clinical-outpatient/SOPs/Patient-Care/SOP-OPT-001-Appointment-Management.md

Standard Operating Procedure: Outpatient Appointment Management

Document ID	SOP-OPT-001
Title	Outpatient Appointment Scheduling and Management
Revision	1.0
Effective Date	[DATE]
Author	[AUTHOR]
Approved By	[APPROVER]
Department	Outpatient Services

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1. Purpose

To establish standardized procedures for scheduling, managing, and documenting outpatient appointments to ensure efficient clinic operations, optimize provider schedules, and enhance patient access to care.

2. Scope

This procedure applies to all outpatient appointment scheduling including:

• New patient appointments
• Follow-up appointments
• Procedure appointments
• Telehealth visits
• Same-day/urgent appointments
• Specialist referrals

3. Responsibilities

3.1 Scheduling Staff

• Schedule appointments per protocols
• Verify insurance and authorizations
• Communicate appointment details to patients
• Manage appointment reminders

3.2 Front Desk Staff

• Complete patient check-in/check-out
• Collect copays and outstanding balances
• Update patient demographics
• Schedule follow-up appointments

3.3 Clinical Staff

• Prepare patients for encounters
• Document clinical information
• Communicate provider schedules

3.4 Providers

• Adhere to schedule templates
• Communicate scheduling preferences
• Approve schedule modifications

4. Definitions

Term	Definition
New Patient	Patient not seen by practice within past 3 years
Established Patient	Patient seen within past 3 years
Slot	Designated time block for specific appointment type
Template	Schedule structure defining available appointment types
No-Show	Patient who fails to appear for scheduled appointment

5. Procedure

5.1 Appointment Scheduling

5.1.1 Information to Collect

Required Information	Check
Patient full legal name	☐
Date of birth	☐
Contact phone number(s)	☐
Email address (optional)	☐
Insurance information	☐
Referring provider (if applicable)	☐
Reason for visit	☐
Preferred appointment times	☐

5.1.2 Appointment Type Selection

Appointment Type	Duration	Notes
New Patient Comprehensive	60 min	Full history and physical
New Patient Focused	30-45 min	Single concern
Established Patient Follow-up	15-20 min	Routine follow-up
Established Patient Extended	30-40 min	Complex issues
Procedure	Varies	Per procedure type
Telehealth	15-30 min	Virtual visit
Same-Day/Urgent	15-20 min	Acute concerns

5.1.3 Scheduling Process

1. Verify Patient Status

   • New vs. established patient
   • Check for alerts or special needs
   • Review last visit date

2. Match Appointment Type

   • Assess reason for visit
   • Select appropriate appointment type
   • Confirm duration adequate for needs

3. Find Available Slot

   • Check provider availability
   • Offer multiple date/time options
   • Consider patient preferences

4. Complete Booking

   • Confirm appointment details
   • Verify contact information
   • Document special requests

5. Provide Appointment Information

   • Appointment date and time
   • Location and parking information
   • Pre-appointment instructions
   • What to bring (insurance, ID, referral, etc.)
   • Cancellation policy

5.2 Appointment Reminders

Reminder Type	Timing	Method
Initial confirmation	At scheduling	Verbal + written
First reminder	7 days prior	Automated call/text/email
Second reminder	2-3 days prior	Automated call/text/email
Final reminder	1 day prior	Automated call/text/email

5.3 Check-In Process

1. Patient Arrival

   • Greet patient professionally
   • Verify identity (photo ID)
   • Confirm appointment details

2. Registration Update

   • Review and update demographics
   • Verify insurance information
   • Collect copies of cards if changed
   • Verify emergency contact

3. Documentation Collection

   • Obtain referral authorization (if required)
   • Collect completed forms
   • Obtain signatures as needed

4. Financial

   • Verify insurance eligibility
   • Collect copay
   • Discuss outstanding balances
   • Arrange payment plans if needed

5. Clinical Handoff

   • Note patient arrival in system
   • Alert clinical staff
   • Provide estimated wait time if delayed

5.4 Check-Out Process

1. Schedule Follow-up

   • Review provider orders for follow-up timing
   • Offer appointment options
   • Provide written confirmation

2. Orders and Referrals

   • Provide lab/imaging orders
   • Explain referral process
   • Schedule procedures as indicated

3. Financial Close

   • Collect any additional payments
   • Provide receipts
   • Explain billing process

4. Patient Materials

   • After visit summary
   • Educational materials
   • Prescription information

5.5 No-Show Management

1. Same-Day Follow-up

   • Attempt to contact patient
   • Document contact attempts
   • Offer rescheduling

2. Documentation

   • Mark appointment as no-show
   • Document reason if known
   • Note rescheduling attempts

3. Pattern Identification

   • Track chronic no-shows
   • Implement interventions:
     • Phone reminders
     • Require confirmation
     • Consider scheduling policies

4. Clinical Considerations

   • Flag urgent clinical needs
   • Notify provider if clinically significant
   • Send follow-up communication per policy

5.6 Cancellations and Rescheduling

Patient-Initiated

1. Document reason for cancellation
2. Offer alternative dates
3. Update appointment status
4. Fill vacated slot if possible

Provider-Initiated

1. Notify affected patients promptly
2. Offer alternative dates/providers
3. Document reason
4. Prioritize by clinical urgency

5.7 Wait List Management

1. Add to Wait List

   • Earlier date desired
   • Specific provider requested
   • Urgent clinical need

2. Work Wait List

   • Check daily for openings
   • Contact patients in priority order
   • Update list status

6. Special Situations

6.1 Same-Day Appointments

• Reserve slots for urgent needs
• Assess acuity to determine appropriateness
• Document medical necessity

6.2 Telehealth Appointments

• Verify technology capability
• Provide access instructions
• Confirm consent for telehealth
• Test connection before appointment

6.3 Interpreter Services

• Identify language needs at scheduling
• Arrange interpreter services in advance
• Allow additional appointment time
• Document interpreter used

7. Documentation

• FRM-OPT-001 New Patient Registration
• FRM-OPT-002 Insurance Verification
• Appointment confirmation letter/text
• Check-in/check-out log

8. Quality Metrics

Metric	Target
Schedule utilization	>85%
No-show rate	<10%
Same-day cancellation rate	<5%
Wait time to appointment (new patients)	Per specialty benchmark
Patient satisfaction with scheduling	>90%

9. References

• Practice management policies
• Insurance contract requirements
• State and federal regulations

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Revision History

Rev	Date	Description	Author
1.0	[DATE]	Initial release	[AUTHOR]