Question

For a hospital, how would the good processes be for making appointment, doing diagnosis, scheduling treatment, process billing/payment/insurance?

Answer 1

For any set of activities that are recurring, it is good to have a robust process that keeps evolving to incorporate all the operational risks and activities.

In case of a hospital where the key steps are making an appointment, diagnosis of the concern, scheduling a treatment and eventually the payment/billing process. Lets try and ad the important activities that should be a part of a good process for the different operational activities

1. Making an Appointment

Registration of the patient (New Patient) - May be providing a patient ID

Adding visit (Returning patient); using Patient ID to track previous visits

Availability of the Physician for the said appointment

Getting a declaration for use of PII/NPI Information(Legal Requirement in some regions)

Making information available to the Physician

Recording the name of the receptionist/booking agent with time stamp

Capturing Insurance Information, possibly with policy number

2. Doing Diagnosis; Rather tracking the diagnosis and sharing it with the patient.

Providing a standard template for recording observation/diagnosis

Live update of inputs by the physician

Making a copy of diagnosis with prescription available to the patient post the consultation.

Suggesting/Scheduling a followup appointment as per the prescription

3. Scheduling Treatment

Based on the diagnosis, scheduling a followup appointment

In case of immediate treatment, automatically blocking time of technicians needed for treatment
locking of necessary rooms e.g. ICU, Operation Theatre etc.

Getting necessary acknowledgments, declaration done (Using a checklist)

4. Billing Process

Right from the time of entry of the patient, keeping a track of the costs involved

Sending timely updates of the cost being incurred

informing the terms of bling at the time of registration or admission

Intimating the Insurance incase needed proactively

providing details of mode of payment

transparent details of billing summary

The above details may not be exhaustive, however are very much needed for a good process for the above activities.