Open consultation hours: Organize efficiently & bill correctly

According to the law: Which doctors must offer open consultations?

According to Section 7 of the Contract Physicians Licensing Ordinance (Ärzte-ZV), certain specialist groups are required to offer open consultation hours.

The following specialist groups are affected in accordance with the EBM chapter:

• ophthalmologists
• surgeons
• dermatologists
• Gynecologists
• otolaryngologists
• Child and adolescent psychiatrists
• neurologists
• neurosurgeons
• neurologist
• orthopedists
• psychiatrists
• urologist

How many hours are required by law?

The Appointment Service and Supply Act (TSVG) engages doctors and psychotherapists in primary care, at least 5 hours per week offer open consultations without making an appointment in advance. Office hours must be reported to the Association of Statutory Health Insurance Physicians (KV) and published on the practice website.

To note:

The exact regulations may vary depending on the federal state. An overview of the legal regulations can be found in the respective medical associations or on the websites of the associations of Statutory Health Insurance Physicians.

How do patients benefit from open consultations?

Open consultations offer patients numerous benefits:

1. Easy access: Patients can come without making an appointment or a referral form, which is particularly important for acute symptoms.
   
2. Quick help: Acute medical concerns can be dealt with promptly.
   
3. Initial assessments: Patients are given the opportunity to quickly classify their symptoms and, if necessary, initiate further treatments.

Good to know: If too many patients come to open consultation hours, practice staff have the right to postpone less urgent cases to a later open consultation. Only in acute emergencies does a patient have a definite right to open consultation.

How do doctors benefit from open consultations?

Open consultations offer doctors numerous benefits that improve both their practice organization and patient care. By being able to treat acute cases without making an appointment, doctors can provide their patients with quick and efficient care. This results in a better patient engagementg, as patients feel that their health concerns are being taken seriously in a timely manner.

By the way, open consultation services are billed separately, which is a more comprehensive and financially beneficial care that enables patients.

Another advantage is the Reducing emergency treatment in clinics. When patients can resolve acute problems in practice, this relieves emergency rooms. In addition, the flexible handling of open consultations allows doctors to Better planning of working hours. Open consultation hours can be offered specifically at times when demand is high.

What are the disadvantages of open consultations for practices?

Although open office hours offer many advantages, there are also some disadvantages that practices must consider. One potential problem is unpredictable number of patients. On days when demand is high, there can be long waiting times, which can be frustrating for both patients and practice staff. This overload can affect the quality of care as doctors may not have adequate time for each patient.

Another disadvantage is the Planning challenge. Open office hours require a flexible organization of the practice process, which can make daily planning more complicated. Practices must ensure that sufficient personnel (or efficient systems) are in place to manage patient flows without sacrificing other scheduled appointments.

In addition, billing open office hours can be more complicated, as it is done separately from other services. This can mean additional administrative work for the practice team. To overcome these challenges, supports Nelly practices during digitization. As a result, open consultations can be organized and managed more efficiently, so that practices achieve more with less effort. More about that later.

How are open consultations billed?

Open consultation hours are billed separately from other services and are subject to specific regulations. Doctors and psychotherapists can bill for the services provided during open consultations on an extrabudgetary basis, which means that they are not included in the regular budget.

Billing is usually carried out by the Association of Statutory Health Insurance Physicians (KV), although the exact modalities may vary depending on the federal state. The office hours of open office hours must be reported to KV in advance, and the corresponding services will be billed in accordance with the requirements of the uniform assessment standard (EBM). It is important to carefully document all services provided to ensure smooth billing.

Practices should also regularly check on recent changes in billing guidelines inform to ensure that they comply with all legal requirements.

Important points about accounting for open office hours

• Labeling: The use of pseudo-GOP 99873O is required to bill for open consultation hours. The “O” stands for open consultation hours.
  
• Documentation in PVS: In the practice management system (PVS), placement type 4 must be selected in field ID 4103 in order to correctly identify open consultation hours.
  
• Maximum treatment limit: Practices should set a maximum limit on the number of extrabudgetary treatment cases. A maximum of 17.5% of all patients in a practice may be billed via open consultation hours, based on current medical group cases.
  
• New certificate for preventive examinations: If a patient has already been to the practice for a preventive examination in the current quarter, a new certificate must be created in PVS for the open consultation.
  
• Billing for follow-up consultations: If the patient comes to open consultation first and later for a preventive examination, all subsequent consultations are billed using the open consultation certificate.
  
• Regional differences: The billing guidelines may vary depending on the Association of Statutory Health Insurance Physicians (KV). It is therefore useful to contact the responsible KV for possible deviating regulations.

How to organize an open consultation efficiently despite a lack of staff

Organizing an open consultation can be challenging, especially when staff is scarce or overwhelmed. However, there are strategies to make processes efficient and ensure good patient care:

1. ‍Optimal time planning: Select office hours strategically to avoid peak hours. Early planning and taking past experience into account can help to better estimate the number of patients.‍
2. Introduce a triage system: Implement a triage system to sort patients by urgency In this way, acute cases can be dealt with quickly, while less urgent concerns can be postponed until later.‍
3. Flexible staffing resources: Consider whether you can use temporary employees or part-time workers to support office hours. Involving administrative staff in simple tasks can also reduce pressure on medical staff.
4. ‍Get feedback: Gather feedback from employees and patients to find out which aspects of open consultations can be improved. Continuous adjustments help to optimize processes.
5. ‍Efficient documentation: Use digital systems for documentation and billing. Well-organized practice software can minimize administrative costs and increase efficiency. Since there is particular potential here, we'll take a closer look at digital solutions in the next section.

Efficient patient treatment through digital practice modernization

Digitalizing your practice can make it much easier to organize open consultations and at the same time reduce administrative costs.

With Nelly, you have the opportunity to optimize various processes to increase efficiency and patient satisfaction.

• Digital anamnesis: Let patients fill out their medical history from the comfort of their own home. This saves time in practice and enables consultation hours to be organized more efficiently.
  
• Efficient scheduling and document management: Use digital technologies such as electronic health records to optimize your workflow. Nelly integrates these solutions into your existing practice management system.
  
• Digital invoice delivery with factoring: Save yourself valuable time when billing. With Nelly's integrated factoring solution, we take care of the entire billing process for you. This eliminates time-consuming steps such as payment reminders and claims management, so you can concentrate fully on your patients.
  
• Proactive patient feedback: Nelly enables you to obtain targeted feedback from patients. After treatment, they receive automated reminders to give their opinion. This anonymized feedback gives you valuable insights to make targeted improvements and to to increase patient satisfaction.

Nelly also offers tailor-made solutions to digitize specific processes in your practice. In this way, you reduce staff workload and at the same time reduce waiting times for your patients.

Common questions

How long do patients wait during open consultations?

Waiting times for open consultations can vary significantly, depending on the number of patients and the urgency of the concerns. Waiting times are usually between 30 minutes and several hours. Peak hours or unforeseen events may extend waiting times. However, effective triage and organization can help to minimize waiting times.

How is an open consultation paid?

An open consultation is paid on an extrabudgetary basis, which means that the services provided are not included in the practice's regular budget. Billing is carried out by the Association of Statutory Health Insurance Physicians (KV) in accordance with the Uniform Assessment Standard (EBM). Pseudo-GOP 99873O is required to mark open office hours.