RE: Solo practitioner and scheduling

[Guest guest]

Scheduling time is not much of a problem if you have the patients do it themselves online. I use AppointmentQuest. The patients can take their own vitals if you have the blood pressure machine and scale in the reception area. My schedule allows for 10 , 25 , 30 , 40 , and 50 minute appointments, with 5 minute breaks after the short appointments, and 10 minute breaks after the 50 minute appointments. Most of the time, my wife “volunteers” as my receptionist, and collects the money and records the vitals. When she is gone, I block out an additional 15 minutes each hour and do it myself. This works fine for me. dts From: [mailto: ] On Behalf Of annewSent: Friday, July 08, 2011 5:50 PMTo: Subject: Solo practitioner and scheduling I am moving towards a part-time, cash only solo practice.How do folks doing it solo, get patients in, vitals taken, do the medical visit, and then collect payment, schedule the next visit in the usual time frame of a visit?Isn't it least 5 minutes to get vitals, settle in, then 5-10 minutes to process the exit of a patient (pay bill, reschedule, etc)? So in a " 30 minute " visit at least 10 minutes are used in non-direct medical care.Do you make " 30 minute " visits and use a 45 minute slot? Do you charge accordingly?Curious.... Thanks in advance.Anne

[Guest guest]

how many pts a day...curious...

RE: Solo practitioner and scheduling

Scheduling time is not much of a problem if you have the patients do it themselves online. I use AppointmentQuest.

The patients can take their own vitals if you have the blood pressure machine and scale in the reception area.

My schedule allows for 10 , 25 , 30 , 40 , and 50 minute appointments, with 5 minute breaks after the short appointments, and 10 minute breaks after the 50 minute appointments.

Most of the time, my wife “volunteers” as my receptionist, and collects the money and records the vitals. When she is gone, I block out an additional 15 minutes each hour and do it myself. This works fine for me.

dts

From: [mailto: ] On Behalf Of annewSent: Friday, July 08, 2011 5:50 PMTo: Subject: Solo practitioner and scheduling

I am moving towards a part-time, cash only solo practice.How do folks doing it solo, get patients in, vitals taken, do the medical visit, and then collect payment, schedule the next visit in the usual time frame of a visit?Isn't it least 5 minutes to get vitals, settle in, then 5-10 minutes to process the exit of a patient (pay bill, reschedule, etc)? So in a "30 minute" visit at least 10 minutes are used in non-direct medical care.Do you make "30 minute" visits and use a 45 minute slot? Do you charge accordingly?Curious.... Thanks in advance.Anne

[Guest guest]

Exactly, actually saves time. And you learn so much more.

________________________________________

From:

[ ] On Behalf Of sharkinn

[sharkinn@...]

Sent: Saturday, July 09, 2011 1:09 PM

To:

Subject: Re: Solo practitioner and scheduling

No, for established patients, it really doesn't take more than 3-5 minutes for

all that. We exchange pleasantries while I am walking them from the " No-waiting "

room to a seat by my desk, which is in my office/exam room. (And I frequently

get a lot of info about their condition by watching them walk in.) I ask if

there are any changes in their insurance (which you won't have to do), then

launch into gathering the history. I weigh them at the scale that is a few steps

from my desk, on the way to the exam table. Taking vitals at the beginning of

the physical exam takes only a couple of minutes and gives me a lot of info. I

have picked up several new-onset atrial fibs while taking the pulse and BP.

Then, a few steps back to my desk to collect payment and schedule next appt,

which takes only a couple of minutes. I have open access, so many folks don't

need to schedule their next appt; they just call when it is time or they want to

come back. If they have a copay, which yours won't, I collect that at the

beginning of the visit, so I don't forget. It all goes so much more smoothly and

quickly for the patient than in a regular practice, so they love it and word

gets around very quickly about how much more pleasant it is to come to your

office than all the other docs. I always schedule 30-60 minute appts, since

there is plenty of other stuff that can be done after visits that don't take up

all the allotted time.---Sharlene---

>

> I am moving towards a part-time, cash only solo practice.

>

> How do folks doing it solo, get patients in, vitals taken, do the medical

visit, and then collect payment, schedule the next visit in the usual time frame

of a visit?

>

> Isn't it least 5 minutes to get vitals, settle in, then 5-10 minutes to

process the exit of a patient (pay bill, reschedule, etc)? So in a " 30 minute "

visit at least 10 minutes are used in non-direct medical care.

>

> Do you make " 30 minute " visits and use a 45 minute slot? Do you charge

accordingly?

>

> Curious.... Thanks in advance.

>

> Anne

>

[Guest guest]

I can see how I might learn more by taking the vitals, but I don't see how it saves time..After all, in my prior practice one person checked them in (and it easily looked like 5 minutes min) and another person checked them out -- and that often looked like 5-10 min. And my prior practice was  also cash only.

I guess I will have to see.  I was just trying to get a feel about flow and how to schedule patients in this new solo world. I hear some of you say, schedule the same,,, Another likes  catch up time worked into the schedule.

I think I will start with a " gappy " schedule,,,, Re-registering my former patients who follow me to this new practice will take a little more time.Thanks everyone. (excuse the typos ... I have my long distant contacts in

On Sat, Jul 9, 2011 at 4:41 PM, Kennedy, Jim ( Affiliate FM-SOM ) wrote:

Exactly, actually saves time. And you learn so much more.

________________________________________

From: [ ] On Behalf Of sharkinn [sharkinn@...]

Sent: Saturday, July 09, 2011 1:09 PM

To:

Subject: Re: Solo practitioner and scheduling

No, for established patients, it really doesn't take more than 3-5 minutes for all that. We exchange pleasantries while I am walking them from the " No-waiting " room to a seat by my desk, which is in my office/exam room. (And I frequently get a lot of info about their condition by watching them walk in.) I ask if there are any changes in their insurance (which you won't have to do), then launch into gathering the history. I weigh them at the scale that is a few steps from my desk, on the way to the exam table. Taking vitals at the beginning of the physical exam takes only a couple of minutes and gives me a lot of info. I have picked up several new-onset atrial fibs while taking the pulse and BP. Then, a few steps back to my desk to collect payment and schedule next appt, which takes only a couple of minutes. I have open access, so many folks don't need to schedule their next appt; they just call when it is time or they want to come back. If they have a copay, which yours won't, I collect that at the beginning of the visit, so I don't forget. It all goes so much more smoothly and quickly for the patient than in a regular practice, so they love it and word gets around very quickly about how much more pleasant it is to come to your office than all the other docs. I always schedule 30-60 minute appts, since there is plenty of other stuff that can be done after visits that don't take up all the allotted time.---Sharlene---

>

> I am moving towards a part-time, cash only solo practice.

>

> How do folks doing it solo, get patients in, vitals taken, do the medical visit, and then collect payment, schedule the next visit in the usual time frame of a visit?

>

> Isn't it least 5 minutes to get vitals, settle in, then 5-10 minutes to process the exit of a patient (pay bill, reschedule, etc)? So in a " 30 minute " visit at least 10 minutes are used in non-direct medical care.

>

> Do you make " 30 minute " visits and use a 45 minute slot? Do you charge accordingly?

>

> Curious.... Thanks in advance.

>

> Anne

>

------------------------------------

[Guest guest]

think i put this on the wrong thread so adding it back where it should go...i have no staff ever at the office (wife does billing but all from home).  I take insurance so probably collect copays on 25-50% of patients depending on day (rest are mcare or dont pay at time of visit).  Doing vitals myself think is easy and has some fringe benefits  First, not every visit needs vitals.  Many do, but the 40 yo coming in for sprained ankle that had a physical 3 months ago doesn't.  Doing things myself allows me to be selective about what is truly needed for the visit and not waste time doing things that are not.  Next, I have found several instances where my height especially were far more accurate than prior vitals measures from years past that were done by staff.  Next, rather than checking BP right after someone has walked into a room.  I check it routinely after they have been sitting for at least 5-10 minutes and thus get more accurate measurements.  Finally, it's a good time to do some quick review of systems or just do some social chatting which facilitates knowing the patients better.

Payments probably take two minutes tops, a touch longer at the beginning of the year when I'm copying updated insurance cards more frequently.  I have my intuit merchant services web page already up, type in amount and reason for payment in memo, swipe card on usb card reader, enter payment in my PM system and print receipt if patients want.  They dont have to sign anything.  Again, can do some social chatting during that time (80% seems to be people asking about my kids or how things are going with my practice).

I see 4-8 patients daily on average.  I looked at whether adding back staff would be useful in generating more revenue and I concluded it would not for me.  The only tasks I could give to staff that would noticeably make a difference as to how many patients I could see daily and have on panel would be having them do the bulk of patient communication and that specifically goes against the practice model I setup.  For me, since I spend so long with patients (avg 45 minutes per visits) and do so much email communication, I just cannot handle more volume daily or patient census (400 patients).  It's just the way I do things.   The simple things like vitals, payments, refills, preauths, etc. amount to so little time for me the cost of staff would be more than any additional revenue I could generate.  

That all being said, I rely on my non-covered benefits fee to ensure I have sufficient revenue because of my low volume.  $300 per year obviously helps and I play to avg 130-150K per year.- Show quoted text -

 

With my wife there, typically 10 – 12 on a 6 hour day, 7 – 9 on a 4 hour day.    By myself, up to 1 less per hour.

 dts 

From: [mailto: ] On Behalf Of Dr Levin

Sent: Saturday, July 09, 2011 4:50 AMTo: Subject: Re: Solo practitioner and scheduling

   how many pts a day...curious...

RE: Solo practitioner and scheduling

   Scheduling time is not much of a problem if you have the patients do it themselves online. I use AppointmentQuest. 

The patients can take their own vitals if you have the blood pressure machine and scale in the reception area. 

My schedule allows for 10 , 25 , 30 , 40 , and 50 minute appointments, with 5 minute breaks after the short appointments, and 10 minute breaks after the 50 minute appointments.   

Most of the time, my wife “volunteers” as my receptionist, and collects the money and records the vitals.  When she is gone, I block out an additional 15 minutes each hour and do it myself.   This works fine for me.

dtsFrom: [mailto: ] On Behalf Of annew

Sent: Friday, July 08, 2011 5:50 PMTo: Subject: Solo practitioner and scheduling

  I am moving towards a part-time, cash only solo practice.How do folks doing it solo, get patients in, vitals taken, do the medical visit, and then collect payment, schedule the next visit in the usual time frame of a visit?

Isn't it least 5 minutes to get vitals, settle in, then 5-10 minutes to process the exit of a patient (pay bill, reschedule, etc)? So in a " 30 minute " visit at least 10 minutes are used in non-direct medical care.

Do you make " 30 minute " visits and use a 45 minute slot? Do you charge accordingly?Curious.... Thanks in advance.Anne

[Guest guest]

It saves time, in my estimation, because you can get information while you are doing this.

On another note, why do you want to save time? If you are running a low volume practice, one of the good things is to spend enough time to get the information, do the anticipatory guidence and do the things that make our practices

special. I do my own xrays, and so when I am with the patient throughout the visit, they tell me things that they might only tell a nurse or an MA or not say at all. Face time is critical and it can begin as soon as the patient walks in the door.

There is more to a visit, than the " doctor stuff. "

From: [ ] On Behalf Of Anne Walch [healingpathnow@...]

Sent: Saturday, July 09, 2011 4:12 PM

To:

Subject: Re: Re: Solo practitioner and scheduling

I can see how I might learn more by taking the vitals, but I don't see how it saves time..

After all, in my prior practice one person checked them in (and it easily looked like 5 minutes min) and another person checked them out -- and that often looked like 5-10 min. And my prior practice was also cash only.

I guess I will have to see. I was just trying to get a feel about flow and how to schedule patients in this new solo world. I hear some of you say, schedule the same,,, Another likes catch up time worked into the schedule.

I think I will start with a " gappy " schedule,,,, Re-registering my former patients who follow me to this new practice will take a little more time.

Thanks everyone.

(excuse the typos ... I have my long distant contacts in

On Sat, Jul 9, 2011 at 4:41 PM, Kennedy, Jim ( Affiliate FM-SOM )

wrote:

Exactly, actually saves time. And you learn so much more.

________________________________________

From: [ ] On Behalf Of sharkinn [sharkinn@...]

Sent: Saturday, July 09, 2011 1:09 PM

To:

Subject: Re: Solo practitioner and scheduling

No, for established patients, it really doesn't take more than 3-5 minutes for all that. We exchange pleasantries while I am walking them from the " No-waiting " room to a seat by my desk, which is in my office/exam room. (And I frequently get a lot of info about

their condition by watching them walk in.) I ask if there are any changes in their insurance (which you won't have to do), then launch into gathering the history. I weigh them at the scale that is a few steps from my desk, on the way to the exam table. Taking

vitals at the beginning of the physical exam takes only a couple of minutes and gives me a lot of info. I have picked up several new-onset atrial fibs while taking the pulse and BP. Then, a few steps back to my desk to collect payment and schedule next appt,

which takes only a couple of minutes. I have open access, so many folks don't need to schedule their next appt; they just call when it is time or they want to come back. If they have a copay, which yours won't, I collect that at the beginning of the visit,

so I don't forget. It all goes so much more smoothly and quickly for the patient than in a regular practice, so they love it and word gets around very quickly about how much more pleasant it is to come to your office than all the other docs. I always schedule

30-60 minute appts, since there is plenty of other stuff that can be done after visits that don't take up all the allotted time.---Sharlene---

>

> I am moving towards a part-time, cash only solo practice.

>

> How do folks doing it solo, get patients in, vitals taken, do the medical visit, and then collect payment, schedule the next visit in the usual time frame of a visit?

>

> Isn't it least 5 minutes to get vitals, settle in, then 5-10 minutes to process the exit of a patient (pay bill, reschedule, etc)? So in a " 30 minute " visit at least 10 minutes are used in non-direct medical care.

>

> Do you make " 30 minute " visits and use a 45 minute slot? Do you charge accordingly?

>

> Curious.... Thanks in advance.

>

> Anne

>

------------------------------------

[Guest guest]

Well, said Jim. I agree.

Exactly, actually saves time. And you learn so much more.________________________________________From: [ ] On Behalf Of sharkinn [sharkinn@...]Sent: Saturday, July 09, 2011 1:09 PMTo: Subject: Re: Solo practitioner and scheduling

No, for established patients, it really doesn't take more than 3-5 minutes for all that. We exchange pleasantries while I am walking them from the "No-waiting" room to a seat by my desk, which is in my office/exam room. (And I frequently get a lot of info about their condition by watching them walk in.) I ask if there are any changes in their insurance (which you won't have to do), then launch into gathering the history. I weigh them at the scale that is a few steps from my desk, on the way to the exam table. Taking vitals at the beginning of the physical exam takes only a couple of minutes and gives me a lot of info. I have picked up several new-onset atrial fibs while taking the pulse and BP. Then, a few steps back to my desk to collect payment and schedule next appt, which takes only a couple of minutes. I have open access, so many folks don't need to schedule their next appt; they just call when it is time or they want

to come back. If they have a copay, which yours won't, I collect that at the beginning of the visit, so I don't forget. It all goes so much more smoothly and quickly for the patient than in a regular practice, so they love it and word gets around very quickly about how much more pleasant it is to come to your office than all the other docs. I always schedule 30-60 minute appts, since there is plenty of other stuff that can be done after visits that don't take up all the allotted time.---Sharlene---

>> I am moving towards a part-time, cash only solo practice.>> How do folks doing it solo, get patients in, vitals taken, do the medical visit, and then collect payment, schedule the next visit in the usual time frame of a visit?>> Isn't it least 5 minutes to get vitals, settle in, then 5-10 minutes to process the exit of a patient (pay bill, reschedule, etc)? So in a "30 minute" visit at least

10 minutes are used in non-direct medical care.>> Do you make "30 minute" visits and use a 45 minute slot? Do you charge accordingly?>> Curious.... Thanks in advance.>> Anne>------------------------------------

[Guest guest]

One thing I'll throw out is this:  the potential benefit of scheduling patients for next visit before they leave.  In my IMP, it is not necessary (in prior practices, appointments were only available 2 or 3 months out, so patients HAD to schedule that far ahead to get an appointment with me).  When I had my recent visit from my malpractice cooperative rep, she highly suggested scheduling the follow-up appointments at the time of the visit.  It is a simple way to keep track of those who need follow-up (if you get a notice of a cancellation, reminds you to follow-up with those who need it).

SharonSharon McCoy MDRenaissance Family Medicine

10 McClintock Court; Irvine, CA  92617PH: (949)387-5504   Fax: (949)281-2197  Toll free phone/fax: 

www.SharonMD.com

 

oh forgive me I did not see Sharlene  just said   all this AND better! oops.Jean

well sometimes visits do  feel  very busy    And we are having to document -type- as the visit goes along but stilll working this way is actucally so much better  VS are not " separte Nor are  copays etc It is  all part of the flow.

With meaningful use  I changed my work  flow( HAVE to do ht  and wt more often Have to get the language preference in and ethnicity HAVE to make sure computer reads the  tobacco status HAVE to do up a vis t  summary)

short answer --is to think about the work you need to  do  plan visit times accordingly  and get your tools like Emr or AQ to do most of the work,  but also to realize as the others say that patietns VS and paying and rescheduling are intergrated into the visit It is  a neuro exam to walk them in watch them  fine mototr the card out of the wallet  step on scale etc And  they a re usually talking the whole time telling me history.

Until you work this way indeed it seems like all these tasks cannot " fit " but when intergarted it is far more efficient to do them yourslef.When new  you have no routine ,so hopefully you will have a small panel /slow days to start and you might leave more time than you think to see how it will go

 

--- knowing what the patietn is in for and allowing enough time matters this comes out of  knowing people, teaching them tot ell you what their agenda is so you schedule accordingly, double chkcing when you schedule them

 Carla Gibson told us a while ago  how  she lost her recpetionsit, spent a weekend hooking up Appointment Quest and  then  how  people so perfectly   matched their time requests to what they  they needed AND when nearing their time would say " my 30min are UP

 thus showing how cool it is to put things in the  hands of the patietns --- also knowing the patients in your own practice makes a differnce  People are unknowns  in big practices   THye are stuck at  differnt stations in the practice repeating and  waiting You wil know them and  collect teh copay in 30 seconds.Knowing  patitns allows you to say  put  Gordon in at the en d of a session becasue he tallks alot and will not leave, or   put  Lynn in at the end of the day becasue she has no  transportation  and no shows  etc

In my practice there  is not alot of  paying (medicare mostly) but  it is part of the work flow as i  near the end  and I am asking so  you can do your copay now and anything else How does this plan  sound to you etc..At least half the time  I am still workin on doin up refills and folks a re pulling out checkbooks before I ask  becasue they know they have to pay me..

 ---Appointments for next time   are not set all  that much---

 they call to be seen when their  refills run outThis approach works fabulously  Patients leave my office having everything they need(I hope, I aim for,,) til the next visit  refills a re  set up  the  mammogram order is done-I mean I may actually DO this stuff at lunch or 5 30 but the patietns know   they have confidcne they got what they needed and are " on automatic " when they run out they call to be seen that day  come back

----so the visit summary I have now incorporated -- this was a change in work pattern actuallly is great INstead of printing them a med list- it is in the template of the summary. An d instead of a reminder appointment card or the card- it is on the summary.

 This little [practice stuff  is  a very  differnt way of workingIf you always   ask the patietn their agenda and if  the  agenda is set up front  you should find you can get all this done  easily If I coudl type I would even get the note finished  (I tidy them  up later)

Once patietns get to   trust you will see them etc all goes smoothly It is not like a big place wheer they a re lost shuttled from  ffront desk to nurse to doc to  check out all diferent stations where they wait and an d have yet another person who doesnot know them  look the same stuff upad  waste time -THAT is why things take  so long!

see if that helps

 

I am moving towards a part-time, cash only solo practice.

How do folks doing it solo, get patients in, vitals taken, do the medical visit, and then collect payment, schedule the next visit in the usual time frame of a visit?

Isn't it least 5 minutes to get vitals, settle in, then 5-10 minutes to process the exit of a patient (pay bill, reschedule, etc)? So in a " 30 minute " visit at least 10 minutes are used in non-direct medical care.

Do you make " 30 minute " visits and use a 45 minute slot? Do you charge accordingly?

Curious.... Thanks in advance.

Anne

--      MD          ph    fax

--      MD          ph    fax

[Guest guest]

Absolutely! And as I try to tell the cheapo selfish insurance types, today any IMP doc might be learning something of meaningful use that does not even come into play for months or even years. But because you chatted in that comfortable small talk way and any given patient starts talking about family stuff, personal silly life things, eating habits and favorite activities, WHO KNOWS... And one day when you are half stumped with some new problem that is not cooperating and coming to you easily.... BAM, Lightbulb Moment Pops into your head....

"Oh right Mrs. told me about her family's weird this that or the other thing!!! She's not this, she's really suffering from XYZ syndrome!!!"

And some Hamster Wheel Slave of the Matrix would never had made this great insightful leap, not because of a lack of caring, knowledge, training or intelligence.... But simply because he and his patients are both victims caught up in the Matrix created to serve and cover up for, the rs and the greater Medical Industrialized Complex....

In just the last few months, has made a few of these very interesting, WOW, Lightbulb kind of insightful Diagnosis, some very unusual to say the least... Not common at all. One almost a weird, almost sounds like a Joke.... But she had two very different, many people would not have thought of them as being joined problems in a very sick patient..... But a good search of data because of this extra time to keep thinking about the folks you honestly know and are People to you, not just some random customer or patient.... Cross checked to see if there was a relationship, and darn it if these things were not Co-Morbid... This weird batch of problems this poor man has had for years and even with great well respected specialists, never was the entire batch of them properly put together... Now he and his Doc are off moving in the correct direction and for once we have that Dr. House like, this fits all of

the problems and symptoms and now we can attack help him as we all real problem....

And as someone who works here, I just love watching these incredible moments that lead to a completely different way of dealing, treating and finally giving both sides that, Ah Ha moment and understanding. It clearly is so awesome for both the doctor and their patients and family members. Even when the news is not perfect or even pleasant... Knowing, and feeling confident in what is happening to you so then you can come to terms with it and deal with it.... And hopefully treat, cure or at least manage and live with it.... And it is one of those minor miracles or good people working together, caring about one another and applying themselves to the problem sincerely.... It is so wonderful to watch and witness.... And that is why I am so very proud of my wife and all of our good friends here in this group.... I know and I read about these same "Lightbulb Moments" and your concern asking and debating

different medical conditions and symptoms and it is just so wonderful to witness... You folks are great. Keep the Faith!

To: Sent: Monday, July 11, 2011 3:52 PMSubject: RE: Re: Solo practitioner and scheduling

Well, said Jim. I agree.

Exactly, actually saves time. And you learn so much more.________________________________________From: [ ] On Behalf Of sharkinn [sharkinn@...]Sent: Saturday, July 09, 2011 1:09 PMTo: Subject: Re: Solo practitioner and scheduling

No, for established patients, it really doesn't take more than 3-5 minutes for all that. We exchange pleasantries while I am walking them from the "No-waiting" room to a seat by my desk, which is in my office/exam room. (And I frequently get a lot of info about their condition by watching them walk in.) I ask if there are any changes in their insurance (which you won't have to do), then launch into gathering the history. I weigh them at the scale that is a few steps from my desk, on the way to the exam table. Taking vitals at the beginning of the physical exam takes only a couple of minutes and gives me a lot of info. I have picked up several new-onset atrial fibs while taking the pulse and BP. Then, a few steps back to my desk to collect payment and schedule next appt, which takes only a couple of minutes. I have open access, so many folks don't need to schedule their next appt; they just call when it is time or they want

to come back. If they have a copay, which yours won't, I collect that at the beginning of the visit, so I don't forget. It all goes so much more smoothly and quickly for the patient than in a regular practice, so they love it and word gets around very quickly about how much more pleasant it is to come to your office than all the other docs. I always schedule 30-60 minute appts, since there is plenty of other stuff that can be done after visits that don't take up all the allotted time.---Sharlene---

>> I am moving towards a part-time, cash only solo practice.>> How do folks doing it solo, get patients in, vitals taken, do the medical visit, and then collect payment, schedule the next visit in the usual time frame of a visit?>> Isn't it least 5 minutes to get vitals, settle in, then 5-10 minutes to process the exit of a patient (pay bill, reschedule, etc)? So in a "30 minute" visit at least 10 minutes are used in non-direct medical care.>> Do you make "30 minute" visits and use

a 45 minute slot? Do you charge accordingly?>> Curious.... Thanks in advance.>> Anne>------------------------------------

[Guest guest]

Yes my malpractice wasn't happy either. I put a card in an index box and if the patient didn't come in when expected i.e. med should have run out my nurse gets them to schedule. I can't prebook so far out, too many no shows and just plain easier for me. The tougher ones are those who come to establish care and then never come in because they are getting all specialist care and then WHAM! suddenly very sick and guess who is called in to do home visits! My Medicare patients don't want to pay for physicals and if their cardiologist and endocrinologist are taking care of everything they see no need to see me unless sick. Suggestions?

I am moving towards a part-time, cash only solo practice.How do folks doing it solo, get patients in, vitals taken, do the medical visit, and then collect payment, schedule the next visit in the usual time frame of a visit?Isn't it least 5 minutes to get vitals, settle in, then 5-10 minutes to process the exit of a patient (pay bill, reschedule, etc)? So in a "30 minute" visit at least 10 minutes are used in non-direct medical care.Do you make "30 minute" visits and use a 45 minute slot? Do you charge accordingly?Curious.... Thanks in advance.Anne

-- MD ph fax -- MD ph fax

[Guest guest]

I set reminders in my emr tickler system when I want to see people back and then send a note by email when its time.  If needed I include lab orders to be done prior

> Yes my malpractice wasn't happy either.  I put a card in an index box and if the patient didn't come in when expected i.e. med should have run out my nurse gets them to schedule. I can't prebook so far out, too many no shows and just plain easier for me. The tougher ones are those who come to establish care and then never  come in because they are getting all specialist care and then WHAM! suddenly very sick and guess who is called in to do home visits!  My Medicare patients don't want to pay for physicals and if their cardiologist and endocrinologist are taking care of everything they see no need to see me unless sick. Suggestions?

> >

> > >   > > > > I am moving towards a part-time, cash only solo practice.> > How do folks doing it solo, get patients in, vitals taken, do the medical visit, and then collect payment, schedule the next visit in the usual time frame of a visit?

> > Isn't it least 5 minutes to get vitals, settle in, then 5-10 minutes to process the exit of a patient (pay bill, reschedule, etc)? So in a " 30 minute " visit at least 10 minutes are used in non-direct medical care.

> > Do you make " 30 minute " visits and use a 45 minute slot? Do you charge accordingly?> > Curious.... Thanks in advance.> > Anne> > > > >

> -- > > > >      MD>      >      > ph    fax >

> > > > -- > > > >      MD>      >      > ph    fax >

> > > > > > > >

[Guest guest]

i usually dont give followup, just instruct patients to call, however one of the

board questions was to give followup on patients so that question i got wrong,

somebody with diabetes with hba1c of 8.. next best step was to give appt.

go figure.

not real world..

g

> >>

> >>> **

> >>>

> >>>

> >>> I am moving towards a part-time, cash only solo practice.

> >>>

> >>> How do folks doing it solo, get patients in, vitals taken, do the medical

> >>> visit, and then collect payment, schedule the next visit in the usual time

> >>> frame of a visit?

> >>>

> >>> Isn't it least 5 minutes to get vitals, settle in, then 5-10 minutes to

> >>> process the exit of a patient (pay bill, reschedule, etc)? So in a " 30

> >>> minute " visit at least 10 minutes are used in non-direct medical care.

> >>>

> >>> Do you make " 30 minute " visits and use a 45 minute slot? Do you charge

> >>> accordingly?

> >>>

> >>> Curious.... Thanks in advance.

> >>>

> >>> Anne

> >>>

> >>>

> >>

> >>

> >> --

> >>

> >>

> >>

> >> MD

> >>

> >>

> >> ph fax

> >>

> >>

> >

> >

> >

> > --

> >

> >

> >

> > MD

> >

> >

> > ph fax

> >

> >

> >

> >

>

[Guest guest]

When I started my solo practice five years ago, I hired a medical assistant to do blood pressures, sign in the patient, draw blood etc. I spent more time teaching and correcting and communicating with her about values she obtained than it now takes me without a medical assistant to do those things myself. As one other writer here has pointed out , I can asked the patient about follow-up information since last visit  while I am wrapping the blood pressure cuff on the arm and pushing the button to measure. They step on the scale on the way to their seat. If blood draw is necessary nine times out of 10 it is not a difficult venipuncture and it takes three  min. to draw this blood. I would have to fill out the paperwork for the order anyway if they were going to lab. Paying a medical assistant, doing payroll issues, figuring taxes, unemployment reporting was much more of a hassle than measuring blood pressure in the course of the visit, at least for me.

On Mon, Jul 11, 2011 at 12:39 PM, Kennedy, Jim ( Affiliate FM-SOM ) wrote:

 

It saves time, in my estimation, because you can get information while you are doing this.

On another note, why do you want to save time? If you are running a low volume practice, one of the good things is to spend enough time to get the information, do the anticipatory guidence and do the things that make our practices special. I do my own xrays, and so when I am with the patient throughout the visit, they tell me things that they might only tell a nurse or an MA or not say at all. Face time is critical and it can begin as soon as the patient walks in the door.

There is more to a visit, than the " doctor stuff. "

 

From: [ ] On Behalf Of Anne Walch [healingpathnow@...]

Sent: Saturday, July 09, 2011 4:12 PMTo: Subject: Re: Re: Solo practitioner and scheduling

 

I can see how I might learn more by taking the vitals, but I don't see how it saves time..After all, in my prior practice one person checked them in (and it easily looked like 5 minutes min) and another person checked them out -- and that often looked like 5-10 min. And my prior practice was  also cash only.

I guess I will have to see.  I was just trying to get a feel about flow and how to schedule patients in this new solo world. I hear some of you say, schedule the same,,, Another likes  catch up time worked into the schedule.

I think I will start with a " gappy " schedule,,,, Re-registering my former patients who follow me to this new practice will take a little more time.Thanks everyone. (excuse the typos ... I have my long distant contacts in

On Sat, Jul 9, 2011 at 4:41 PM, Kennedy, Jim ( Affiliate FM-SOM ) wrote:

Exactly, actually saves time. And you learn so much more.________________________________________From: [ ] On Behalf Of sharkinn [sharkinn@...]

Sent: Saturday, July 09, 2011 1:09 PMTo: Subject: Re: Solo practitioner and scheduling

No, for established patients, it really doesn't take more than 3-5 minutes for all that. We exchange pleasantries while I am walking them from the " No-waiting " room to a seat by my desk, which is in my office/exam room. (And I frequently get a lot of info about their condition by watching them walk in.) I ask if there are any changes in their insurance (which you won't have to do), then launch into gathering the history. I weigh them at the scale that is a few steps from my desk, on the way to the exam table. Taking vitals at the beginning of the physical exam takes only a couple of minutes and gives me a lot of info. I have picked up several new-onset atrial fibs while taking the pulse and BP. Then, a few steps back to my desk to collect payment and schedule next appt, which takes only a couple of minutes. I have open access, so many folks don't need to schedule their next appt; they just call when it is time or they want to come back. If they have a copay, which yours won't, I collect that at the beginning of the visit, so I don't forget. It all goes so much more smoothly and quickly for the patient than in a regular practice, so they love it and word gets around very quickly about how much more pleasant it is to come to your office than all the other docs. I always schedule 30-60 minute appts, since there is plenty of other stuff that can be done after visits that don't take up all the allotted time.---Sharlene---

>> I am moving towards a part-time, cash only solo practice.>> How do folks doing it solo, get patients in, vitals taken, do the medical visit, and then collect payment, schedule the next visit in the usual time frame of a visit?

>> Isn't it least 5 minutes to get vitals, settle in, then 5-10 minutes to process the exit of a patient (pay bill, reschedule, etc)? So in a " 30 minute " visit at least 10 minutes are used in non-direct medical care.

>> Do you make " 30 minute " visits and use a 45 minute slot? Do you charge accordingly?>> Curious.... Thanks in advance.>> Anne>------------------------------------

[Guest guest]

Maybe some kind of automated reminder system that works with your EMR could help solve the no show/reminder problem. The one that works with my EMR sends out an email one week ahead (85% have email), a text message (SMS) three days ahead (if they have a cell phone), a voice message two days ahead, and if they haven’t  confirmed they get up to two more automated voice calls.  Most have had 4 to 5 reminders before the appointment.  They show up and no suggest I’m nagging.  Sometimes they laugh and tell me they had five reminders on their voice mail.  All reminders include a suggestion to use Instant Medical History ahead of the appointment.  Patients with special needs or preferences get a personal call.  The EMR tracks these people and provides a list. The text messaging part was recently added and has been a nice touch. Neighbors, MDHuntsville, Alabama Solo using FlexMedical EMR since 2/2009 From: [mailto: ] On Behalf Of MyriaSent: Monday, July 11, 2011 5:00 PMTo: Subject: Re: Solo practitioner and scheduling Yes my malpractice wasn't happy either. I put a card in an index box and if the patient didn't come in when expected i.e. med should have run out my nurse gets them to schedule. I can't prebook so far out, too many no shows and just plain easier for me. The tougher ones are those who come to establish care and then never come in because they are getting all specialist care and then WHAM! suddenly very sick and guess who is called in to do home visits! My Medicare patients don't want to pay for physicals and if their cardiologist and endocrinologist are taking care of everything they see no need to see me unless sick. Suggestions? I am moving towards a part-time, cash only solo practice.How do folks doing it solo, get patients in, vitals taken, do the medical visit, and then collect payment, schedule the next visit in the usual time frame of a visit?Isn't it least 5 minutes to get vitals, settle in, then 5-10 minutes to process the exit of a patient (pay bill, reschedule, etc)? So in a " 30 minute " visit at least 10 minutes are used in non-direct medical care.Do you make " 30 minute " visits and use a 45 minute slot? Do you charge accordingly?Curious.... Thanks in advance.Anne-- MD ph fax -- MD ph fax

[Guest guest]



appointment quest does this --

1) It sends out automated reminders 2 days before.

2) As you "check in" pts, the pts that do NOT come you can switch to "no show".

3) You can easily run reports through any date sequence to see who is no show.

4) I ALWAYS offer to make appts for follow up -- if over 6 months, or pt cannot commit, we keep list to "recall," very effective.

Also return business is a great business idea, and this is a business... return customers help with planning and staying open.

BTW, by "strict" development of the "open access model" there is "no prohibition" for making appts ahead as long as you have same day appts available.

Regards,

Matt Levin, MD

Solo in Western PA since 2004

FP since 1988

RE: Solo practitioner and scheduling

Maybe some kind of automated reminder system that works with your EMR could help solve the no show/reminder problem. The one that works with my EMR sends out an email one week ahead (85% have email), a text message (SMS) three days ahead (if they have a cell phone), a voice message two days ahead, and if they haven’t confirmed they get up to two more automated voice calls. Most have had 4 to 5 reminders before the appointment. They show up and no suggest I’m nagging. Sometimes they laugh and tell me they had five reminders on their voice mail. All reminders include a suggestion to use Instant Medical History ahead of the appointment. Patients with special needs or preferences get a personal call. The EMR tracks these people and provides a list. The text messaging part was recently added and has been a nice touch.

Neighbors, MD

Huntsville, Alabama

Solo using FlexMedical EMR since 2/2009

From: [mailto: ] On Behalf Of MyriaSent: Monday, July 11, 2011 5:00 PMTo: Subject: Re: Solo practitioner and scheduling

Yes my malpractice wasn't happy either. I put a card in an index box and if the patient didn't come in when expected i.e. med should have run out my nurse gets them to schedule. I can't prebook so far out, too many no shows and just plain easier for me. The tougher ones are those who come to establish care and then never come in because they are getting all specialist care and then WHAM! suddenly very sick and guess who is called in to do home visits! My Medicare patients don't want to pay for physicals and if their cardiologist and endocrinologist are taking care of everything they see no need to see me unless sick. Suggestions?

I am moving towards a part-time, cash only solo practice.How do folks doing it solo, get patients in, vitals taken, do the medical visit, and then collect payment, schedule the next visit in the usual time frame of a visit?Isn't it least 5 minutes to get vitals, settle in, then 5-10 minutes to process the exit of a patient (pay bill, reschedule, etc)? So in a "30 minute" visit at least 10 minutes are used in non-direct medical care.Do you make "30 minute" visits and use a 45 minute slot? Do you charge accordingly?Curious.... Thanks in advance.Anne

-- MD ph fax

-- MD ph fax

[Guest guest]

As most of you know AC uses its own internal office email system for staff to create special Yellow Lightlighted "Reminders" timed out at whatever intervals of time you want... Weeks, months, a year, whatever. Then we simply call, email or snail mail the patient a note that it is time to get your labs done and come have a F/U visit or what have you....

BTW, for a year or so before the reminder system was created by Jon in AC, with AC's quiet blessing for a creative work around solution, we created an extra staff member provider (because providers get space in the calender system) Dr Reminder. We simplied used Dr. Ray much in the same way that the reminder system works now and in some respects I gather our work around was sort of the model for it. It just meant programming in an extra never to go away schedule in the system that an patient could be assigned to..... If we saw in you July and wanted you back in three months for a follow up, we simply put an appointment in the calender for Dr. Ray's schedule for about two and half months out, to give us some lead time there to make the call or write the letter, send you a lab order to get done and get you in just about in a perfect 3 months for your next F/U for your lipids for

example.

It's worked just about perfectly for us for a number of years now. It's simply a matter of us making sure we stay with in and create the reminders at the time of the visit, so then we get them in the system to remind us all....

To: Sent: Tuesday, July 12, 2011 7:17 AMSubject: RE: Solo practitioner and scheduling

Maybe some kind of automated reminder system that works with your EMR could help solve the no show/reminder problem. The one that works with my EMR sends out an email one week ahead (85% have email), a text message (SMS) three days ahead (if they have a cell phone), a voice message two days ahead, and if they haven’t confirmed they get up to two more automated voice calls. Most have had 4 to 5 reminders before the appointment. They show up and no suggest I’m nagging. Sometimes they laugh and tell me they had five reminders on their voice mail. All reminders include a suggestion to use Instant Medical History ahead of the appointment. Patients with special needs or preferences get a personal call. The EMR tracks these people and provides a list. The text messaging part was recently added and has been a nice touch.

Neighbors, MD

Huntsville, Alabama

Solo using FlexMedical EMR since 2/2009

From: [mailto: ] On Behalf Of MyriaSent: Monday, July 11, 2011 5:00 PMTo: Subject: Re: Solo practitioner and scheduling

Yes my malpractice wasn't happy either. I put a card in an index box and if the patient didn't come in when expected i.e. med should have run out my nurse gets them to schedule. I can't prebook so far out, too many no shows and just plain easier for me. The tougher ones are those who come to establish care and then never come in because they are getting all specialist care and then WHAM! suddenly very sick and guess who is called in to do home visits! My Medicare patients don't want to pay for physicals and if their cardiologist and endocrinologist are taking care of everything they see no need to see me unless sick. Suggestions?

I am moving towards a part-time, cash only solo practice.How do folks doing it solo, get patients in, vitals taken, do the medical visit, and then collect payment, schedule the next visit in the usual time frame of a visit?Isn't it least 5 minutes to get vitals, settle in, then 5-10 minutes to process the exit of a patient (pay bill, reschedule, etc)? So in a "30 minute" visit at least 10 minutes are used in non-direct medical care.Do you make "30 minute" visits and use a 45 minute slot? Do you charge accordingly?Curious.... Thanks in advance.Anne

-- MD ph fax

-- MD ph fax

[Guest guest]

, Which EMR are you using that does email, text AND voice msg reminders?   MIght it be a free EMR?  And thanks for the tip re the Instant Medical History --I'll check that out.thanks, Anne

 

Maybe some kind of automated reminder system that works with your EMR could help solve the no show/reminder problem. The one that works with my EMR sends out an email one week ahead (85% have email), a text message (SMS) three days ahead (if they have a cell phone), a voice message two days ahead, and if they haven’t  confirmed they get up to two more automated voice calls.  Most have had 4 to 5 reminders before the appointment.  They show up and no suggest I’m nagging.  Sometimes they laugh and tell me they had five reminders on their voice mail.  All reminders include a suggestion to use Instant Medical History ahead of the appointment.  Patients with special needs or preferences get a personal call.  The EMR tracks these people and provides a list. The text messaging part was recently added and has been a nice touch.

  Neighbors, MD

Huntsville, Alabama Solo using FlexMedical EMR since 2/2009

 From: [mailto: ] On Behalf Of Myria

Sent: Monday, July 11, 2011 5:00 PMTo: Subject: Re: Solo practitioner and scheduling

   Yes my malpractice wasn't happy either.  I put a card in an index box and if the patient didn't come in when expected i.e. med should have run out my nurse gets them to schedule. I can't prebook so far out, too many no shows and just plain easier for me. The tougher ones are those who come to establish care and then never  come in because they are getting all specialist care and then WHAM! suddenly very sick and guess who is called in to do home visits!  My Medicare patients don't want to pay for physicals and if their cardiologist and endocrinologist are taking care of everything they see no need to see me unless sick. Suggestions?

  I am moving towards a part-time, cash only solo practice.How do folks doing it solo, get patients in, vitals taken, do the medical visit, and then collect payment, schedule the next visit in the usual time frame of a visit?

Isn't it least 5 minutes to get vitals, settle in, then 5-10 minutes to process the exit of a patient (pay bill, reschedule, etc)? So in a " 30 minute " visit at least 10 minutes are used in non-direct medical care.

Do you make " 30 minute " visits and use a 45 minute slot? Do you charge accordingly?Curious.... Thanks in advance.Anne

--      MD         

ph    fax

--      MD          ph    fax

[Guest guest]

whoops...there it is: Flex Medical....

 

Maybe some kind of automated reminder system that works with your EMR could help solve the no show/reminder problem. The one that works with my EMR sends out an email one week ahead (85% have email), a text message (SMS) three days ahead (if they have a cell phone), a voice message two days ahead, and if they haven’t  confirmed they get up to two more automated voice calls.  Most have had 4 to 5 reminders before the appointment.  They show up and no suggest I’m nagging.  Sometimes they laugh and tell me they had five reminders on their voice mail.  All reminders include a suggestion to use Instant Medical History ahead of the appointment.  Patients with special needs or preferences get a personal call.  The EMR tracks these people and provides a list. The text messaging part was recently added and has been a nice touch.

  Neighbors, MD

Huntsville, Alabama Solo using FlexMedical EMR since 2/2009

 From: [mailto: ] On Behalf Of Myria

Sent: Monday, July 11, 2011 5:00 PMTo: Subject: Re: Solo practitioner and scheduling

   Yes my malpractice wasn't happy either.  I put a card in an index box and if the patient didn't come in when expected i.e. med should have run out my nurse gets them to schedule. I can't prebook so far out, too many no shows and just plain easier for me. The tougher ones are those who come to establish care and then never  come in because they are getting all specialist care and then WHAM! suddenly very sick and guess who is called in to do home visits!  My Medicare patients don't want to pay for physicals and if their cardiologist and endocrinologist are taking care of everything they see no need to see me unless sick. Suggestions?

  I am moving towards a part-time, cash only solo practice.How do folks doing it solo, get patients in, vitals taken, do the medical visit, and then collect payment, schedule the next visit in the usual time frame of a visit?

Isn't it least 5 minutes to get vitals, settle in, then 5-10 minutes to process the exit of a patient (pay bill, reschedule, etc)? So in a " 30 minute " visit at least 10 minutes are used in non-direct medical care.

Do you make " 30 minute " visits and use a 45 minute slot? Do you charge accordingly?Curious.... Thanks in advance.Anne

--      MD         

ph    fax

--      MD          ph    fax

[Guest guest]

when you do open access you get few no shows.Jean

 

whoops...there it is: Flex Medical....

 

Maybe some kind of automated reminder system that works with your EMR could help solve the no show/reminder problem. The one that works with my EMR sends out an email one week ahead (85% have email), a text message (SMS) three days ahead (if they have a cell phone), a voice message two days ahead, and if they haven’t  confirmed they get up to two more automated voice calls.  Most have had 4 to 5 reminders before the appointment.  They show up and no suggest I’m nagging.  Sometimes they laugh and tell me they had five reminders on their voice mail.  All reminders include a suggestion to use Instant Medical History ahead of the appointment.  Patients with special needs or preferences get a personal call.  The EMR tracks these people and provides a list. The text messaging part was recently added and has been a nice touch.

  Neighbors, MD

Huntsville, Alabama 

Solo using FlexMedical EMR since 2/2009

 From: [mailto: ] On Behalf Of Myria

Sent: Monday, July 11, 2011 5:00 PMTo: Subject: Re: Solo practitioner and scheduling

   Yes my malpractice wasn't happy either.  I put a card in an index box and if the patient didn't come in when expected i.e. med should have run out my nurse gets them to schedule. I can't prebook so far out, too many no shows and just plain easier for me. The tougher ones are those who come to establish care and then never  come in because they are getting all specialist care and then WHAM! suddenly very sick and guess who is called in to do home visits!  My Medicare patients don't want to pay for physicals and if their cardiologist and endocrinologist are taking care of everything they see no need to see me unless sick. Suggestions?

  I am moving towards a part-time, cash only solo practice.

How do folks doing it solo, get patients in, vitals taken, do the medical visit, and then collect payment, schedule the next visit in the usual time frame of a visit?

Isn't it least 5 minutes to get vitals, settle in, then 5-10 minutes to process the exit of a patient (pay bill, reschedule, etc)? So in a " 30 minute " visit at least 10 minutes are used in non-direct medical care.

Do you make " 30 minute " visits and use a 45 minute slot? Do you charge accordingly?Curious.... Thanks in advance.Anne

--      MD    

    

ph    fax

--      MD          ph    fax

--      MD          ph    fax

[Guest guest]

But the ones who do are repeaters in my book. So I'm starting to send letters that they will be charged a no show fee.

I am moving towards a part-time, cash only solo practice.How do folks doing it solo, get patients in, vitals taken, do the medical visit, and then collect payment, schedule the next visit in the usual time frame of a visit?Isn't it least 5 minutes to get vitals, settle in, then 5-10 minutes to process the exit of a patient (pay bill, reschedule, etc)? So in a "30 minute" visit at least 10 minutes are used in non-direct medical care.Do you make "30 minute" visits and use a 45 minute slot? Do you charge accordingly?Curious.... Thanks in advance.Anne

-- MD ph fax

-- MD ph fax

-- MD ph fax

[Guest guest]



Just don't reschedule 'em....

We've discussed no-show fees in past, pts usually just disappear and they don't pay em.

Good luck...I think it's more effective with those pts to mark them as "chronic NS" in the scheduler. I won't let them schedule ahead, just the same day.

Matt in Western PA

Solo FP since 2004

FP since 1988

Re: Solo practitioner and scheduling

But the ones who do are repeaters in my book. So I'm starting to send letters that they will be charged a no show fee.

I am moving towards a part-time, cash only solo practice.How do folks doing it solo, get patients in, vitals taken, do the medical visit, and then collect payment, schedule the next visit in the usual time frame of a visit?Isn't it least 5 minutes to get vitals, settle in, then 5-10 minutes to process the exit of a patient (pay bill, reschedule, etc)? So in a "30 minute" visit at least 10 minutes are used in non-direct medical care.Do you make "30 minute" visits and use a 45 minute slot? Do you charge accordingly?Curious.... Thanks in advance.Anne

-- MD ph fax

-- MD ph fax

-- MD ph fax

[Guest guest]

I have that in my Billing Agreement that all pts sign when they

join my practice –that they will be charged for the no shows.

Eads, MD

Pinnacle Family Medicine

Colorado Springs, CO

www.PinnacleFamilyMedicine.com

From:

[mailto: ] On Behalf Of Myria

Sent: Tuesday, July 12, 2011 5:11 PM

To:

Subject: Re: Solo practitioner and scheduling

But the ones who do are repeaters in my book. So I'm

starting to send letters that they will be charged a no show fee.

I am moving towards a part-time, cash only

solo practice.

How do folks doing it solo, get patients in, vitals taken, do the medical

visit, and then collect payment, schedule the next visit in the usual time

frame of a visit?

Isn't it least 5 minutes to get vitals, settle in, then 5-10 minutes to

process the exit of a patient (pay bill, reschedule, etc)? So in a " 30

minute " visit at least 10 minutes are used in non-direct medical care.

Do you make " 30 minute " visits and use a 45 minute slot? Do you

charge accordingly?

Curious.... Thanks in advance.

Anne

--

MD

ph fax

--

MD

ph fax

--

MD

ph fax

[Guest guest]

I use FlexMedical by Oceris. You can google them if you wish. I came across them because they have their home office in Huntsville, Alabama where my practice is located. Not sure what support they offer outside of the Southeast. From: [mailto: ] On Behalf Of Anne WalchSent: Tuesday, July 12, 2011 7:41 AMTo: Subject: Re: Solo practitioner and scheduling , Which EMR are you using that does email, text AND voice msg reminders? MIght it be a free EMR? And thanks for the tip re the Instant Medical History --I'll check that out.thanks, Anne Maybe some kind of automated reminder system that works with your EMR could help solve the no show/reminder problem. The one that works with my EMR sends out an email one week ahead (85% have email), a text message (SMS) three days ahead (if they have a cell phone), a voice message two days ahead, and if they haven’t confirmed they get up to two more automated voice calls. Most have had 4 to 5 reminders before the appointment. They show up and no suggest I’m nagging. Sometimes they laugh and tell me they had five reminders on their voice mail. All reminders include a suggestion to use Instant Medical History ahead of the appointment. Patients with special needs or preferences get a personal call. The EMR tracks these people and provides a list. The text messaging part was recently added and has been a nice touch. Neighbors, MDHuntsville, Alabama Solo using FlexMedical EMR since 2/2009 From: [mailto: ] On Behalf Of MyriaSent: Monday, July 11, 2011 5:00 PMTo: Subject: Re: Solo practitioner and scheduling Yes my malpractice wasn't happy either. I put a card in an index box and if the patient didn't come in when expected i.e. med should have run out my nurse gets them to schedule. I can't prebook so far out, too many no shows and just plain easier for me. The tougher ones are those who come to establish care and then never come in because they are getting all specialist care and then WHAM! suddenly very sick and guess who is called in to do home visits! My Medicare patients don't want to pay for physicals and if their cardiologist and endocrinologist are taking care of everything they see no need to see me unless sick. Suggestions? I am moving towards a part-time, cash only solo practice.How do folks doing it solo, get patients in, vitals taken, do the medical visit, and then collect payment, schedule the next visit in the usual time frame of a visit?Isn't it least 5 minutes to get vitals, settle in, then 5-10 minutes to process the exit of a patient (pay bill, reschedule, etc)? So in a " 30 minute " visit at least 10 minutes are used in non-direct medical care.Do you make " 30 minute " visits and use a 45 minute slot? Do you charge accordingly?Curious.... Thanks in advance.Anne-- MD ph fax -- MD ph fax

[Guest guest]

I have it in mine also, and I collect about once a month.

To: Sent: Tuesday, July 12, 2011 8:39:05 PMSubject: RE: Solo practitioner and scheduling

I have that in my Billing Agreement that all pts sign when they join my practice –that they will be charged for the no shows.

Eads, MD

Pinnacle Family Medicine

Colorado Springs, CO

www.PinnacleFamilyMedicine.com

From: [mailto: ] On Behalf Of MyriaSent: Tuesday, July 12, 2011 5:11 PMTo: Subject: Re: Solo practitioner and scheduling

But the ones who do are repeaters in my book. So I'm starting to send letters that they will be charged a no show fee.

I am moving towards a part-time, cash only solo practice.How do folks doing it solo, get patients in, vitals taken, do the medical visit, and then collect payment, schedule the next visit in the usual time frame of a visit?Isn't it least 5 minutes to get vitals, settle in, then 5-10 minutes to process the exit of a patient (pay bill, reschedule, etc)? So in a "30 minute" visit at least 10 minutes are used in non-direct medical care.Do you make "30 minute" visits and use a 45 minute slot? Do you charge accordingly?Curious.... Thanks in advance.Anne

-- MD ph fax

-- MD ph fax

-- MD ph fax

[Guest guest]

I might try that. Thanks for the idea.

I am moving towards a part-time, cash only solo practice.How do folks doing it solo, get patients in, vitals taken, do the medical visit, and then collect payment, schedule the next visit in the usual time frame of a visit?Isn't it least 5 minutes to get vitals, settle in, then 5-10 minutes to process the exit of a patient (pay bill, reschedule, etc)? So in a "30 minute" visit at least 10 minutes are used in non-direct medical care.Do you make "30 minute" visits and use a 45 minute slot? Do you charge accordingly?Curious.... Thanks in advance.Anne

-- MD ph fax

-- MD ph fax

-- MD ph fax