The following instructions pertain specifically to a written appointment system. However, the protocols are pertinent to a computerized system and should be followed for the most effective use of the appointment system.
A. Prior to Appointment
- Appointment sheets will be placed in a notebook. There are two way to manage the appointment sheets:
- Use a separate notebook for each provider or;
- Place all sheets in one notebook separating providers by dividers and tabs. The name of each provider is placed on the tab for easy reference.
- Place appointment sheets eight weeks in advance. At the end of each week, place a full week of appointment sheets under the existing sheets for each provider. In the event this is not feasible, maintain an interval as close to the eight-week period as possible.
- Fill out the top of each sheet with the date, day of week, and name of dental provider in ink.
B. Making an Appointment
The appointment sheet is divided into 15-minute intervals called SLOTS. The length of each appointment is then in increments of 15-minute slots.
A reason for broken appointments is that appointments are scheduled at inconvenient times for patients. It is important that patients are ASKED if the available appointment time is convenient.
The process for making appointments is as follows:
- Use a pencil for all entries onto the scheduling sheet. 5/30/07To ensure legibility, it is best to print.
- Enter the patient’s name and ID number, and/or the date of birth (DOB) in the desired time. If more than one 15-minute slot is required, draw an arrow through the additional slots allocated for that patient’s appointment.
- Under the heading TELEPHONE NUMBER, enter the patient’s home/cell and work telephone numbers. If the patient has neither, indicate no phone.
- Under the heading PROCEDURE, enter the purpose of the visit.
Guidelines for purpose of visit
- For a new patient, write NP.
- For a recall patient, write RECALL.
- For a treatment appointment, indicate the type of treatment to be done, i.e., amalgam, composite, endodontics, perio scaling, extraction, space maintenance. Due to space constraints, it is best to abbreviate the terms (amal, comp, endo, perio, ext, SM).
This information is useful both in personalizing the telephone confirmation and in identifying the instrument setup needed for the visit.
5. Under the heading ALERT:
- Indicate if premedication (PREMED) is required;
- Indicate of lab work (LAB) is necessary for that visit. This will prompt the receptionist to ensure that the lab work is available for that visit;
- Indicate if nothing by mouth (NPO) if ordered by the dentist or dentist hygienist.
6. Under the heading INIT, the receptionist making the appointment writes his/her initials after making the appointment. 5/30/07 CONF, the receptionist writes his/her initials and places the date when the appointment was confirmed by telephone. This is only done when the reception has actually talked to the patient or parent/guardian. Telephone reminders must be made at least 48 hours in advance of the appointment time.
7. Under the heading DISPOSITION, indicate the disposition of the appointment using the following codes:
AK = Appointment Kept
BA = Broken appointment
WI = Walk-in visit
C. Appointment Transmission Slip
At the end of each visit, the provider fills out the appointment transmission form indicating when the patient should be seen, how many slots are needed, the reason for the visit, and any pertinent alerts. This form can be used for multiple providers if the dental provider requests that the patient see a medical provider prior to the next visit, a referral to another dental provider such as the hygienist or specialist, and for multiple visits to the same provider. If the patient needs a recall visit, this is indicated under the heading RECALL. The appointment transmission slip can either be at the bottom of an encounter form or a separate document.
- Double Booking – Double booked slots are provided for the purpose of assuring adequate patient flow due to the expected broken appointment rate. The number of slots filled will depend on each program’s broken appointment rate. Appointments with the highest broken appointment rates are for new patients and for recall patients, particularly for the hygienist. It is recommended that these slots be filled with short procedu5/30/07s who have a history of broken appointments.
Patients with telephones – Telephone calls must be made to all patients 48 hours prior to the appointed time. When reminding the patient of the visit, review the time, date, provider, and procedures scheduled for that visit. Courtesy and accurate information are necessary to ensure that the patient returns for the appointment. When the appointment has been confirmed, the receptionist then initials and dates the appointment sheet under the heading CONF. If the patient cannot be contacted personally, leave all the above information on the voice mail or whomever answers the phone. A call-back to the patient or parent/guardian should be made to ensure the information is transmitted.
E. Missed Appointments
The following will be completed for broken appointments:
- The notation MISSED APPOINTMENT must be made in the patient record and reviewed and signed by the dental provider.
- If the patient has been treated before and has missed only one appointment, the patient must be contacted and reappointed. A notation must be made in the patient record regarding the reason for the broken appointment. If the patient does not desire to be reappointed, a notation must be made in the record with the reason, if given.
- If the patient has been treated before and has missed two or more visits, the patient must be contacted and counseled regarding the importance of keeping an appointment. If the patient still wants an appointment, the next appointment will be made in the DOUBLE BOOKING section until the patient demonstrates reliability.
- If the patient is a new patient (not a patient of record), no follow-up is necessary.
- Lists of patients missing two or more appointments must be maintained by the receptionists. Patients from this list who call for an appointment will either be placed on the waiting list or given an appointment in the DOUBLE BOOKING section. These patients will counseled as to the importance of keeping an appointment.
The definition of a cancellation is when the open slots resulting from the cancellation can be filled by another patient. If the cancellation is made on the day of the appointment and the slots cannot be filled, then this is noted as a broken appointment, not a cancellation. When a patient cancels, remove the patient’s data on the appointment sheet and make another appointment for that patient. Make sure that the same number of slots are blocked out when the patient is reappointed.
If an appointment time is not available or the patient is not available for existing appointment slots, then the patient will be placed on the cancellation priority list for the date(s) requested. In the event of a cancellation on one of these dates, the patient will be contracted and an appointment made.
All patients requiring appointments more than eight weeks in advance will be placed in the recall system. The process for the recall system is as follows:
- The provider indicates the interval in months for the next recall appointment on the Appointment Transmission Slip under the heading RECALL.
- The Appointment Transmission Slip is given to the patient with the moths interval indicated.
- A list of recall patients is generated one month prior to the month of the visit. This list includes the following patient information: name, ID or record number, address, telephone number(s), provider to be seen, and reason for visit (if other than recall).
- Patient Reminders – Telephone calls are made to the patient requesting a convenient time and date for the recall appointment. All transactions are noted on the recall list with the date and initials of the receptionist or dental assistant. If a patient cannot be reached by telephone, then a reminder card is mailed to the patient requesting that a telephone call be made to the dental clinic for a recall visit. This is noted on the recall list.
- When the appointment is made, the date is entered on the recall list. On the appointment sheet, the reason for the visit must be entered. In most instances, this will be RECALL.
- Patients not appointed – A list of patients not contacted will be sent to each provider for review and follow-up if requested. If not further action is requested, a notation of RECALL-NO RESPONSE is entered into the patient’s record.
H. Referral to Other Providers
- External Referrals – All external referrals will be made utilizing the consultation form.
- Internal Referrals – All internal referrals are made utilizing the Appointment Transmission Slip.