Myrtle Hilliard Davis Comprehensive Health Centers, Inc

Myrtle Hilliard Davis Comprehensive Health Centers, Inc.

Policy: Appointment SchedulingAccess AM001

Department: Medical

Approved by: President/CEO

CMO

Revised: March 14, 2011

Purpose: Provide guidance in scheduling appointments for new and establishedpatients in the electronic appointment scheduler. To maintain adequate scheduling slots and improve flow and access to care. Myrtle Hilliard Davis Comprehensive Health Centers, Inc. will make every effort to schedule patients’ appointment according to desired preference.

New Patient /EstablishedAppointment: Query Intergy for birth date and social security to check for previous visit in the Intergy System. Scroll down list to see if patient has been seen at MHDCHC in the past. If the name appears in the roster with the same demographic information, schedule patient using the same account number.

Policy: Any patients who make appointments who have not been registered will complete a Quick registration per telephone. The information is needed:

1.First and last name (ask patient to spell name)

2.Current Telephone

3.Date of Birth

4.Social Security Number

5.What type of service needed

6.What day and time preferred

Established Patient must provide at least 2 types of information to schedule an appointment

First and last name (ask patient to spell name)
Social Security Number

3. Date of Birth

4. What type of service requested

5. What day and time preferred

Requesting the address and phone number will facilitate contact for appointment reminder services and mailing services if needed.

After registration is completed proceed to the Intergy Appointment scheduling. The following steps will allow an appointment to be scheduled.

Click Select Patient Icon located to your left.
Enter patient date of birth, Name or Social Security number
Highlight the correct patient and click OK button
Patient name will appear under SELECT PATIENT ICON with existing appointments
Click on patient name to assure demographics are correctly entered
Select a patient preferred provider or assign to the rotating provider according to availability.
Click on CALENDAR at top left of screen you may use arrows to go forward with dates.
Find available date by clicking on calendar or use SEARCH button bottom left to locate put in date range for appointment.
Select date by either method highlight the date and click, screen opens to that date
Click on time slight desired screen will change to Make Appointment Screenuse reason code drop box and click appropriate reason or use free text to indicated reason.
Verify telephone number again and click SAVE to set appointment.
Patient should be given instruction to bring picture Identification, check stub or award letter for disability/social security, insurance cards and something mailed to the current address used when appointment scheduled.
Patient should arrive 30 minutes to 1 hour in advance to complete registration.

Please make every effort to schedule follow up appointments with same provider as assigned. Give patient an appointment card for next visit.

Policy: Registration ProcessAccess AR001

Department: Fiscal

Approved by: President/CEO

CFO

Revised: March 2011

Purpose: To ensure that information obtained is adequate to assure that the health center is reimbursed for services provided.

Policy: Toestablish baseline demographics, financial and insurance information in the electronic health system. The registration process initiates HIPAA Privacy Practice compliance by having patients sign required documents. The process also includes patient signing the required Consent for Treatment/Financial Responsibility document.

Procedure:

New Patients and update evaluation:

Patient completesa pre-numbered registration form.
Once called to the registration area patient must provide the appropriate documents

Current photo I.D. (Driver’s License, Passport, State I.D., Credit card photo)

Proof of residency (piece of dated mail)

Proof of income (check stub, income tax return or unemployment statement)

Enter patient demographic and financial information
Verify insurance coverage prior to entering information into system
Once all information is verified and entered into the system patient signs the following forms:

Consent for Treatment /Financial Responsibility
Patient Registration Form
Registration Verification Form
HIPPA Privacy Notice

Established Patients: Patients with scheduled appointments are verbally asked for current demographics (address and phone number) if information has changed, patient will be update by clinical support staff in the demographics. All financial information changes should be directed to registration for update. Patients who have not updated their registration information in the past 12-months will be required to complete theregistration process to update information.

Detailed Registration Processes:

When registering patients, registrar should request the following information; a picture Identification, check stub or award letter for disability/social security, insurance cards and a mailer to the current address used when appointment scheduled.
Using the 3 options to identify patients’(name, DOB, SS#) in the system either locate the temp registration or current registration information in Intergy ask patient to verbally give the information and check against what is in system, make any necessary changes by clicking (M)modify, (C)cancel, (D)dependent, (I)insurance (L)last Diagnosis, (E)extended, (S)supplemental.
Select (M) to change information in the system or add information not obtained during temp registration. Tab through all fields and update as appropriate which include marital status, employer or school, dental medical record, insurances, ethnicity and race, veteran’s status, language and person responsible for billed services. If different from patient information.
Enter emergency contact information in screen provided (name, address, relation to patient and phone number).
Insurance verification is critical to updating or creating a new registration on patient in the Intergy system. Please follow correct channels to contact and verify private insurance carriers, enter Medicaid/Medicare number in the State verification system (EMOMED) to determine if coverage is current or discharged. The same verification process applies for dental insurance coverage. Be sure to enter name, insurance group number and person holding insurance policy in system to ease billing process. It is important that the co-pay status be entered and patient be asked to make co-payments prior to seeing provider.
(S) Supplemental is indicated for sliding scale fee patients. Under (I) document the number in the household, enter gross income, number of dependents. If patient presents proof of income the system will calculate the sliding fee percentage and saves this information in the system.
The encounter is printed and the patient is then directed to cashier to make payment as determined by the system and according to the Federal Poverty Guidelines.

Policy: Provider Empanelment Access AM002

Department: MEDICAL

Approved: President/CEO

CMO

Revised: March 2011

Purpose: To ensure all patients are assigned to a provider and establish a Medical Home

by providing continuity of care and visit coordination.

1) Insured patients will be assigned based on the provider assigned as their

primary care provider.

2.) All new patients will be assigned to the provider with the smallest panel with preference given to new providers.

3.) If aprovider’s panel is full new patientsare assigned according to availability.

4.) Patient may request a provider of their preference. When appropriate a patient’s visit should be coordinated with other providers (i.e. ophthalmology, podiatry)and diagnostic tests (i.e. lab or radiology tests).

5.) Patients assigned through the Community Referral Coordinator Program at area hospitalemergency roomsare assigned to the next available provideror to their PCP if they are an established patient.

Policy: Same day/ Next day Appointment Scheduling Access AM003

Department: MEDICAL

Approved by: President/CEO

CMO

Revised Date: March 2011

Purpose: MHDCHC will provide access to meet the needs of the patient with SameDay/Next Day appointments. The appointment scheduling template facilitatesscheduling to accommodate same day and next day appointments.

Policy: Support staff will add patients to appointment schedule as per patient request with emphasis on urgent/emergent appointment access. When scheduling appointments, every attempt should be made to accommodate patients need in a timely manner.

Procedure:

Patient requesting an urgent/emergent appointment or appointment for an acute medical issue shall be given a same day/next day appointment.
Support staff to open the Appointment Scheduler that contains 2 extra slots per appointment time slots between 8am-12pm daily, with Same Day and NextDay appointments reason codes.
Support staff to add patient to the appropriate appointment slot in schedule template.
Support staff will only use one of the two extra appointment slots in the schedule template allowing open access. (i.e. scheduled chronic condition plus sameday appointment in the same time slot)
Support staff to inform provider of urgent/emergent appointment added to schedule.

The availability ofsame day and next dayappointments will allow MHDCHC to accommodate patients attempting to access health care for acute medical conditions.

Policy: Walk-In Appointment Access AM003a

Department: MEDICAL

Approved by: President/CEO

CMO

Revised Date: March 2011

Purpose: MHDCHC will provide access to meet the needs of the patient with walk-in appointments. The appointment scheduling template allows for the addition of walk-in patients.

Policy: Patients walking into MHDCHC for acute care are assigned to the designated walk-in provider or added to available slots on the appointment schedule template (i.e. sameday appointment). In the event all provider schedule templates are at capacity, walk-in patients are triaged by the Clinic Manager and Site Coordinators or professional nurses.

Procedure:

Walk-in patient presents to cashier or registration.
Patients are issued an encounter to see the designated walk-in provider or added to available appointment slots on the provider schedule template (i.e. sameday appointment).
In the event all provider schedule templates are at capacity, walk-in patients are triaged by the Clinic Manager and Site Coordinators or professional nurses.
Patients with no acute medical condition are given the option to wait for a provider or make a next day appointment.
Patients that elect to wait for the providers who are at capacity are informed of possible long wait time and added to schedule.
Providers are informed of patients added to schedule template.

The availability of walk-in appointments will allow MHDCHC to accommodate patients attempting to access health care for acute medical conditions.

Policy: Triage Policy Access AM004

Department: MEDICAL

Approved by: President/CEO

CMO

Revised: March 2011

Purpose: To provide patients access to have same day medical advice and see if concern warrants immediate or urgent medical care.

Policy: Patients seeking medical service who may be in distress upon arrival to facility will be assessed by the clinic manager/site coordinator or professional nurses. The clinic manager/site coordinator or professional nurse will greet the patient and ask reason for the visit. The clinic manager/site coordinator or professionalnurse will determine if patient will be seen same day or given appointment for the earliest availability of service. The clinic manager/site coordinator or professional will determine the service area in which the patient will receive care.

Definition of Terms

Emergent- patient in unstable condition and require immediate medical attention to module for vital signs and assessment. Walk-in appointment scheduled (See chief complaints by body regions/organs/systems)

Urgent- patient in stable condition requires vital signs assessment schedule as same day appointment. (See chief complaints by body regions/organs/systems)

Appointment- patient assessed and given future appointment maybe Next day or according to provider availability.

Attached is a list of STAT situation that require immediate intervention and a Chief Complaints by body regions/Organ Systems.

STAT TRIAGE SITUATIONS

ALLERGIC REACTION- difficulty swallowing/throat swelling, shortness of breath/chest tightness

CARDIAC- any chest pain

GASTROINTESTINAL-vomiting (Blood, food, liquids), bloody stools (bright red or tar colored)

FEVER-infant less than 3 moths temp > 100.4 Fahrenheit

NEUROLOGIC-sudden loss of balance, severe headache, droopiness of face on one side, or inability to move one side, unsteadiness, unable to speak, loss of control of movements, seizures or inability to swallow.

PREGNANCY- abdominal pain, bleeding lack of fetal movement, leaking fluid or severe headaches and visual (eye) disturbances

POISONING- any awareness of suspected poisoning or ingestion

PULMONARY- shortness of breath, wheezing or coughing up blood and chest pain when breathing

TRAUMA-large amount of bleeding from wound, laceration or head injury

VITAL SIGNS- self monitored V.S. with high numbers BP above14O/90, respiration greater than 50 in children and 40 in adults, heart rate greater than 120.

MENTAL HEALTH-mention of suicide, threatening harm to others, crying or hearing voices

SEXUAL ASSAULT-report of sexual assault

Chief ComplaintCategory/Action

HEAD

Headache-acute (24 hours or less) (check BP)Urgent

Headache- chronicASAP

Headache-associated with blurred vision (check BP)Urgent

Headache-associated high blood pressure (check BP)See HEART (BP up)

Headache-associated with vomiting (check BP)Urgent

Head injuryUrgent

Head injury-associated with decrease consciousnessEmergent

Head sore-ringwormASAP

Head sore-associated with exclusion from schoolUrgent

EYES

Blurred vision-acute (check BP)Urgent

Blurred vision-chronicASAP

Decrease vision-acute (check BP)Urgent

Decrease vision-chronicAppointment

Double vision-chronicASAP

Double vision-acute (check BP)Urgent

Eye dischargeUrgent

Eye injuryUrgent

Eye injury-associated with active bleedingEmergent

Eye painUrgent

Pink eyeASAP

Pink eye-associated with exclusion from schoolUrgent

Chief ComplaintCategory/Action

EARS

Decreased hearingAppointment

Decreased hearing- associated with traumaASAP

EaracheUrgent

Earache- associated with dischargeUrgent

Ear discharge with painASAP

Ear waxAppointment

Infected external earUrgent

Post-auricular fissure-infectedUrgent

Ringing in ears-acute(check BP)Urgent

Ringing in ears-chronicAppointment

NOSE

Inability to smellAppointment

Nose bleedASAP

Nose bleed-actively bleedingEmergent

Nose injury-acuteUrgent

Nose injury – greater than 1weekASAP/Appointment

Runny nose- associated with fever (check Temp)Urgent/ASAP

Runny nose-chronicASAP/Appointment

Stuffy nose- associated with fever (check Temp)Urgent/ASAP

Stuffy nose-chronicASAP/Appointment

Chief ComplaintCategories/Action

MOUTH

Fever BlisterUrgent/ASAP

Mouth injury-acuteUrgent

Sores in mouthASAP

Sores in mouth associated with fever(Check temp)Urgent

Sores in mouth-associated with decreased oral intake Urgent

ThrushASAPT

Tooth abscessASAP

Tooth painASAP

THROAT

Difficulty swallowing-acute (check temp)Urgent

Difficulty swallowing-chronicASAP

Hoarse voice –acute (check temp)Urgent

Hoarse voice-chronicAppointment

Tonsils enlarged-acute (check temp)Urgent

Tonsils enlarged-chronicAppointment

Tonsils enlarged chronic- associated with hx difficulty breathingASAP

NECK

Neck injury-acuteEmergent

Neck injury-chronic (check BP)Urgent/ASAP

Neck massASAP

Stiff NeckUrgent/ASAP

Chief ComplaintsCategories/Actions

CHEST

Chest pain-acuteEmergent

Chest pain-chronic (check BP)Urgent

Rib injuryUrgent

Rib injury-associated with shortness of breathEmergent

BREAST

Breast massASAP

Breast painUrgent

Breast pain-associated with lactationASAP

Nipple dischargeASAP

LUNGS

CoughingUrgent/ASAP

Coughing associated with fever (check temp)Urgent

Coughing associated with hemoptysis (blood in sputum) Urgent

Difficulty breathing-acute Emergent

Difficulty breathing-chronicASAP

Shortness of breath-acuteEmergent

Short of breath-chronicASAP

WheezingEmergent

Chief ComplaintsCategories/Actions

HEART

Chest pain-acuteEmergent

Chest chronic (Check Bp)Urgent/ASAP

High Blood Pressure (check BP)Urgent

greater than 160/100Emergent

less than160/100 needs meds refillASAP

wants BP checkAppointment

Palpitations (check BP)Urgent

Rapid pulseASAP

ABDOMEN

Abdominal massASAP

Abdominal mass –associated delayed mensesASAP

Abdominal-acute Urgent

Abdominal pain-chronicASAP

ColicAppointment

ConstipationASAP

DiarrheaUrgent/ASAP

Diarrhea- child (check temp)Urgent/ASAP

Diarrhea- child associated lethargyEmergent

VomitingASAP

Vomiting-activeUrgent

Chief ComplaintsCategories/Actions

Vomiting-associated with head trauma (check BP)Emergent

Vomiting-child associated with ingestionEmergent

RECTAL

ConstipationASAP

DiarrheaUrgent/ASAP

Diarrhea-child (check temp)Urgent/ASAP

Diarrhea –child associated with lethargyEmergent

HemorrhoidsAppointment

Increased flatus-gasAppointment

Rectal bleedingUrgent

Rectal painUrgent

Rectal traumaUrgent

Rectal trauma associated with rapeEmergent

GENITAL/URINARY

Blood in urineUrgent

Delayed menses missed periodAppointment

Diaper rashASAP/Appointment

Diaper rash-associated with diarrhea (check temp)ASAP/Urgent

Dysuria-painful urinationASAP/Urgent

Penile dischargeASAP/Urgent

Penile traumaUrgent

RapeEmergent

Chief ComplaintsCategories/Actions

Scrotal massASAP

Scrotal mass associated with painEmergent

Scrotal painEmergent

Vaginal Bleeding-not associated with mensesUrgent

Vaginal bleeding prenatal patientEmergent

Vaginal itchingASAP

Vaginal trauma not rapeUrgent

EXTREMITIES

Hot jointsUrgent

Numbness (check BP)Urgent

Pain-acute Urgent

Pain acute associated with chest painEmergent

Pain chronicAppointment

Swollen joint associated with traumaASAP

Tingling in extremities (check BP)ASAP/Urgent

TraumaUrgent

SKIN

ChickenpoxContact Provider

DiscolorationAppointment

ItchingAppointment

MoleAppointment

RashAppointment

CHIEF COMPLAINTSCategories/Actions

Rash-associated with exclusion from schoolASAP/Urgent

SoreAppointment

CNS

Decreased consciousnessEmergent

Dizziness (check BP)Urgent

Double vision (check BP)Urgent

Headache (See head)