File: Office Binder \ Case Management
New Patient 1st & 2nd Day Sequence of Procedures
NOTE: This is an example of a patient’s first and second day in the office, with a list of the actions the patient goes through in sequence. Usually, patients are not adjusted until their second day, though some therapy is often provided on the first day.
Use this as an example and list out the actions in your office, step by step. This list can then be used for training new staff and periodic review of your procedures during staff meetings for fine tuning and improvement.
BEFORE THE PATIENT'S FIRST DAY
New Patient Appointment made over the phone, or when patient walks in according to new patient appointment procedure. (New patient appointment procedure always includes "May I ask who referred you?")
FIRST DAY PROCEDURE
_____1.Initial Contact – Patient walks in and is warmly greeted by the receptionist.
_____2.Explanation of Procedures – The Case Manager explains to new patient the general procedure for that day.
_____3.New Patient Paperwork – Receptionist hands the paperwork to the new patient, and goes over what the new patient should do with the paperwork.
_____4.Hospitality – While the new patient is sitting down to do the paperwork, the Case Manager or receptionist asks if the new patient would like some coffee, tea, or water, if available.
_____5.Senior Doctor Notification – While patient is filling out paperwork, the receptionist should inform the assigned doctor that a new patient is here. She should give the doctor a piece of paper with the patient's name on it.
_____6.Senior Doctor Introduction – The doctor should briefly go over and introduce himself to the new patient while the new patient is filling out the paperwork.
_____7.Completion of New Patient Paperwork – When the new patient has completed the paperwork, the Case Manager should politely and personally escort the new patient to the exam room and explain that the doctor will be in shortly to do a consultation and examination of the patient.
_____8.Pre-Consultation – The Case Manager does a pre-consultation per procedure and then tells the patient that the doctor will be in shortly to do a consultation and an examination.
_____9.Consultation – The doctor does a thorough consultation.
_____10.Examination – The doctor does a thorough examination.
_____11.Report of Consultation and Exam – The doctor tells the patient that, based upon the consultation and exam, the patient should have some x-rays taken. To help answer any financial questions that the patient may have, the doctor explains that he will have the name of the person doing the financial consultation come in and discuss the new patient's financial responsibilities.
_____12.Financial Consultation #1 – The financial consultant comes in, having confirmed the new patient's insurance, gives new patient a brief report on what the charges will likely be for that day. She receives the patients agreement to continue, and then escorts the patient into the x-ray area, and tells the patient how to prepare for x-rays.
_____13.X-rays – The doctor comes in and does the x-rays, and then tells the new patient what to get dressed and have a seat when dressed.
_____14.Physiotherapy – Once dressed, the doctor prepares the new patient for therapy by explaining to the new patient the first therapy procedure, and gets the new patient started with their first therapy.
_____15.X-rays are Developed
_____16.X-ray Conference – The doctor briefly reviews the new patient's x-rays and decides on a tentative treatment program.
_____17.New Patient to Adjustment Bay – The therapist routes the new patient to the adjust bay when the new patient has completed the initial therapy.
_____18.First Adjustment – The doctor re-introduces himself to the new patient. He tells the patient that there is nothing in the x-rays that would prevent the patient from an initial adjustment. He briefly explains to the patient what the adjustment does, and then does the adjustment.
_____19.Explanation of Report of Findings – The doctor explains to the new patient about the next day's report of findings. He emphasizes his need to study the x-rays thoroughly to get a clear understanding of the patient's conditions, and correlate them with the exam findings that were obtained today. He explains that today's therapy and initial adjustment was simply a kind of a "first-aid", and that before any real treatment begins, it will be necessary for him to thoroughly review the diagnostic information obtained. He then personally escorts the new patient to the front desk, and tells the receptionist to schedule the new patient for a report of findings.
_____20.Schedule for Report of Findings – The Front Desk CA schedules the new patient for the report of findings for the next day, or as soon as possible.
_____21.Collect Fees – The Front Desk CA collects fees from the patient for that day's services.
_____22.Sends the Patient Away with a Smile – The Case Manager and Front Desk CA thank the new patient for coming in, assures the patient that the doctor is very competent and will be able to help the patient, and that they look forward to seeing the patient on the next visit. During this time, phones and other traffic are secondary to the cordial and friendly goodbye to the patient.
SECOND DAY PROCEDURE
- Greeting – The patient is greeted by the Front Desk CA in a friendly and interested manner.
- Assessment Form – The Front Desk CA instructs the patient to complete the assessment form.
- Report of Findings Preparation – The patient is escorted by the Case Manager to the exam room for the report of findings.
- Report of Findings – The doctor does a thorough and effective report of findings to the patient including giving the patient a verbal and written treatment plan. He completes the report of findings by telling the patient that before treatment begins, the Case Manager will come in to set up appointments for future visits, as well as go over any questions they may have regarding finances.
- Financial Consultation – The doctor informs the person doing the financial consultation that the patient is ready for the next financial consultation. Per the procedures on the financial consultation or "post report," she completes the consultation with the patient, including signing the patient up for the spinal care class. She also schedules the patient per the treatment plan, and gives the patient a copy.
- New Patient Orientation – The Case Manager then walks the patient out of the consultation room, and gives the patient the "new patient orientation." This would include check-in and check-out procedures, location of restrooms, procedure for lying down on the adjusting table and why, etc. She then places the patient in the therapy bay, or adjusting table as appropriate, and tells the patient that the doctor will be there shortly. She then informs either the therapist or the doctor that the patient is now ready for treatment.
- Therapy and Adjustment – The patient receives their services as per their treatment program.
- Check-Out – The patient is then asked to return to the front desk, where the Front Desk CA collects money for that day's procedure. She confirms their next appointment, and says they look forward to seeing them again.
Petty, Michel & Associates 1998 1.3- New Patient Flow.doc revised 9/11/98Page 1 of 3