Clinical Assistance for Management and Treatment

Referral coordination: Your doctor may already have a list of doctors, for example, retina specialists, that they refer their patients to. Discuss with your doctor or office manager where to find this list of doctors. Additional items to note: does your office schedule the appointment, or does the patient? Are you able to provide directions upon request? Are you responsible for sending the chart information over to the referred office? ​

Scheduling ordered tests: Your doctor may choose to order tests as a result of the patient’s symptoms or diagnosis. The best practice recommendation would be to schedule the patient while they are in the exam room per the doctor’s request. Continue to cultivate value in your services by paying attention to your words. Staying away from words like “monitor”. For example, saying, “Dr. Lee needs to evaluate any changes to your condition in 3 months, and has ordered visual fields test for you. Let’s get that scheduled for you today.” This sounds more important than, “Dr. Lee needs to monitor you, and would like to see you back in 3 months for a test.” This primarily will be discussed by the doctor in the exam room, but it’s important that we use similar semantics to create a consistent culture. ​

​Pharmacy: At the conclusion of the office visit your doctor may prescribe drops, ointments, or oral medications for a patient. Discuss with your doctor or office manager your office protocol. Is this sent electronically? Are you printing a copy for the patient to take? Does the doctor need to sign the prescription? In what instances are you using a signature stamp? This may be dependent upon your state regulations. Will you need to call in the prescription for the patient? Do we have pharmacy information for the patient documented for future reference? Where are we collectively documenting that this has been completed, so that the doctor can refer to it later and know this has been completed? You may need to call in a prior authorization or refill request for the patient. Are there any prescription coupons or savings to extend to the patient? Sometimes a pharmacy may call back and will need to request a change in medication due to allergies or insurance coverage. Determine how you will review this in your office. It is important to relay this information to the doctor, as there are some instances where the patient may need to stay on a specific medication regardless of insurance coverage. Always be sure to notate ANY prescription change in the patient chart as it pertains to their treatment plan, and is important in any follow-up visit. ​

Tracking medical office visits: How do we know if all of the tests ordered by the doctor have been scheduled at their next appointment? Check with your practice management software systems to see if there is a way to generate a report. The best practice is reviewing at the end of each day. Are there any patients they did not schedule and we need to follow up with them the next day? Another component of tracking medical office visits; did those patients actually come in for their scheduled appointments? The test ordered may indicate progression or worsening of a condition or disease. If we let the patient miss this appointment, this may be a case where the damage is done, and we’d wish we’d worked harder to get them in and not let them fall through the cracks. Be an advocate for the patient’s health and vision. We hope to always see healthy eyes, but if there is an opportunity to intervene before significant permanent damage is done, we should strive to prevent that.