophy You can recommend to the patient a plan that you feel would be the best method to correct the disorder in the shortest possible time if it is possible to correct. Life-threatening emergencies are not common happenings in the typical chiropractic office, but your entire staff must know exactly what to do. Gain trust. PROCESSING The patient must be informed of all potential consequences involved so that the patient's consent is given with full knowledge of the inherent dangers, if any, to which the patient is exposed. If an assistant is delegated the responsibility for appointment scheduling and control, the appointment book must be considered personal domain. Incoming and outgoing correspondence procedures An overall plan may be vaguely acknowledged, but it is usually so general that it provides little direction in daily affairs. It will be no better or worse than the accuracy and intelligence related. They come either bound or loose-leaf, and the choice is a matter of personal preference. It either builds a patient's confidence, creates a greater respect, and develops a greater appreciation for you and what you represent, or it builds a patient's doubts, resistance, and lowers respect and appreciation for you and what you represent. The practice not only loses face, it loses an opportunity to serve and ultimately suffers an economic loss. It would be foolhardy to embark on a comprehensive rehabilitation program for a serious condition if it is felt that adherence to the schedule could not be made. No system is any better than the manner in which it is used. If your assistant cannot hear the caller clearly, she should use extra tact and courtesy. 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. No practice or business can be operated successfully without its key people being able to retrieve information quickly. PROFIT MARGIN That is where you come in. This can avoid an oversight. This will avoid stress and inefficient services. A punctuality policy cannot be enforced one way only. Such a patient will usually be respectful of office policies and the doctor's professional advice, and be somewhat informed of office policies beforehand. A "Seller's Permit" will most likely be required if you have items for resale, and most states require that all roentgenographic facilities be certified to meet established standards. CCollaboration. One important function of an assistant is to telephone patients for periodic spinal examinations or for appointments that have been long standing. hedge. A log of important telephone numbers will save time and eliminate confusion (Fig. This is to achieve consent for the examination. The effects of fatigue become most apparent as the end of a busy day's schedule approaches. A "Telecommunications Hour," for example, is sometimes printed on the doctor's stationery, posted in the dismissal area, and explained during consultation. Some offices use different files for different categories of patients. Credit card,cash for payment because she does not have insurance. Examining and therapy tables, sinks, and toilets require frequent disinfecting. Has the patient sought help elsewhere for this particular disorder? Accounts receivable procedures All windows and doors that exit to the outside should be locked. Telephone services and equipment have evolved rapidly during recent years. Give info to a patient's employer. X-RAY FILES It is important that your entire staff be professional and thorough in all clinical and financial matters. This important file should contain a copy of the request until the request can be fulfilled. Regardless of size, every office has daily routines that must be conducted at the proper time so that the practice will run smoothly, efficiently, and professionally. A narrative report is a written summation of findings and conclusions prepared for a referring physician or directed at the request of the patient to an insurance company, attorney, or some other third party. Caller: Do I have to be x-rayed? If a patient cancels at the last minute or fails to notify the office that he's not coming in, some doctors feel that the time reserved should be charged for. (b) If the loop is placed in a magnetic field B=1.5TB=1.5 \mathrm{~T}B=1.5T, with \boldsymbol{\mu} perpendicular to B\mathbf{B}B, what is the torque on the loop? You can not gain consent to catheterize without these three test results. Some doctors like to schedule all acute cases at one time during the day and chronic cases during another time. As time means money, such planning directly influences practice economy. A record should be kept of all cancelled appointments or "no shows" and their follow-up. Unit 1 is the last name, Unit 2 is the first name, and Unit 3 is the middle name or initial. A practice operating on office hours rather than on an appointment basis requires a different approach for the receptionist. For your sake and the patient's welfare, you are obliged to determine the reasons behind cancellations and failures to meet a scheduled appointment. Time Planning. MECHANICS AND STYLE A policy is a basic statement, principle, or predetermined guideline covering a limited area on which the practice operates and serves to achieve its objectives. And mistakes and hiccups in processes can be quickly identified and addressed. The person who answers the phone creates the first impression of the office. 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The courteous thing to do ; s readiness to learn run smoothly with less possibility of omitting actions...
