Overview Scheduling PDF

**Overview Scheduling** **The certified medical administrative assistants (CMAA) most important scheduling responsibility is to manage the workflow of patients.** **Understanding how this responsibility can be accomplished includes several factors, such as accurate screening, insurance verification...

**Overview Scheduling** **The certified medical administrative assistants (CMAA) most important scheduling responsibility is to manage the workflow of patients.** **Understanding how this responsibility can be accomplished includes several factors, such as accurate screening, insurance verification, and balancing patients\' and the provider\'s scheduling needs and preferences according to the protocols of the medical organization.** **Another vital factor for workflow management and the scheduling process is communication with all medical professionals, patients, and other perspective appointment-seekers sharing pertinent information.** Prior to scheduling appointments, the CMAA must be familiar with the medical organization\'s protocols and how to efficiently collect patient information for verification purposes. There may be challenges in every step of scheduling appointments; however, the CMAA needs to use due diligence to be effective while managing the optimal scheduling process. **Workflow** **Efficient, continuous working pace.** **Screening** **Gathering pertinent health and insurance information.** **Verification Information validation.** **Preferences The medical organizations and provider's norms.** **Protocols** **A written plan that specifies criteria to be followed in defined situations.** **A telehealth appointment provides the patient with the option to receive health care virtually.** Health care organizations offer telehealth opportunities based on the details of their organization and the population they serve. **When a telehealth encounter is an appropriate scheduling option and the patient consents to this type of service, care must be taken to provide detailed instructions for accessing the encounter. The CMAA typically provides an email, text message, or portal message that includes accessibility instructions for various types of devices.** **Telehealth Platforms and Technology** **Telehealth encompasses various technological options included in the electronic health record (EHR) and practice management systems and patient portals such as messaging, visual and audio, and conferencing**. It is important to note that federal, state, and commercial payers may have specific definitions and requirements for telehealth services.  **The CMAA may be involved in scheduling telehealth appointments based on the medical organization\'s protocol, patient\'s consent, and compatible equipment.** Telehealth requirements include the following.  - Stable internet connection - An electronic device (tablet, computer, phone with a camera, microphone, speakers, earbuds, headset) - A private, safe area to communicate with limited background noise, interference, and interruptions.  **TELEHEALTH TOOLS Telehealth** **requirements include a stable internet connection and electronic devices such as a tablet, computer, phone with a camera, microphone, speakers, earbuds, and a headset.** **The patient portal is an electronic communication tool to serve both the patient and a medical organization**. **Patients can send messages, manage, and update demographic and insurance information, complete health questionnaires, request or schedule follow-up (nonurgent) appointments, update allergies, request medication refills, review test results, review after-visit summaries and notes, and make payments.** **The CMAA will need to monitor the portal, manage patient requests, and respond to or delegate patient messages.** Additionally, the portal can be an **effective customer service tool** to maintain communication, provide educational materials, and send reminders for preventive care and screenings, such as annual exams, immunizations, colonoscopies, mammograms, and laboratory tests.  **Types of Appointments Appropriate for Telehealth** **The option for telehealth encounters is determined by the following.** - Type of medical specialty, such as primary care, diabetes care, mental health care, counseling - Type of service required to treat the patient. - For example, follow-up appointment versus a complete physical examination, which would not require hands-on palpations from the provider. - Provider preferences, such as appointment purpose, time, patient health status - Patient preferences for comfort level versus in-person appointment, geographic and transportation accessibility, current health status - Third-party payer guidelines for allowed telehealth encounters. - Payers may specify the service codes allowed for telehealth encounters. **Common telehealth care options include the following.** - Result discussion of lab test or x-rays - Mental health therapy and counseling - Management of chronic conditions - Dermatology - Prescription management - Nutrition counseling - Postsurgical follow-up **Pre-Appointment Screening Requirements** **If a telehealth appointment is deemed appropriate, the CMAA will then discuss with the patient about the technological options and platforms that the patient has access to.** Some patient portals include a telehealth platform, and the **CMAA should verify the patient is comfortable using it.** Once that is established, the appointment time can be scheduled, and the patient can receive helpful pre-appointment reminders, such as:​​​​ - List of all current medications - Current symptoms and tried home treatments (exercise, blood pressure log) - Information on current health status changes (appetite, temperature, sleep patterns) - Recommendation to have a pen and paper available for any notes or directions from the provider during the appointment. - **Pre-appointment screening requirements include the CMAA\'s responsibility as well as the patient\'s.** The shared requirements are commonly performed prior to the scheduled appointment through a phone call, patient portal, or mail service. - **One of the important considerations for telehealth encounters is consent.** Consent laws vary by state, but most states require informed consent specific to technology-based communications. **The consent form should include all payer or state requirements and a statement that explains the organization\'s policy regarding copayments for telehealth.** **Medicare requires this type of consent but allows it to be verbal and should be documented annually in the patient\'s health record.** - Telehealth visits often include health screening questionnaires, which contain questions regarding the patient\'s past and current health; physical and mental history; family, social, and employment history; medications; and allergies. **The CMAA may need to help complete the survey with the patient to confirm comprehension of the screening questions and aid in collecting the health status.** Patient questionnaires may also include depression and tobacco use screenings and other applicable quality measures to support value-based care models or quality incentive programs.  **TELEHEALTH CONSENT FORM** The telehealth consent form should include all payer or state requirements and a statement that explains the organization\'s policy regarding copayments for telehealth. Pre-Appointment Screening Requirements +-----------------------+-----------------------+-----------------------+ | **Requirement** | **CMAA** | **Patient** | +=======================+=======================+=======================+ | Insurance eligibility | x | | | and verification | | | | status **CMAA** | | | +-----------------------+-----------------------+-----------------------+ | Appointment | x | x | | confirmation day, | | | | date, and time via | | | | phone, patient | | | | portal, electronic | | | | | | | | messaging  | | | | **CMAA/Patient** | | | +-----------------------+-----------------------+-----------------------+ | Immunization and | x | x | | vaccination updates | | | | **CMAA/Patient** | | | +-----------------------+-----------------------+-----------------------+ | Current health status | x | x | | changes | | | | **CMAA/Patients** | | | +-----------------------+-----------------------+-----------------------+ | Any other pertinent | x | | | information (e.g., | | | | medication refill | | | | requests; most recent | | | | surgical, | | | | | | | | laboratory, and | | | | radiological | | | | reports; and | | | | consultation notes) | | | | **CMAA** | | | +-----------------------+-----------------------+-----------------------+ | Technological | x | x | | instructions and | | | | capability | | | | confirmation  | | | | **CMAA** | | | +-----------------------+-----------------------+-----------------------+ **Technology Capability Checks for Telehealth** **Additional communication and instructions may be necessary 15 min prior to the scheduled appointment, such as camera positioning, audio equipment check, and verification that the patient is in a private and safe area.** The patient registration process can help increase the overall quality of patient service and satisfaction and increase the provider\'s productivity with the patient. **Accurate patient registration also supports the revenue cycle**. The registration information can be collected through various methods. - By phone and keyed directly into the patient health record - Patient portal data input or imported into the patient health record. - Paper format through the mail or in person, which will then need to be scanned and abstracted into the patient health record. **The CMAA may need to assist patients in comprehending and completing all the registration information, by reviewing the forms to ensure completeness and accuracy. Information to be collected includes the following.** - **Patient information** - Legal first and last name - Date of birth - Gender/sex - Marital status - Race - Ethnicity - Preferred language - Veteran status - Mailing address - Physical address if different than mailing address - Phone home/work/mobile - Email - Preferred method of contact\ (text, phone call, email) - Driver\'s license or state identification - Social Security number - **Employer information** - Employer name - Employment status - **Emergency contact** - Name - Relationship - Phone contact - **Insurance information** - Primary and secondary insurance plan - Mailing address - Subscriber\'s name and date of birth - Relationship to patient - Policy ID/numbers - Deductible - Copay - Coinsurance - **Pharmacy information** - Name - Address - Phone - Allergies - Reaction - Medications/supplements - Dose/amount/how often - Ordering physician - Advance directive - **Signature required forms.** - Medical records release form - Minor/guardian consent form - Financial policy - Consent forms include: - **Notice of privacy practices** - Consent for treatment - Consent for use and disclosure of health information related to treatment. - Assignment of benefits - Consent for telehealth Collect/Verify Patient Information ================================== - **After collecting the patient registration information, the CMAA will need to verify the information by repeating the information back to the patient, comparing the patient information with the insurance cards, and verifying the patient\'s identity using two identifiers.** - Verify the billing address, preferred method of contact, and contact information.  - This information must be accurately verified, as the **essential identifiers (legal name, date of birth) are used for all appointments and identifying the correct patient.** Lastly, **import or key in the information and, depending on the EHR system, scan the cards into the electronic record. ** **Procedures Used to Avoid Duplicate Electronic Health Record** **When creating a new patient health record, it is important to prevent medical record duplication.** This concept begins with searching the database for existing records, using verified patient identifiers such as current and previous names and date of birth. **Another consideration is taking the time to obtain and input all patient registration information accurately during the collection step. ** **Records should be cross-referenced by names to account for any legal name changes (due to marriage, adoption, divorce, transitioning).** Additional identifiers may be necessary to search and avoid duplication, which is essential for these types of records. **Secondary identifiers that help detect or reduce duplicate records include the following.** - Photo identification - Social Security number - Gender - Sex - Address - Cell phone - Medical record number (MRN) - Last appointment date **Information to Provide to Patient Prior to Appointment** **During the pre-appointment confirmation step, it is recommended to offer the following.** - Suggestions on how to prepare for the appointment (bring valid photo identification and insurance cards, write out questions for the provider, bring a current medication list) - Geographic directions - Parking instructions - Transportation assistance - Acceptable forms of payment information - **No-show and cancellation policies** **Scheduling appointments is managed by one of two methods: within the practice management or electronic health records system or manually using a paper appointment book. The decision to use either method depends on the organization.** The CMAA should be able to adapt to either method.  EHR Scheduling Including Templates and Techniques ================================================= **One of several differences between electronic and manual scheduling is the availability of customizable templates**. **The practice management system or EHR scheduling module provides appointment templates as guides for the necessary information to be keyed, such as date, appointment type, and purpose.** **The technique should follow the prompts within the template for specific information.** **When prompts are required and accidentally skipped, the EHR will usually generate an audio or visual reminder for the specific area needing information keyed in.** **Electronic scheduling applications can generate patient reminders, which is a significant advantage of using a manual appointment book.** **CMAAs will need to be conscientious, making sure to include all required information when scheduling appointments to maintain efficient patient workflow.** Manual Scheduling Procedures ============================ Manual scheduling procedure is when the medical organization uses a hardcopy paper appointment schedule instead of electronic means. **The paper schedule can be a book or printed pages that include daily time periods to physically handprint the appointment information such as patient first and last name, phone contact, and appointment purpose. An advantage of manual scheduling is that scheduling remains accessible during system failures and power outages**. **A disadvantage to a manual schedule occurs when two or more staff members are attempting to schedule an appointment or view the schedule**. **Only one staff member can manage, print appointment information, or view the log at a time.** **This can cause overlaps or delays in scheduling and patient checkout.** The manual appointment schedule is the same as the electronic schedule in that the information is considered a legal document. Thus, **when an appointment is canceled or rescheduled, the original appointment should remain in place and include a documented reference notation with the reason for the cancellation/reschedule, date of cancellation, date of rescheduling, and the CMAA's initials and time of change.** The manual schedule is set up using the same scheduling types, interval time periods, and **matrix** designations.  Interval A period between appointments. **Confirming appointments is usually done one week prior to the patient's scheduled appointment and sometimes again the day before the appointment.** This is accomplished through the patient's preferred method of communication, such as via phone call, patient portal, text, email, or mail. Some organizations contract with an automated service to generate the actual message as a friendly reminder for the appointment. Other organizations combine pre-appointment screening and appointment confirmation at the same time. Whatever the confirmation method, the CMAA will ultimately be responsible for confirmation, which helps reduce gaps in the workflow.  Appointment confirmation messages should include relevant details about the appointment, such as arrival time, copayment requirements, insurance cards, and identification, as well as any reminders that may be specific to the type of appointment. For example, some providers ask patients to bring in current medications and supplements rather than bringing a list for a chronic care management appointment.  Confirming appointments is usually done one week prior to the patient's scheduled appointment and sometimes again the day before the appointment. This is accomplished through the patient's preferred method of communication, such as via phone call, patient portal, text, email, or mail. Some organizations contract with an automated service to generate the actual message as a friendly reminder for the appointment. Other organizations combine pre-appointment screening and appointment confirmation at the same time. Whatever the confirmation method**, the CMAA will ultimately be responsible for confirmation, which helps reduce gaps in the workflow.**  **Appointment confirmation** **messages should include relevant details about the appointment, such as arrival time, copayment requirements, insurance cards, and identification, as well as any reminders that may be specific to the type of appointment.** For example, some providers ask patients to bring in current medications and supplements rather than bringing a list for a chronic care management appointment.  **Patient Self-Scheduling** **Patient self-scheduling can be accomplished conveniently by the patient electronically outside the specific operational hours of the office**. Patient self-scheduling is offered by some medical organizations using kiosks or as a feature of the patient portal, **while other medical specialties prefer all appointment management go through the CMAA for more control and confirmation of the patient\'s health care needs.** **Technical Support** Technical support may be necessary when patients are learning how to use features of the patient portal such as messaging or self-scheduling. **Support can be in the form of printed materials with step-by-step instructions and illustrations or video links.** **The CMAA could also offer a hands-on patient education opportunity.** **Information to Provide to Patient Prior to Appointment** **Patients should be provided with a reminder during the appointment confirmation of some essential information used for check-in to help reduce waiting time.** **The reminder can be in the form of a printed card or list, text, portal, or mail service.** A sample list might include the following. - Scheduled month, day, date, and time - Expected arrival time versus appointment time. - Request to bring photo identification (driver\'s license or state identification) - All current insurance cards. - Organization payment expectation on the date of the appointment - Copayment requirements - All acceptable forms of payments  **Medical organizations will have established protocols for no-show (missed) or late-canceled appointments as well as any related patient fees.** Not all organizations charge patient fees for late cancellations or missed appointments. For those that do, fair and legal policies must be followed. **The policy must be communicated to the patient prior to the scheduled appointment, preferably during the registration process, detailing the protocols and patient responsibilities.** **This can be accomplished through the distribution of the medical organization\'s welcome materials, confirmation notifications, patient portals, or phone conversations.** The organization cannot be selective about whom the policy applies to, such as Medicare beneficiaries only. **Another consideration is that not all payers allow this policy. ** For example, some states (such as California) will not allow no-show fees for Medicaid patients. Regardless of whether an organization uses this type of policy, prior confirmation (reminders) reduces the incidence of no-shows or late-canceled appointments. **Policies and Procedures for No-Show, Missed, and Canceled Appointments** **Patients may have unforeseen reasons (family member sick, deaths) that cause a no-show or missed appointment. If a patient does not appear for the scheduled appointment:** - First review the medical organization protocol (policies and procedure manual). - Contact the patient for the reason. - Offer to schedule another appointment. - Determine if any financial charges apply and notify the patient as appropriate. - Inform the provider in case further medical instructions are necessary. - Document the information in the patient\'s health record.   **Patients cancel and reschedule appointments any time prior to the actual scheduled appointment for various reasons (child or parental care, transportation) through the patient portal or direct phone calls.** **When a cancellation occurs, it will mean modifications to the overall schedule are necessary to maintain an effective workflow.** Offering the patient another time within the same day or a different day will be necessary depending on the medical service needed. **Rescheduling appointments could also occur due to office needs, weather, and provider schedule changes.** It will be necessary to contact patients as soon as possible to communicate the need to reschedule and offer the next possible appointment option. It may not be necessary to give a reason in all cases other than lack of provider availability.  A provider may order diagnostic tests such as bloodwork, x-rays, procedures, or preadmission testing that are services not offered by the ordering provider. When this occurs, the patient will need a scheduled appointment at another location or medical organization**. The CMAA can offer to schedule those appointments for the patient, or the CMAA may offer the patient a contact list of locations/providers within the patient\'s insurance plan to make the appointments. The contact list should be attached to the provider\'s written order with the specific test or procedure to be performed.** When a health care organization have interoperable EHRs, orders are transmitted to the laboratory or imaging center. **This is helpful for the patient when scheduling, as the outside facility will have the provider\'s order in their system**. **Schedule a follow-up appointment for the patient to review the results with the provider.** Insurance Eligibility and Benefits Verification =============================================== **Arrangements for diagnostic tests and procedures require insurance eligibility and benefits verification prior to scheduling the appointment**. **The first step is to verify the insurance information is current as listed in the patient account.** **Eligibility and benefits verification can be accomplished using an application in the PM system or EHR, through a clearinghouse, at the payer website, or by phone.** **Eligibility** Meeting the stipulated requirements to participate in the health care plan. **Referral, Precertification/Preauthorization, and Predetermination Requirements** **Each medical organization should inform patients of the insurance plans the provider accepts for services prior to scheduling an appointment for diagnostic testing and procedures.** **Depending on the type of insurance plan and the nature of the health care services needed, a referral, precertification, preauthorization, or predetermination of benefits may be required.** **Keep in mind that precertification, preauthorization, and predetermination are tasks the CMAA accomplishes prior to scheduling an appointment**. This step is necessary to determine if the insurance plan covers payment for the future service, authorizes the service, and determines the amount paid for the service. The **CMAA will need to discuss the coverage and payment options for the financial responsibilities with the patient.**   **Precertification, Preauthorization, and Predetermination** **Precertification is performed to determine if a specified surgery, diagnostic imaging, treatment, or therapy is a covered benefit under the patient's plan.** **Preauthorization is a request to determine if a specified surgery, diagnostic imaging, treatment, or therapy is considered by the payer to be medically necessary.** **This request is submitted to the payer with clinical notes, diagnoses, related medical history, any test results, and treatments to date to support the request.** **It is important to note the difference between precertification and preauthorization**. **All claims are paid based on medical necessity, and medical necessity is determined by the payer.** **Preauthorization is an extra step taken to assure the patient\'s claim for service is medically necessary and the claim is paid.** For example, a blepharoplasty may be a covered benefit according to the payer but may not be considered medically necessary until certain conditions have been met or clinical documentation supports certain diagnoses related to the surgical service.  **Predetermination is used to find out how much the plan allows for payment of a specified surgery, diagnostic imaging, treatment, or therapy.** **Take Note** **If preauthorization is not approved, the specialist can file an appeal and provide additional patient history to support medical necessity.** **Referrals** **A referral is an order from a primary care provider for a patient to see a specialist or for specified services and procedures**. Appointments may be scheduled either by the patient or by the CMAA. **Referrals may be sent or received by fax, secure portal/app, or mail and would include the patient\'s current diagnosis, referral purpose, and some demographics. However, the same determination steps for insurance coverage will be necessary prior to scheduling the appointment. ** **Schedule Preadmission Testing** **Scheduling preadmission testing (PAT) is important to prepare the patient for a scheduled surgical admission. PAT is performed a day or two prior to the admission and is often done at the facility where the surgery will be performed.** The details of the tests are determined for each patient according to the surgical services needed. Typical preadmission testing includes the following. - Blood or urine laboratory tests - Radiology imaging - Electrocardiogram Schedule Follow-Up Appointments =============================== **Follow-up appointments are common practice for reasons such as chronic illness, reporting test results, and after a surgical procedure or hospitalization.** **Follow-up appointments are usually scheduled within a specific timeframe from the original appointment or discharge.** **These appointments usually take less time with the provider since the appointment purpose is focused on the patient\'s health progress and questions the patient might have.** They are, however, very important and should be managed carefully. **Patients who have a chronic illness may feel they are routine appointments, but from the clinical perspective, they assess important clinical markers that could indicate the progression of the condition or related systemic concerns. Hospital discharge follow-ups are equally important, as they ensure the patient has all required medical supplies, DME, support services, and medications to support the patient's recovery. A hospital follow-up appointment also supports the patient\'s understanding of treatment plans and instructions, which are beneficial in the prevention of readmissions.** Considerations for In-Network and Out-of-Network Coverage ========================================================= **A provider that is considered in-network participates in the insurance program and agrees to the fee schedule defined by the payer.** **An out-of-network provider does not participate in an insurance program and does not have an agreed-upon fee schedule. Therefore, the patient will have a higher out-of-pocket expense than the in-network amount.** **New patients need to be made aware of whether the provider is in or out of the patient\'s insurance plan network and how that impacts their financial responsibility. The difference could be significant, and the patient may not understand the impact.** **For example, when a patient sees an out-of-network provider, the coverage may include a deductible amount. Consider that deductible amounts often range from \$500 to \$5,000.** **Medical organizations use various methods for scheduling appointments depending on the medical specialty.** The following table provides an example method to define patient appointments. The method determined will be used to create the patient scheduling matrix discussed below. Optimal Scheduling **Service Type** **Type Defined** **Protocol Examples** ------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------ ----------------------- ***Comprehensive *** New or established patient for a specified complaint at highest coding level, multiple complaints, injuries, or worsening chronic conditions.  60 min ***Complete annual physical exam*** Thorough review of body systems, including preventive care and screenings.  60 min ***Established/follow-up*** Received services from the same provider or same group (and the same specialty) within three years. Includes known condition. 15 min ***New patient*** Has not received services from the provider or same group (and the same specialty) within three years. 60 min ***Urgent*** **Medically necessary within 24 hours.** 20 min ***Other entities *** Non-patient related (depositions, sales representatives, staff meetings, training). 30 min **Prior to establishing a schedule, a matrix is created**. **A matrix is the designed timeframe for appointments based on the method of appointment durations.** **The office defines clinical hours, provider and clinical staff, room, and equipment availability.** **Matrix A matrix is the designed timeframe for appointments based on the method of appointment durations.** **Types of Appointment Scheduling** **There are various types of appointment scheduling used (electronic or manual) depending on the medical specialty and provider preferences. Usually, CMAAs do not determine the types of scheduling; however, understanding the methods is beneficial.** **Scheduling Methods** **Block scheduling**: Grouping similar patient conditions at specific times. **Double-booking**: Multiple patients at the same time. **Open booking:** **Unscheduled walk-ins**; occurs during open office hours and in the order of their arrival. **Modified wave scheduling**: Like wave; however, **patients are scheduled in a 15-minute time.** **Time-specified scheduling**: Also known as streaming; **scheduled at a designated time.** **Wave scheduling**: **Schedule two or three patients** **during a designated hourly period** **(last 30 minutes of the hour, patients seen in order of arrival**).  Considerations for Scheduling ============================= Optimal scheduling is based on multiple considerations and protocols within the medical organization. **Patient considerations include the reason for the visit, type of visit, and the patient status.** For example, does the patient need a follow-up appointment in person or telehealth, preventive care, or a specified service? Understanding what type of service, the patient needs is essential. **Provider preferences and protocols determine the order of the appointments.** This means that some providers may only see new patients on a specific day or hour of the week, while established patients are seen on the other days of the week or when the needed equipment for the appointment is available for use. For example, is the equipment shared between two different providers within the same organization, or is it otherwise available? Thus, familiarity with the preferences and protocols is essential. **While all considerations are part of the scheduling process, the most important may be the purpose of the appointment.** This is often referred to as **the reason for the visit or the chief complaint**. **The patient status is also important since new patient appointments are usually scheduled for longer time periods than established patients.** Whether the appointment is for a new or established patient, **it must first be determined if the purpose is urgent and if the patient needs to be seen within 24 hours.** Urgent appointments will depend on the patient\'s symptoms. The organization will have a specific protocol with a list of questions, symptoms, and resolutions to be followed for an urgent appointment. **Most schedules have carved out time periods throughout the operational hours in a day for urgent appointments**. **Keep in mind urgent patients are a priority for the overall patient health and safety and to aid in any future potential legal oversights.** **Another scheduling consideration is for late arrivals, whether that is the patient, provider, staff, or sales representative.** All could be late for many valid uncontrollable reasons (illness, family situation, transportation). **However, the known frequent late arrival can be managed by scheduling them for the last appointment of the day or informing them the appointment time must be maintained.** For example, the provider will be leaving for the hospital right after the appointment concludes, so a late arrival would require that the appointment be rescheduled.  **Telehealth** The virtual delivery of health care services remotely. **new patients** the initial patient appointment or the first encounter **after a three-year absence** from the organization. **established** patients Received same provider services **within the last three years.** **Urgent** Medically necessary within 24 hours. **Provider Preferences, Needs, and Schedule** **Scheduling considerations also refer to provider and staff availability, the organization\'s building, and any required equipment.** The following table presents an overview of **some factors the CMAA will need to think about prior to offering an appointment.** **Scheduling Considerations** **Building    ** **Operational:** - Normal operational building hours and accessibility - Any scheduled or unscheduled construction or maintenance - Holiday and religious observations - Service delivery schedules - Security alarms, practice trainings (fire, weather related) **Equipment/Rooms    ** **Shared accessibility:** - Equipment and instruments  - Examination or surgical rooms - Patient waiting area and/or conference rooms. - Provider\'s private office **Established Patient    ** **Whether:** - **All demographic information has been updated and reviewed**. - **Insurance has been verified for the purpose of the encounter.** - The patient\'s preferred provider is available. - The patient\'s prior punctuality habits will need modification.  - Possible transportation requirements are necessary. - Accommodations have been made; possible considerations for accessibility include: - Caregiver with the patient - Wheelchair - Language translator - Hearing and visual translator **Interval  ** - Time between appointments - Staff catch-up time - Unforeseen occurrences  **New Patient  **  **Whether:** - The transfer of medical records from previous provider is complete. - All demographics have been collected and created in the new medical record. - Insurance eligibility has been verified for the new visit purpose. - Possible transportation requirements are necessary. - Accommodations have been made; possible considerations for accessibility include: - Caregiver with the patient - Wheelchair - Translator - **Travel and parking directions are needed.** **Providers ** - Preferred working hours, days, and specific times - Unavailable times, hours, days, months - Interval time for catch-up, phone calls, and charting time - Overall punctuality habits **Sales Representatives  ** **Whether:** - **The provider and all staff are available and required for product, medication, or procedure-learning event. ** - The time is before or after all scheduled patients or once a week. **Urgent  ** Whether the patient purpose and symptoms meet the organization\'s urgent protocol