Appointment Availability & Scheduling

A. Specialty or Primary Care Services and Diagnostic Services (including Diagnostic Radiology, EEG/EMG, Pulmonary Function Lab, GI Procedures, Cardiac Testing, Speech/Hearing Center, EKG, Sleep Study Center, Echocardiography)

  1. Inpatient Consults – see separate section regarding inpatient consults
  2. Each department will define criteria for determining urgent and routine visits to assist staff in proper triage and will use the guidelines below to determine appropriate time frames for scheduling
    1. Urgent Care – same day if indicated, not to exceed 24 hours of request
    2. Non-urgent or routine care and follow up visits – preferably within one week of requested time frame
  3. Each practice will develop arrangements for clinical access to any urgently needed consultations on a daily basis. This may include:
    1. Daily office hours, or flexible access to YMG outpatient space
    2. An on call schedule for phone calls from referring physicians, the Emergency Department, or patients
    3. It is recognized that fellows or non‐physician providers may perform the initial steps in some consultations; however, there should always be an attending physician available to participate in the care of the patient.
  4. An appointment with a member of the section's physician team should be offered to the patient if the requested attending physician is not available within the appropriate time frame.

B. Appointment Schedule Management:

  1. Standard Hours of Operation: Practice session times are a minimum of four (4) hours in duration. An example of a typical practice schedule would be:

  2. Morning SessionAfternoon Session
    8:00 a.m. to 12:00 Noon1:00 p.m. to 5:00 p.m.
  3. A scheduled patient appointment that is changed at the physician's request is defined as bumped. Physician absences due to illness, family or clinical emergencies or weather related events are excluded. Because of the diverse nature of the practices at Yale Medical Group, each department will need to define what constitutes a clinical emergency for their practice. In all other cases, physicians should try to minimize bumping patient appointments by arranging for coverage within their practice as appropriate. An appointment that is rescheduled for the same day is not considered a bumped appointment.
  4. Acceptable physician bump rates, or the percentage of bumped appointments as compared to all scheduled appointments for that physician are as follows:

  5. Scheduled Patient VisitBump Rate
    Less than 30 days0%
    30 or more days2%
  6. Physician schedules should provide available appointments far enough in advance to meet the demands of the clinical specialty. Practices should have a mechanism in place to identify and contact patients who need to schedule their next visit two months prior to the appropriate return date based on their medical condition. The patient will be contacted at that time to remind them to call the practice for an appointment.

C. Referral Process Verification: For New and Return Patients

  1. Departments are responsible for verifying that necessary insurance referrals or pre‐authorizations exist prior to rendering any professional service by working the managed care report generated by the practice management system in advance of all scheduled visits.
  2. At the time of scheduling, patients should be informed that they are responsible for obtaining a valid referral prior to their visit. The department should also communicate to the patient that if no referral is in place on the day of their appointment they will be required to:
    1. Contact their referring provider to obtain a valid referral or
    2. Reschedule their appointment so a referral and/or authorization can be obtained, or
    3. Sign a waiver agreeing to be financially responsible for any professional services they receive.
  3. When scheduling patients staff must link the patient appointment to the active referral in the practice management system.

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