Checking for Messages and/or Faxes

Someone must review messages and prepare the telephone system for the day’s activities. The telephone message must be switched from the night and weekend message to the telephone system used during the day. Usually the night and weekend message states that the office is closed, gives an emergency telephone number, or directs the caller to leave a message if the matter is not urgent. During the day, the medical assistant may answer the telephone directly or the caller may have to select an option from a menu before being connected to a member of the office staff.

If the medical office uses an answering service, the medical assistant must call the service to indicate that the office is open. The medical assistant must also obtain any messages that have come in within the past hour or nonurgent messages left during the night. For calls relating to illness, the answering service would have contacted the physician on call overnight.

After checking the message mailbox or answering machine, the medical assistant usually checks for faxes that have arrived overnight and routes the messages and faxes to the appropriate person.

A separate mailbox or answering machine may be used for prescription refill requests. If this is the case, the medical assistant should retrieve the messages from this mailbox before the physician arrives.

Preparing for the Day’s Activities

It is helpful to take a minute at the beginning of the day to organize the day’s tasks. This includes reviewing the appointment schedule and noting deviations from the routine schedule, such as physicians who are out of the office for all or part of the day. If the medical office uses a manual day sheet, it must be dated and prepared for use. (This is discussed in detail in Chapter 44.) Reminders about the day’s activities may be stored using an electronic task system and/or a physical tickler file. A tickler file is a set of 43 file folders, one for each month (for a total of 12 folders) and an additional set of 31 folders for the days of the current month. Written notes, bills to be paid, receipts, or other items are filed in these folders to “tickle” the memory at the time when they must be handled. (Tickler files are also discussed in Chapter 41.)

The medical assistant usually counts the cash in the cash drawer, a fixed amount of money used to make change when patients pay in cash. The cash drawer (change fund)is usually kept locked except when the medical assistant is actually sitting at the reception desk.

Making Sure Patient Charts Are Prepared

Patient charts are usually pulled the evening before the next appointment day or are prepared in the morning before the patients arrive. Even if the office uses an electronic medical record, some providers will want to be able to consult a patient’s old paper medical record. The charts must be arranged for each physician in order of the arrival of the patient. A separate appointment schedule is usually prepared for each physician. A charge slip may be created for each person before the visit, or the entire billing and charging system may be electronic. Some offices also print other sheets, for example, a list of medications for the patient to review and update.

Copies of the appointment schedule(s) are printed and placed at designated locations. The medical assistant usually places a schedule in each physician’s office, at the reception desk, and at the medical assistant’s desk. The schedule may be printed the evening before in case of a power outage or server problem, but it is usually updated with new appointments in the early morning so a new schedule should be printed just before patients start arriving.

Charts or other forms for the day are usually kept at the front desk. Some physicians prefer to have all medical records for their scheduled patients on their private desk when they start to see patients.

Checking the Office and Waiting Room

The waiting room, reception area, and examination and treatment rooms all need to be checked for the following: cleanliness, neatness, correct temperature, and appropriate reading material. The medical assistant should make sure that the cleaning service has cleaned all parts of the office and emptied the trash. The medical assistant may need to turn on a television, radio, and/or DVD player in the patient waiting room. Magazines should be stored neatly and replaced with current issues as needed. If there are toys in the waiting room, they should be cleaned regularly and stored neatly. Holders in the waiting room that contain information brochures for patients should be restocked and arranged neatly (Figure 37-1).

Checking Equipment and Supplies

The medical assistant should perform a visual safety check of the medical office daily. This includes removing any hazards that might block hallways or exits and making sure that all equipment is performing correctly. It is helpful to fill the paper trays of the copier, printer, and fax machine every morning.

The reception area and examination rooms should be tidied and restocked daily, either in the morning or at closing and sometimes again at a specified time during the day. Biohazard waste containers should be checked, and waste discarded properly if necessary. The medical assistant may need to turn on or set up equipment used for clinical procedures, run controls in the laboratory, and/or remove items from a battery charger. It may also be necessary to unload the autoclave and put away items that were sterilized the evening before.

Closing the Medical Office

At the end of the day, the activities of the morning are reversed. Many medical offices run the autoclave in the afternoon so that items can dry overnight. Medical records for the following day may be created for new patients and removed from the files for established patients. This is often done in the afternoon because it leaves more time in the morning. Before leaving the office, the medical assistant must perform the following tasks (Procedure 37-2):

Putting It All into Practice

My name is Keisha White, and I work in a small office with two internists. We are the primary care providers for most of our patients. I am responsible for opening the office every day, and I usually arrive at about 8:00 am. I leave before the office closes every day except Friday. Gerri, another medical assistant, is responsible for closing the office. We had an alarm system put in about 5 years ago, so as soon as I enter the office, I go to the keypad and enter the code so that the alarm won’t go off. Then I have a look around as I turn on the lights. Sometimes the air seems a little stale, so I either open a window or turn up the air conditioning, depending on how hot it is outside. After I turn on the copier and the computers, I call the answering service to tell them that I have arrived. I take down any messages and handle them. Then I make sure the telephones are set so that patients can call. Next I turn on the lights in the patient waiting area, make sure everything is tidy, and unlock the door for patients. We like to have music in the waiting room, so I make sure there are six CDs in the player and turn it on. I usually change the selection every day because we get tired of hearing the same music all the time. We have shifted over to an electronic medical record, but we haven’t finished scanning in all our old records.. Gerri pulls the old medical records for the next day before she leaves in the afternoon. Once the computers are warmed up, I check the electronic calendar to see if there is anything special to do that day, and I print appointment schedules. We keep one schedule at the front desk, and I put one on each physician’s desk. When each patient arrives, we print a charge slip for the physician. Then we call the patient to escort him or her to the examination room. The first appointment is scheduled for 8:30, so I really have to keep moving in order to be ready for the day. 

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