Provider Scheduling Reference Manual

Provider Scheduling Reference Manual Saint Michael s Hospital Outpatient Scheduling Department Main Line: (715) 346-5180 Scheduling Hours: Monday through Friday 8am -5pm Scheduling Coordinators: Judy McDermott Joyce Waite Greta Ladenthin Jacqui Nowak Scheduling Supervisor Jennifer Sniatynski Phone: 715-342-6759 Scheduling Manager: Karen Ott Phone: 715-343-3094 For Same Day Testing: Respiratory Care: 715-346-5183 Imaging Services: o CT: 715-346-5035 o Echocardiography: 715-346-5341 o MRI: 715-346-5414 o Nuclear Medicine: 715-346-5153 o Radiology: 715-346-5140 o Ultrasound: 715-346-5154 o Vascular Lab: 715-346-5154

IMAGING SERVICES: Special Procedures o Spinal Injections o Kyphoplasty Cat Scans (CT) Echo Magnetic Resonance Imaging (MRIs/MRAs) Nuclear Medicine Scans (NM) Radiology Procedures Ultrasound (US) Vascular Lab Studies (VL) General X-Ray Cardiac Stress Testing RESPIRATORY CARE SERVICES Pulmonary Function Studies Cardiac Monitors Respiratory Treatments EKG s TESTS NOT SCHEDULED IN OUTPATIENT SCHEDULING Cardiopulmonary Rehab (715) 295-3946 EEG/EMG (715) 342-7775 GI Services (715) 346-5431 IV Therapy (715) 346-5490 Laboratory Services (715) 346-5050 Ambulatory Surgery (715) 346-5689 Mammograms - Screening (715) 342-7712 - Diagnostic (715) 342-6482 Oncology Services (715) 343-3030 Rehab Services (715) 346-5190 Diabetic Education & Nutrition Counseling (715) 342-7549 2

GENERAL INFORMATION NEEDED TO SCHEDULE APPOINTMENT **Note: Have patients chart available to answer questions needed to schedule appointment Needed for all appointment types: Patient s Name Patient s Date of Birth Patient s Phone Number Test to be scheduled Diagnosis or reason for visit Ordering provider Patients height & weight Previous films pertaining to diagnosis List of patient medications and allergies Needed for many appointment types: Medical guarantee of non pregnancy Laboratory results Orders must be entered in CMR, sent or faxed to: Radiology Fax: (715) 343-3140 Respiratory Care Fax: (715) 343-3146 Laboratory Fax: (715) 342-7901 *Note: Additional questions may need to be asked depending on information given during scheduling procedures to ensure the patient s safety. 3

Sedation Policy Pediatric Oral Sedation: Patient must be over 3 months of age to receive oral sedation. Patient must be NPO 6hrs prior to the procedure. A current H&P is needed (to be done within 30days of procedure). Patient will be monitored by the Radiology RN starting immediately after oral sedation has been given, during the procedure and a minimum of 30 minutes after procedure. Complete two vital sign checks prior to discharge as per SDC protocol. Sedation will be administered by the Radiology RN as per written order by the ordering physician. Adult patients receiving oral anti-anxiety medication as a one time dose prior to ordered radiology procedure will be assessed as needed by the Radiology RN. IV Sedation: Patient must be 17 years of age or older for IV Sedation All patients must be NPO 6hrs prior to procedure. A current H&P is needed (to be done within 30days of procedure). Patients will be monitored by the Radiology RN immediately following start of IV Sedation, during the procedure and a minimum of 30 minutes and will complete two vital sign checks prior to discharge as per SDC protocol. Sedation will be administered by the Radiology RN as per written order by the attending physician. Note: Patients current H&P needs to be sent to the radiology department at least 3days prior to procedure. If H&P is not received by the day of the procedure, the procedure will not be performed. Anticoagulants Policy If patient is on anticoagulants, the following medication protocol applies: o Lovenox: patient must be off for 2 days o Coumadin/Warfarin: patient must be off for 5 days o Plavix/Aggrenox: patient must be off 7 days o Ticlid: patient must off for 14 days o Any aspirin: patient must be off 48 hours o Heparin IV: patient must be off 4-6 days o Heparin Sub Q: patient must be off for 1 day Iodine Allergy Policy If patient allergic to iodine o Patient will need to be pre-medicated according to the following protocol: 32mg Methylprednisolone 2 Doses: 12 hours prior to CT and again 2 hours prior to CT 50mg Benadryl 1 hour prior CT 4

Special Procedure / Interventional Radiology Tests: Angiogram, Fistulogram, Kyphoplaty Same day appointment call: (715) 343-3010 Future appointment call: (715) 346-5180 Information Needed To Schedule an Appointment General Information: Name, DOB, Phone Number. Diagnosis. Patients Weight? (Limit 400 lbs) Is patient on any anticoagulation therapy? Any allergies? Medical guarantee of non pregnancy Other Information Needed By Test Type: For Angiogram and Kyphoplasty need H&P within last 30 days For Kyphoplasty: Outpatient Scheduling will schedule a consult with the radiologist For Kyphoplasty: prior films are needed For Fistulogram: Needs radiologist approval prior to scheduling. OPS will obtain pertinent information and send to radiologist, once the sheet is returned from the radiologist, OPS will contact physician s office to schedule appointment, the physician s office will in turn contact the patient with the date, time and prep any for the procedure. *Note: Any procedures that require the patient to go to 5W will need an H&P done within 30 days of the procedure. 5

Injections Same day appointments call: (715) 346-5140 Scheduled appointments call: (715) 346-5180 Tests: Lumbar epidural Lumbar transforamenal/nerve Block Lumbar facet injection Caudal epidural Cervical epidural Cervical transforamenal/nerve Block Cervical facet injection S1 sacral nerve root block Si joint injection Pars injection Trigger Point Injection Joint Injections (Hip, knee, shoulder, elbow, etc) Iliopsoas Bursa Injection Tendon Sheath Injection Information Needed To Schedule an Injection Appointment Patient s Weight? Is patient on any anticoagulation therapy? Allergies? If iodine allergy, patient must be pre-medicated per protocol Guarantee of non pregnancy Specific level or area? Previous films relating to current diagnosis? Films must be sent to radiology department prior to date of test if not on PAC system If patient is on anticoagulants: refer to anticoagulant policy on pg: 4 Additional Information Needed For Epidural and Transforamenal Injections: Injections may be given in a series of three injections: Is this the patient s 1 st, 2 nd, or 3 rd injection? o **Injections to be a minimum of 3 weeks apart. If requesting sooner than 3 weeks, Radiologist needs to approve prior to scheduling appointment** 6

CT Appointments Same day appointments call: (715) 346-5035 Future appointments call: (715) 346-5180 Note: CT scanner Weight Limit= 450 pounds INFORMATION NEEDED TO SCHEDULE AN APPOINTMENT Name, DOB, Phone Number. Diagnosis. Patient s weight. Medical guarantee of non pregnancy Is test to be done with or without IV contrast? Are there previous films related to this diagnosis? Other Information Needed By Test Type: Studies with IV Contrast: Creatinine in last 6 months? o If not done, this is needed only in the following situations: Patient has diabetes Patient has hypertension or is on anti-hypertensive medications Patient has history of Renal or Cardiac disease Patient has had chemotherapy Is patient allergic to iodine? o If yes, please refer to iodine allergy policy on pg 4 Does patient have diabetes? If yes, what medications is patient on? Certain medications will need to be held after the CT scan and must be approved by the physician managing the patient s diabetes. Studies with Oral Contrast: How would patient like to obtain the Barium if required for CT? Patient has a choice of picking up the barium at SMH prior to the day of the scan and drinking it at home, or arriving 2 hours prior to the CT and drinking at the hospital. Patient will need to be NPO for 8 hours prior to the CT-they may have clear liquids up to 2 hours prior, when they start drinking the barium Biopsies: What area? Current H&P needed-to be faxed or sent to radiology 3days prior to procedure. Is patient on anticoagulation therapy? If yes, refer to anticoagulation policy on pg. 4 Depending on area, may need radiologist approval prior to scheduling. OPS will obtain pertinent information and send to the radiologist. Once sheet is returned from the radiologist, OPS will contact the physician s office to schedule appointment. The physician s office will in turn contact the patient with the date, time and prep if any for the procedure. 7

Cardiac Testing Echocardiography Appointments Tests: Echo/Cardiac Ultrasound, Echo with Contrast or Bubble Study Same day appointment call: (715) 346-5341 Future appointment call: (715) 346-5180 Information Needed To Schedule an Appointment Name, DOB, Phone Number Patients height and weight Diagnosis Other Information Needed By Test Type: Echocardiogram (Echo) and Echocardiogram with Contrast or Bubble Study Patients 16 yrs and under will need to be scheduled in Marshfield where there is a pediatric cardiologist available. Stress Testing Regular Treadmill Stress Test w/ EKG Tracing No imaging done Stress with EKG tracing Patient is on the treadmill Beta blockers are held for 24h prior to stress Echo Stress Test Stress with Echo imaging Patient is on the treadmill Beta blockers are held for 24h prior to stress Echo Dobutamine Stress Test Patient is not on a treadmill Patient is given Dobutamine to mimic exercise Beta blockers are held for 24h prior to stress A physician is present for the procedure Nuclear Medicine Stress Test Stress with Nuclear Medicine imaging Appt consists of 2 appointments, a rest study and a stress study o Appt: Cardiolite Sestimibi Stresss Patient is on the treadmill for the stress portion of the test Beta blockers are held 24h prior to the stress study o Appt: Cardiolite Lexiscan Stress Patient is not on the treadmill Patient is given Lexiscan (Regadenoson) to mimic exercise 8

Magnetic Resonance Imaging (MRI) Same day appointment call: (715) 346-5414 Future appointment call: (715) 346-5180 Note: Safety questionnaire must be completed prior to scheduling appointment. Note: MRI s are not FDA approved for the first trimester of pregnancy. Information Needed To Schedule Appointment Name, DOB, Phone Number. Diagnosis. Patient s height and weight o Weight limit 350 lbs Is MRI ordered with contrast? If yes, a serum creatinine level is needed. Are there any films relating to the diagnosis? Pacemaker/implanted pumps/defibrillators. o If patient has this-the MRI cannot be performed. If a patient has any implanted devices: will need to know the type and date of placement (must be at least 8 weeks post placement.) Cardiac valves & stents : need make & model # of valve/stent to check if it is MRI compatible. Pt also must be at least 8wks post op, unless approved by Radiologist. 9

Nuclear Medicine Appointments Same day appointment call: (715) 346-5140 Future appointment call: (715) 346-5180 Information needed to schedule an appointment Name, DOB, Phone Number. Diagnosis Patient s height and weight. o Scanner weight limits are 350 pounds and 400 pounds Medical guarantee of non pregnancy Any previous films relating to the diagnosis? Note: Patients can have only one Nuclear Medicine exam per day due to the contrast that they receive for the test. Other Information Needed By Test Type: Bone Scan: What area? Bone scans require 2 appointment times 1 for the Injection & 1 for the Scan, usually 2 hours after injection. Hepato-Biliary or HIDA Scan: Is Provider ordering with or without CCK? Gallium Scan: This is a multiple day test it requires 5 different appointment times over the course of 4 days. Gastric Emptying Scan: Must wait a minimum of 1 week after barium contrast exams. Patient will need to be NPO for 8 hours prior. Lung Scan: These usually need to be done the same day that the provider is ordering it; please verify with ordering provider if the scan is needed same day. Meckel s Scan: Patient will need to be NPO 4 hours prior. 10

Renal Scans: Is provider ordering the scan with or without Lasix? o If without Lasix, patient will need to be off of Hypertensive meds for 1 week, and off of Ace Inhibitors and Diuretics for 24 hrs prior. Patient must drink 20 oz water 1 hour prior to test. Renal Lasix Scan: Patient must be off Ace Inhibitors for 3 days prior and off of Diuretics from the night before. Renal DMSA and Renal Captopril Scans: May require 2 appointment times. Patient must drink 20 oz water 1 hours prior to test Scheduler will instruct on medication For Lymphoscintigraphy Injection and Lymphoscintigraphy With Imaging Where was Mammography/US done? Is Needle placement needed? If yes, under US or Mammography? What time is the surgery scheduled for? (schedule 2.5 hours prior to surgery) For Lymphoscintigraphy Melanoma: Is surgery scheduled & if yes, what time? Thyroid & Uptake Scan Is patient on any thyroid medications, vitamin complexes or antihistamines? **If yes, patient will need to be off these medications for 10 days prior to scan. Is patient on Amiodarone? (**If yes, patient will need to be off the medication for 6 months prior to scan.) Has patient had IV contrast within the last 6 weeks? (**If yes, the scan needs to be scheduled at least 6 weeks from IV contrast procedure.) Requires 2 appointment times-oral medication and scan the same day, 5hrs apart. Thyroid Uptake 24HR Basic Nuclear Medicine questions Is patient on any thyroid medications, vitamin complexes or antihistamines? **If yes, patient will need to be off these medications for 10 days prior to scan. Is patient on Amiodarone? (**If yes, patient will need to be off the medication for 6 months prior to scan.) Has patient had IV contrast within the last 6 weeks? (**If yes, the scan needs to be scheduled at least 6 weeks from IV contrast procedure.) Requires 2 appointment times-oral medication and uptake 24 hrs apart. 11

PET SCAN Same day appointment call: (715) 343-3406 Future appointment call: (715) 346-5180 Information Needed To Schedule Appointment Name, DOB, Phone Number. Patient questionnaire filled out prior to scheduling appointment. PET/CT request form filled out prior to scheduling appointment. Diagnosis. Patient s Height and Weight: table limit of 450 pounds Medical guarantee of non pregnancy. Is patient a Diabetic? Area to be scanned? Does patient have previous CT or MRI films relating to this diagnosis? 12

Radiology Appointments Same day appointment call: (715) 346-5140 Future appointment call: (715) 346-5180 INFORMATION NEEDED TO SCHEDULE APPOINTMENT Name, DOB, Phone Number. Height and weight. Diagnosis. Ordering physician. Previous imaging relating to current diagnosis from outside facilities? Medical guarantee of non pregnancy Is patient allergic to Iodine? Is patient on any anticoagulation therapy? Other Information Needed By Test Type: Biopsy Current H&P needed (to be done within 30 days of procedure). Is patient on Insulin, Oral Hypoglycemic meds or Anti-coagulants H&H,HCG Qual, Platelets, PT/PTT within 3 weeks of procedure. If patient on anticoagulants PT/PTT will be drawn day of procedure. Needs radiologist approval prior to scheduling. OPS will obtain pertinent information and send to radiologist. Once the sheet is returned from the radiologist, ops will contract physician s office to schedule appointment. The physician s office will in turn contact the patient with the date, time and prep if any for the procedure. Cystogram Is urinary catheter in place or is catheter placement needed? HSG (Histosalpingogram) Which OB provider will be performing the procedure? IVP (Intravenous Pyelogram) Need creatinine within 6 months, if patient has diabetes, renal or cardiac disease, hypertension, or on antihypertensive meds, or on chemotherapy. If creatinine is > 1.7 must be repeated within one week of exam. Lumbar Puncture Current H&P needed (to be done within 30 days of procedure). If testing needs to be done on the fluid-the order needs to be sent to the lab. Myelograms (Cervical & Lumbar) Current H&P needed (to be done within 30 days of procedure). H&H,HCG Qual, Platelets, PT/PTT within 3 weeks of procedure. If patient on anticoagulants PT/PTT will be drawn day of procedure. Creatinine within 6 month. 13

Respiratory Care Department Tests: Arterial Blood Gasses, Pulmonary Function Testing, BronchoChallenge Testing, Pulse Oximetry/O2 Saturation, Spirometry Plus Same day appointment call: (715) 346-5183 Future appointment call: (715) 346-5180 Information Needed To Schedule Appointment Name, DOB, Phone Number. Height and Weight HGB within the 30 days prior to test Is patient a smoker? Diagnosis? Note: Refer to guidelines for medications that need to be held. Arterial blood gases (ABG s) Is patient on home O2? Other Information Needed By Test Type: Pulmonary function test w/methocholine HGB done within the last year. Pulse Oximetry/O2 Saturation To be done on room air or on O2? 14

Ultrasound Appointments Same day appointment call: (715) 346-5154 Future appointment call: (715) 346-5180 Note: Breast and OB ultrasounds are performed at MMG. Call 715-342-7750 Information Needed To Schedule an Appointment Name, DOB, Phone Number. Previous films? Diagnosis? Amniocentesis Number of week s gestation? Biopsies and Aspirations What area? Current H&P needed-to be faxed or sent to radiology 3days prior to procedure. Is patient on anticoagulation therapy? If yes, refer to anticoagulation policy on pg. 4 Depending on area, may need radiologist approval prior to scheduling. OPS will obtain pertinent information and send to the radiologist. Once sheet is returned from the radiologist, OPS will contact the physician s office to schedule appointment. The physician s office will in turn contact the patient with the date, time and prep if any for the procedure. Tenotomy Is patient on Anti-coagulants? (If yes, follow Anti-coagulant guidelines) Ultrasound of Extremities: Is provider ordering for soft tissue or to rule out a DVT? 15

Vascular Lab Same day appointment calls: (715-346-5154) Future appointment calls: (715-346-5180) Information Needed To Schedule Appointments Name, DOB, Phone Number. What area/extremity? Diagnosis Other Information Needed By Test Type: For Renal Artery Study o Patient must be NPO after midnight Vein Mapping Study o Which extremity and which veins are to be mapped? 16