What's New
Making Sense of Your Appointments at the Clinic
Patients frequently are unaware there are different categories of appointments, or what is involved in a complete physical. They will certainly get frustrated by problems with insurance coverage that may result from an appointment-type miscommunication after a visit. Not only do different types of appointments block out different lengths of time, but a
provider anticipates what to plan for in advance for a certain visit type, and from an insurance perspective, the appointment type will define how the charges are identified and may have different payment coverage. When patients, staff and insurance all have the same understanding of the appointment type, provider schedules become more “on time”, fewer insurance billing problems arise, and patient satisfaction improves.
Here is a description of the Appointment Types.
Please ask your physician any questions regarding this and be sure to ask your doctor or the clinic staff what type of visit you should schedule for any visit when needed.
1. Ill Visit/Acute Care Visit / Urgent Visit / New Problem Visit
• People may refer to this visit type with any of the above phrases. This visit is typically kept focused on the symptom or condition the patient is concerned about.
• It is scheduled to deal with a single acute problem with usually a 10-15 minute schedule block. Often a schedule has time kept open just for these same day calls.
• From an insurance standpoint labs ordered to help with determining a diagnosis are linked to the problem and are reimbursed different from general screening tests.
• Clinic staff may identify some health care maintenance issue to catch up and add that to an acute visit or may remind you to schedule another visit. When a patient has a serious illness, this may indeed take much longer than the allotted time, but taking
care of the urgently sick patient is always the priority.
2. Medication Check / Chronic Disease Follow Up / Health Maintenance Visit
• This appointment type is often the 2-4 visits per year for many adults dealing with a chronic health condition. Typically one or several ongoing chronic health conditions
are reviewed with usually a 15-20 minute schedule block of time.
• The purpose is to obtain necessary labs needed for monitoring the condition, and for provider and staff to update chronic medications and make necessary adjustments to doses.
• Insurance usually will cover labs, but may cover only a certain number per year and billing problems may result if a patient gets duplicated labs from a subspecialist like a cardiologist and a family medicine doctor. At this visit labs are generally tied to the health condition diagnosis and are also not considered screening labs.
• Clinic staff may identify other health care maintenance issues, such as updating vaccines, but there is minimal time in this appointment block for any additional new problems.
3. Well Visit / Complete Physical / Physical Exam / Pap / Preventive Visit
• This appointment type is generally more of a provider driven visit that deals with recommended health screening, immunizations and reviews individualized healthy behavior counseling, where the goal is to let patients know how their health is overall.
• Insurance often separates this appointment from billing categories for an ill visit with
different rules regarding co-pays and whether the costs apply to a deductible. Depending on the policy insurance may cover a preventive visit yearly or every 2-5 years. For women they may consider a gynecologist exam as a preventive visit. Insurance may or may not cover screening labs depending on family history or personal risk for disease, and the
particular policy. Patient concerns about a health problem if brought up at this appointment may be best handled at a new problem or ill visit.
4. Procedure Visit
• This visit deals with skin biopsies, mole removals, some cosmetic procedures, diagnostic procedures and other simple surgical procedures.
• Each procedure has a certain level of time assigned depending on whether the procedure is anticipated to be simple or more complex and varies from 15 minutes to 1 hour. This visit also usually requires a procedure room and supplies to be reserved and
confirmed.
• Insurance may vary payment depending on rules for a deductible, if it is elective, if it is to be handled in a surgical facility or clinic facility, or if it possibly work-related.
5. Worker’s Compensation Visit
• Work-related injuries and problems may be handled at FHSM depending on the
employers rules.
• The clinic will only bill a worker’s compensation company, therefore chronic or other problems notwork related cannot be added to the visit as that is covered only by your health insurance. No other health maintenance issues can be added to this exam, except perhaps a tetanus booster for a work injury.
6. Lab Visit
• A scheduled time to get blood, urine or other tests and immunizations/injections.
• This is not a time where you will meet with a physician and not part of a provider’s schedule.
• Insurance often does not require a co-pay for this type of visit.
The Following are Tips to Make Your Next
Appointment Scheduling Phone Call Much Easier
Examine your schedule. Take the time to look over your home and work calendars. Choose your most desired dates and times according to your schedule. Write them down to refer to while on the appointment scheduling phone call. Prepare and make the phone
call in privacy. You should make the appointmentscheduling phone call during clinic hours.
Try to avoid calling during peak call times which include the minutes shortly before office opening and office closing as well as lunch time. It is also extremely important that both parties are able to be heard while scheduling the appointment. Make sure you are calling from a room that is free from excess noise.
Gather your personal information. The appointment scheduler may need information such as your name, social security number, and insurance carrier. Depending on the appointment type, you may need to give health information as well. Be sure to provide
detailed information such as known allergies and symptom onset.
Remember, YOU are the expert on your medical history.
For an acute visit please let the clinic know the one problem you need to get evaluated. For a medicine check visit please ask if there is time blocked to also handle any new issue or problem you might have. For a well visit, minor problems may get some advice, but if you have a significant problem a separate visit is usually required. During a lab visit you will not have an opportunity to meet with the doctor.
If our patients understand what the clinic and the insurance company are expecting about each visit, we hope patients will better understand why some issues are asked to be rescheduled. We also hope it will help providers stay on time with less unexpected issues at an appointment creating time delays, and even more important we hope the patients overall experience will be improved with everything going just as expected and as scheduled!
View Current News View Archived News