Scheduling Appointments

Question 1

Appointment book

Answer 1

a book used to schedule, cancel, and reschedule appointments; can be color-coded or arranged so a week is shown at glance

Question 2

Matrix

Answer 2

a table used for scheduling

a system for blocking off unavailable patient appointment times

Question 3

Wave Scheduling

Answer 3

scheduling 3 patients at the same time to be seen in the order in which they arrive

Question 4

Modified Wave Scheduling

Answer 4

allocating 2 patients to arrive at a specified time and the 3rd to arrive approximately 30 minutes later, repeated throughout the day

Question 5

Double-booking

Answer 5

scheduling 2 patients at the same time with the same provider, often to fit in a patient who has an acute illness

this often used to work in a patient with an acute illness when no other time is available

it creates delays in the provider’s schedule that continues throughout the rest of the day

Question 6

Internal appointments or established patients

Answer 6

1st piece of info: Patient’s Name & Date of Birth
2nd: Reason for the visit
3rd: Availability

Question 7

Account balance

Answer 7

the amount owed on an account

the total balance on an account

Question 8

Account received

Answer 8

money owed to the provider

Question 9

Debit

Answer 9

negative

an amount owed

Question 10

Credit

Answer 10

positive

the monetary balance in an individual’s favor

Question 11

Accounts payable

Answer 11

debts incurred, not yet paid

Question 12

Assets

Answer 12

property of an individual or organization that is subject to payments for debts owed

Question 13

Liability

Answer 13

are items that are outstanding; debts; amounts owed

Question 14

2 main reasons why claims are denied or rejected…

Answer 14

1. technical errors
2. insurance policy coverage issues

Question 15

Preauthorization

Answer 15

is a process required by some insurance carriers in which the provider obtains permission to perform specific procedures or services or refers a patient to a specialist

Question 16

When obtaining or verifying prior authorization include the following:

Answer 16

-Authorization code
-Date authorization is effective
-Date authorization expires
-Authorized diagnosis & procedural codes
-Contact information for the specialist office
-How many visits are authorized
-What the authorization has been issued for

Question 17

Precertification

Answer 17

is a process required by some insurance carriers in which the provider must prove medical necessity before performing a procedure

precertification is also sometimes required for specific types of lab test, diagnostic testing, & procedures that are considered unusual or expensive (MRI, chemo meds)