Lesson Five: How do you Rake the Schedule?

To rake the schedule, you first open the schedule and examine the next couple of weeks of appointments carefully looking at the reason for visit. Then, you must find the appointments on the schedule that are good candidates for raking using the reason for visit as your guide. Good candidates for raking include patients that are suffering from an acute illness that may benefit from a sooner appointment. For example, strep throat, flu symptoms, urinary tract infections or anything that may cause pain to the patient and would benefit from getting a sooner appointment to their health center. These are good candidates for raking and patients will likely appreciate the phone call offering him or her a sooner appointment for these services.

Bad candidates for raking are defined as patients with an appointment reason when your labor to call the patient may not be worth the time it takes to call. These reasons for visit include appointments on a defined timeline or appointments that a patient may have made way in advance such as annual physical. If a patient booked an appointment and the reason for visit is an ‘Annual Exam’ or ‘Physical,’ then they may be timing the appointment with when their insurance will pay for that visit a year later. For example, if a female patient’s last annual was March 12th, she cannot be seen any earlier than March 12th for her next annual exam. That reason for visit may not be a good candidate for raking. Before calling that annual exam to offer a sooner date, you should check the date of their last annual and ensure they were seen over a year ago for their last annual exam.

It is recommended that your particular practice identifies their own list of good and bad candidates for raking. Make a tool according to the particular medical service or specialty you provide such as Pediatrics or Women’s Health. Below are some good and bad examples that we’ve identified. What other reasons for visit can you define as good candidates for raking at your practice?

If you are raking the schedule to fill slots that have just been opened from scrubbing, consider calling patients who are scheduled in the same time of day or even the same day of the week as the appointment slot that just opened up. For example, say you just successfully scrubbed an appointment this Thursday at 10:30 am. Then, look at next Thursday, at 10:30 am. What is the reason for visit?  If the reason for visit is for an acute issue such as a URI, i.e. upper respiratory infection, you just found a great candidate for a raking call!

You are less likely to get a patient to take an earlier appointment if the time and day do not match with the original appointment they made. For example, if you call patients scheduled for a future Friday afternoon appointment and you offer them a Wednesday morning appointment, it is less likely they can change their schedule for that slot. This isn’t a100% rule, however, as sometimes the reason for visit is so urgent that patients will change their schedule to accommodate the offer of an earlier visit. You will have to make a judgment call when raking visits such as these as to whether calling patients and offering the appointment change will bear fruit.

Calling Patients to Rake:

When calling patients to rake, remember that you are calling with GOOD news! So often we call patients with bad news. This can be due to bumping their appointment because we’re closing last minute or cancelling them altogether because the provider called off sick. Calling patients with an offer of an earlier appointment is a GREAT reason to call patients. As soon as you have their phone number and their name in front of you, take out the phone and dial their number. Then, use your most pleasant, customer service voice, use the following script to make your first Raking Call:

“Hi, is this Mrs. Smith? Hi Mrs. Smith, this is Bob calling from Happy Little Clinic. Listen, I’m calling because we noticed you have an appointment for next Thursday at 10:30 for an upper respiratory infection and we have good news. We just had an earlier appointment open up THIS Thursday at the same time, 10:30 with your Primary Care Provider. Would you like to come in a week earlier for us to see you?”

Obviously it’s up to patients to determine whether or not this time change will work for them. Sometimes they’ll say yes and other times they’ll have another commitment and will have to decline. Either way, offer these openings to patients when possible and enjoy making the calls when you do! It’s not every day we get to call patients offering them something sooner! If patients do indeed take the earlier appointments, reschedule them knowing that you’ve just opened up appointments next Thursday for the next patient who calls!