Something as simple as appointment scheduling can help improve a physician practice’s bottom line. For example, gathering basic patient data at the time the appointment is scheduled allows for the verification of the patient’s health insurance information before a patient’s visit.
1. What is your full legal name and how is it spelled on your insurance card?
To verify insurance coverage, the health plan or payer requires the patient’s full legal name and the correct spelling as the name is listed on the patient’s insurance card.
2. What is the reason for the appointment?
This information is needed to determine the length of visit, physician assignment and other office services, such as x-rays or lab work, that should be available for the patient.
3. When was your last visit to our office?
Collect accurate patient contact and insurance information for a new patient and for any patient who hasn’t visited the office recently. It is a good practice to verify current insurance information with all patients. The patient’s contact and insurance information may well have changed since the last visit and thus may need to be updated.
4. What is the name of your health insurance company, insurance identification number and group number listed on your insurance card?
Be specific with your request and avoid asking a vague question such as, ”Has anything changed since your last visit?” This reduces the likelihood that the patient will inadvertently omit important information. Accurate patient insurance information is necessary to verify that the patient has current insurance coverage and to obtain the amount of the co-payment and deductible due at the time of the visit. Check with your billing staff to ask what additional information, such as the patient’s birth date, may be help them to verify the patient’s insurance coverage.
5. Is the patient a minor? If so:
- Whose insurance plan covers the patient’s health care and how is the name spelled on the insurance card?
- Does another person (such as the other parent) also carry insurance on the child?
- Who is responsible for the child’s health care decisions?
- Who will accompany the child to the appointment and what is their relationship to the child?
If the patient is a minor, an adult should accompany him or her to the appointment. It is important to know who that person will be before the visit. It most likely will be a parent, but situations in which parents are divorced can create issues for the office that should be addressed up front.
6. What is your phone number at work and home (or those contact numbers for the patient’s responsible party or legal guardian)? Which phone number would you prefer the office to use when contacting you?
The office may need to contact the patient for an appointment reminder, as well as treatment, billing or administrative questions.
7. Are you being referred by a physician or physician office? What is the physician or other provider’s name and phone number?
Your office might see many patients who have been referred by other physicians or medical providers. It is important to know the name of the referring physician and how to reach that physician in case records, orders or other information must be obtained from his or her office.
8. Should specific records or test results be available for the patient visit?
Knowing what test results, x-rays or other patient records might be necessary for the visit helps to ensure the information is available when the physician sees the patient.
Your office may have specific instructions to provide to anyone who calls for an appointment. These instructions might include examples such as:
- the patient should arrive 20 minutes prior to the appointment to fill out any necessary paperwork, or the office has a no-show and cancellation policy
- the patient should bring any of the following that are in his or her possession: medical records, immunization records, list of medications being taken; and a current health insurance identification card
Inform the patient of any outstanding balance owed from previous visits, and tell him or her to make that payment during the next visit.
10. Do you have any questions?
If the patient has a question relating to treatment or administrative matters which you are unable to answer, make a note of it and follow up with the person in the office who can best answer the question. Then call the patient back with the answer before his or her appointment. This is an excellent way to impress patients with the office’s efficiency and professionalism.
For more information visit "Appointment scheduling to improve your bottom line" to access the complete educational flyer that was developed through a cooperative effort between the American Medical Association and the Kentucky Medical Association with thanks to the members of the Kentucky Medical Group Management Association for their contributions.Be specific with your request and avoid asking a vague question such as, "Has anything changed since your last visit?" This reduces the likelihood that the patient will inadvertently omit important information. Accurate patient insurance information is necessary to verify that the patient has current insurance coverage and to obtain the amount of the co-payment and deductible due at the time of the visit. Check with your billing staff to ask what additional information, such as the patient’s birth date, may be help them to verify the patient’s insurance coverage.
Visit "Open access scheduling: Could it improve your patients' experiences and your bottom line?" to access an educational flyer on making same-day appointments available to your patients. This resource will help you better understand this unique type of scheduling system, consider the benefits and challenges of implementation, and see if open access scheduling is right for your practice.
Also access the resources "Prepare that claim," "Follow that claim," and "Appeal that claim," developed to help physicians and their practice staff to review the efficiency of their current internal claims management process. These resources contain sample forms and policies that can be adapted to fit the specific needs of a physician practice, including:
- new patient information sheet
- employer/insurance verification information sheet
- patient/insurance coverage verification form
- encounter form (super bill)
Access toolkits to help you effectively use key Health Insurance Portability and Accountability Act (HIPAA) electronic health care transactions in your practice, including eligibility, claim status, electronic funds transfer and prior authorization. Don't wait—start experiencing the savings!