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paularyfa
Premolar I

No Show hard entries being put into chart

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I called with two occurrences in the last week where we had patients seen and the patient's chart had a hard coded entry from patient flow (per cust. service) that the patient was a NO SHOW. The patient was checked in and out from their appointment as well as a note entry for what the day's visit entailed.  I was told by the escalations rep that we should never add patients to the schedule the same day and that only changes to the schedule same day should be made via patient flow, but I am not certain how that would work when I cannot choose the time for them to be seen, nor the amount of time for the appointment, nor does it show up on the hard schedule.  Can you please explain patient flow, how it integrates with the schedule, how we are supposed to book, cancel, or change time of same day appointments so that it doesn't hard code a fail entry or come up as a no show. Also, I was told that an entry is automatically made by Orthotrac in the patient's chart when they fail, but that isn't the case.  At this point, I am uncertain as to how we should be using the schedule and patient flow. Thx. 

 

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Moderator
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Re: No Show hard entries being put into chart

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Good day Paula ( @paularyfa ),

I have reviewed the notes from Yomika's discussion with you.  What she told you was correct but I think you may have partially gotten the wrong impression about something.  It is not the case that you should never add appointments to the schedule on the same day; if this were the case, you would have no way to record visits for a patient who is making an emergency appointment, walks in unannounced, or just wants to reschedule to a different time. It is true, however, that changes to existing, already-made appointments which were on the schedule at the time patient flow was loaded must be made through patient flow itself using the method she showed you.  

For example, let's take a patient who is on the schedule at 4:30 in the afternoon.  You load patient flow for the day, which reads all appointments from the schedule and loads them into patient flow.  You then get a call from this patient and they say they want to come in at 3:00 instead.  

From the patient flow window, you right click the 4:30 appointment for that patient and select "Change Location".  Then select the "Cancelled" radio button and click OK.  The following screen will appear:

Screenshot 1.png

In this case you would select the second option, to remove the appointment from the schedule.  Doing this will delete the appointment from the schedule day itself, will set the appointment as "Cancelled by office" in the patient's Schedule History, and will cause the appointment to NOT be marked as a No Show.  If you select the first option, the appointment will be left on the schedule calendar, will be marked as a No Show at the end of the day, and will only show "Cancelled" on patient flow itself. 

If you cancel the appointment from outside patient flow via the Schedule screen, the appointment will be removed from the calendar but will be marked as a No-Show when the end of day report is run because it had already been loaded into patient flow at that point. 

Next, you would schedule a new appointment for the patient.  If the patient is already in the office and you want to add this specifically as a walk-in, you would click the "Add Patient" button at the bottom of the Patient Flow window, then select the patient from the patient look-up.  The following screen appears:

Screenshot 2.png

Choose the appointment type and chair and click OK and the patient will be added as a walk-in appointment. Appointments added in this way will not be recorded on the actual schedule calendar itself and will show a "Walk-In" entry in Charting when the visit information is saved. 

If the patient is not yet in the office, you can add the new appointment as an actual scheduled appointment.  Schedule the appointment as usual through the Schedule screen and it will be added to Patient Flow when you exit the Schedule screen.  Adding a new appointment to patient flow presents no difficulties and requires no special steps. Assuming that you check the patient in normally and check them out normally through patient flow, they will be recorded as a completed appointment with no Walk-In entry for that appointment and no No-Show entry either. 

Regards,

Phil Carter / OrthoTrac Escalations

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paularyfa
Premolar I

Re: No Show hard entries being put into chart

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Thanks I think I understand a little better.  What happens to place a no show entry into the patient's chart? I had true no shows that have nothing as chart entries and patients who came in with a no show entry. 

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Re: No Show hard entries being put into chart

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Good day Paula ( @paularyfa ), 

Several possible situations will cause a No Show entry to be written for the patient:

1.  The patient is scheduled for an appointment and really doesn't show up for the appointment so they are not checked into or through Patient Flow.  When the No-Show report is run at the end of the day, the patient is marked as a No-Show. 

2.  The patient is scheduled for an appointment on the day.   Patient Flow is loaded, then the patient calls to cancel the appointment.  The appointment is cancelled outside of patient flow (through Scheduling).  When the No-Show report is run at the end of the day, the patient is marked as a No-Show.  

3.  The patient is scheduled for an appointment on the day.   Patient Flow is loaded, then the patient calls to reschedule the appointment.  The original appointment is cancelled outside of patient flow (through Scheduling).  Even though a second appointment was made and the patient kept that, when the No-Show report is run at the end of the day, the patient is marked as a No-Show for the original appointment. 

4. The patient is scheduled for more than one appointment on the day.  Patient Flow is loaded and the patient is properly checked in and checked out for one of the appointments, but not the other.  When the No-Show report is run at the end of the day, the appointment that the patient wasn't checked in/out for will be marked as a No-Show. 

5.  The patient is scheduled for an appointment on the day.  The patient is extremely late for their appointment (more than the number of minutes defined in the Time Constraints section of Patient Flow Options).  Even if the patient shows up for their appointment, they will still be marked as a No Show when the No Show report is run at the end of the day, because they were so late. 

The only ways I know of that will cause an patient who didn't show up for their scheduled appointment to NOT be marked as a No-Show is that either the No-Show report itself was not run for that day, or the patient was checked through patient flow even though they were not seen. 

Regards,

Phil Carter / OrthoTrac Escalations

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paularyfa
Premolar I

Re: No Show hard entries being put into chart

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How do we avoid the hard coded no show entry then if a patient is late but we see them anyway? Thx.

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Re: No Show hard entries being put into chart

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Good day Paula ( @paularyfa ),

If you have your Time Constraints in Patient Flow set to a time which causes a patient to be marked as a no-show after being XX amounts late for their appointment, there is no way to avoid a "No Show" entry entirely.  I should point out, though, that the "No Show" entry for a patient who is very late but did actually show up for their appointment and was checked through pat flow is not the same as a patient who never showed up at all / was never checked through at all. 

A patient who is marked as a No Show because they were late, but were actually checked through patient flow, will have an entry in Charting marked like this, in the Early/Late column:

No Show - Late.png

A patient who is marked as a No Show because they were never checked through patient flow at all will have an entry in Charting marked like this, in the actual Notes section  (and in patient tracking as well):

No Show - True.png

I hope this helps make the difference clearer. 

Regards,

Phil Carter / OrthoTrac Escalations

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paularyfa
Premolar I

Re: No Show hard entries being put into chart

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Thanks for the clarification.  Understanding a little better.  The confusion lies with us never getting hard chart entries for people who are truly no shows unless we type them ourselves.  It's just confusing that it puts the entry when they are there but doesn't when the are a true appointment fail.

 

Separate from that can you look at my additional question on statements when you have a minute? Thx much.

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Re: No Show hard entries being put into chart

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Good day Paula  ( @paularyfa ),

As I said, "No Show" entries only get created when the No Show report is run.  If you run that report on a daily basis you will not see any problems with actual no shows not being marked as a no-show. 

Regards,

Phil Carter / OrthoTrac Escalations

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paularyfa
Premolar I

Re: No Show hard entries being put into chart

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Hurray for Jabazz!! (sorry if I spelled your name wrong!!)  There was a setting not clicked on charting options.  no show now hard populates in chart.

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