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Process Hub guidance: This guide supports clinic workflows but does not replace clinical judgment, official policies, payer requirements, or the clinic’s triage process. When information is unclear or conflicting, staff should contact the appropriate supervisor or PCP Staff before proceeding.

Pilot draftFront Office

Front Office Scheduling

Scheduling rules organised by annual appointments, providers and other appointment processes.

OwnerJess

Version0.9

Effective dateNot assigned

Review triggerWhenever a new process supersedes this guide

Pilot guide: This guide is being published to test the Process Hub layout. Supervisors remain the final authority for exceptions and process changes.

Process Hub guidance: This guide supports clinic workflows but does not replace clinical judgment, official policies, payer requirements, or the clinic’s triage process. When information is unclear or conflicting, staff should contact the appropriate supervisor or PCP Staff before proceeding.

Purpose

Provide front-office staff with clear, consistent scheduling rules and a standard process for documenting approved exceptions.

Standard Scheduling Process

This overview is being reviewed. Until it is finalised, use the detailed rule tables below and obtain supervisor guidance when a situation is unclear.

Needs Review

Approved exceptions must be documented by creating a patient case in Athena.

SCHEDULING RULES

Detailed Scheduling Rules

Choose a category first, then select the exact rule or provider.

ANNUAL RULES

Select an annual appointment type

WCC — Well Child Check

Provider	All Medical Providers
Daily Wellness Limit	WCC is included in the combined limit of 2 WCC / MAP / WAP appointments per medical provider per day.
Private Insurance	Patients may be scheduled earlier than their previous annual visit date when the new visit is within the current calendar year. It is the patient's responsibility to confirm coverage with their insurance when scheduling earlier.
Private Insurance Example	If the previous annual visit was in December 2025, the patient may request a visit in July 2026 after confirming coverage with their insurance.
Partnership HealthPlan (PHC)	No stated annual limit. PHC patients may continue to receive Well Child Checks through age 21.
Important Scheduling Step	At the initial baby visit, schedule the upcoming wellness appointments to help prevent missed vaccines and visits.
Exceptions / Restrictions	Do not schedule at 11:30 AM or 4:30 PM.

Baby and Child Scheduling Markers

2 days2 weeks29 days2 months 4 months6 months9 months12 months 15 months18 months24 monthsYearly afterward

PHC age reminder: Well Child Checks may continue through age 21 for Partnership HealthPlan patients.

MAP / WAP

Provider	All Medical Providers
Allowed Time	Available annual appointment slots, usually 11:00 AM or 3:00 PM.
Daily Wellness Limit	MAP / WAP is included in the combined limit of 2 WCC / MAP / WAP appointments per medical provider per day.
Private Insurance	Patients may be scheduled earlier than their previous annual visit date when the new visit is within the current calendar year. It is the patient's responsibility to confirm coverage with their insurance when scheduling earlier.
Private Insurance Example	If the previous annual visit was in December 2025, the patient may request a visit in July 2026 after confirming coverage with their insurance.
Partnership HealthPlan (PHC)	Partnership patients may be scheduled earlier within the current calendar year.
AWE Count	MAP / WAP appointments do not count against the separate limit of 2 Medicare AWE appointments.
Exceptions / Restrictions	Do not schedule at 11:30 AM or 4:30 PM.

AWE — Medicare Annual Wellness Exam

Provider	All Medical Providers
Allowed Time	10:00 AM or 2:00 PM only
Duration	1 hour
Limit per Medical Provider	2 per day
Eligibility Rule	Medicare AWE scheduling is strict: schedule at least one year and one day after the previous AWE.
Scheduling Within 7 Days	If the designated 10:00 AM or 2:00 PM AWE slot is still unfilled within seven days of the appointment date, that slot may be used for any visit type. Please schedule courteously and do not fill the entire day with back-to-back MAP, WAP or WCC appointments.

Medicare Patients Aged 64 or Younger

Eligibility Note	Although Medicare commonly begins at age 65, some patients qualify for Medicare before age 65.
Visit Type	AWE
Appointment Reason	Medicare WAP or Medicare MAP
Appointment Length	30 minutes
Remaining Time	Another patient may be scheduled during the remaining 30 minutes of the hour.

Example: A 45-year-old Medicare patient may be scheduled for an AWE at 3:00 PM, and a different patient may be scheduled for a follow-up at 3:30 PM.

Sports Physical

Provider	All Medical Providers
PHC Combined Visit	Partnership HealthPlan allows a Well Child Check and Sports Physical to be completed during the same visit.
PHC Appointment Reason	Use WCC/Sports Physical.
PHC Scheduling Habit	When scheduling a WCC, ask the parent whether the patient plans to participate in sports during the school year. When the answer is yes or uncertain, use WCC/Sports Physical so the forms can be completed during the visit.
Recent PHC WCC	If the patient completed a WCC within the past year, another appointment is usually not needed solely to complete sports physical forms.
Forms After a Recent WCC	Confirm whether the school requires or has provided a specific sports physical form. If a specific form is required, the parent should upload it through the Patient Portal. If no specific form is required, send a case to PCP Staff requesting completion of the appropriate sports physical documentation based on the recent WCC.
Private Insurance	Sports physicals are not covered and are a $50 out-of-pocket expense.
Private Insurance Appointment	Schedule as a separate 30-minute Follow-Up. It cannot be combined with a Well Child Check; two separate visits are required.
Form Validity	Sports physical forms are valid for one year.

Private insurance reminder: Do not combine a Sports Physical with a Well Child Check. PHC is the exception and may use the combined reason WCC/Sports Physical.

PROVIDER RULES

Select a provider

Provider-specific pages will be expanded as scheduling instructions are confirmed.

Dr. Fort

Home Visits	May perform home visits.
Allowed Time	5:00 PM only
Approval	Supervisor approval is required and must be documented in an Athena patient case.
Restriction	Do not schedule home visits on Friday.

Dr. Tatelman

Availability	Dr. Tatelman comes to the area every other Monday.

FNP Jeff

Family PACT	FNP Jeff is currently the only provider who provides Family PACT.
Family PACT Location	McCloud only
Family PACT Restriction	Do not schedule Family PACT at Shasta.
Home Visits	May perform home visits at 5:00 PM only with supervisor approval.
Home Visit Restriction	Do not schedule home visits on Friday. Document approval in an Athena patient case.

DNP Sue

Scheduled Daily Limit	Do not schedule more than 13 appointments per day.
Walk-Ins Above the Limit	DNP Sue may still accept walk-ins above the scheduled limit with management guidance.
Existing Medicare Patients	Medicare patients who are already established with DNP Sue may continue to see her.
New Medicare Patients	Do not schedule new Medicare patients with DNP Sue until further notice.
Secondary Insurance	The restriction on new Medicare patients still applies when the patient has a secondary insurance plan.

Medicare restriction: Schedule Medicare patients with DNP Sue only when they were already established with her. Do not schedule new Medicare patients.

DNP Jade

DNP Jade works virtually and is not physically present in the clinic. Her on-site team assists with hands-on needs, and other clinic providers may help when necessary.

Select the Correct Appointment Type

Visit Being Scheduled	Appointment Type
VVV / fully virtual visit	Telehealth 15
WAP / MAP / WCC	Hybrid Telehealth 30
Medicare AWE	Hybrid Medicare Annual 60
Mt. Shasta follow-up or sickness visit	Shasta Hybrid Follow
Dunsmuir follow-up or sickness visit	Dunsmuir Hybrid Follow

Appointment Reason Format

Location / Visit Type	Required Format
Fully virtual	VVV: [reason for appointment]
Dunsmuir in-clinic	DUNS: [reason for appointment]
Mt. Shasta in-clinic	MS: [reason for appointment]

Example: A patient attending Mt. Shasta for a blood-pressure follow-up should be scheduled as Shasta Hybrid Follow with the reason MS: BP follow up.

FNP Laura

Provider-specific scheduling rules are pending confirmation.

FNP Jennifer

Provider-specific scheduling rules are pending confirmation.

Dr. Nielson

Scheduling Step	When scheduling with Dr. Nielson, send a patient case to Sabra.

Dr. Abadi

Scheduling Step	When scheduling with Dr. Abadi, send a patient case to Katie.

Dr. Cooper

Availability and Locations

Day	Location / Availability
Monday	Out of office
Tuesday	Mt. Shasta — all day
Wednesday morning	McCloud
Wednesday afternoon	Dunsmuir
Thursday	Mt. Shasta — all day
Friday	Out of office

Partnership Chiropractic Appointments

Assigned to SCHC	A Partnership patient assigned to SCHC does not need a referral before scheduling with Dr. Cooper. The patient may be scheduled and is allowed 2 chiropractic visits per month.
Additional Visits Needed	Submit a case to Sabra. Sabra will request a TAR with justification. If approved, schedule only the number of additional visits listed in the TAR.
Not Assigned to SCHC	Check whether an existing referral or approved ERAF has been received from the patient's assigned primary care provider.
Approved ERAF / Referral	If an approved ERAF or referral is on file, the patient may be scheduled with Dr. Cooper and is allowed 2 chiropractic visits per month.
No Approved ERAF / Referral	Advise the patient to contact their assigned primary care provider and request that a referral be sent to SCHC. Do not schedule until the referral or authorisation requirement is resolved.
Minimum Age	Partnership patients must be 12 years old or older to see Dr. Cooper.

Orders

Dr. Cooper does not place medical orders. A patient requesting an order must see an appropriate medical provider.

Visit Count in the Appointment Reason

Visit	Appointment Reason
First visit of the month	1/2
Second visit of the month	2/2

Use only the monthly visit count in the appointment reason. Always count previously scheduled and completed visits so the patient does not exceed the approved number.

VA Chiropractic Appointments

VA chiropractic scheduling is handled by Jess. When a VA patient responds about a chiropractic appointment, leave the scheduling for Jess. Jess must coordinate with the VA, obtain final authorisation and update billing. Scheduling without Jess may leave the authorisation or billing process incomplete and create payment issues.

Sara W

Scheduling is handled by Jess.

Julia

Scheduling is handled by Jess.

Dr. Staszel

Restricted scheduling: Only Sabra, Jess, Katie, Tanya and Scott should schedule appointments on Dr. Staszel’s schedule.

OTHER APPOINTMENT RULES

Select a process

Double Booking

Duration	15 minutes
Permitted Visit Types	Walk-in or Single Problem Focused Follow-Up only
Examples	Blood-pressure follow-up or abnormal-lab follow-up
Approval	Supervisor approval is required.
Documentation	Document the approval in an Athena patient case.
Restriction	Do not use double booking for complex, chronic or multiple-problem visits.

Use of Unfilled AWE Slots

Designated AWE Times	10:00 AM and 2:00 PM
Seven-Day Window	If either designated AWE slot is still unfilled within seven days of the appointment date, the slot may be used for any visit type.
Scheduling Courtesy	Do not fill the entire day with back-to-back MAP, WAP or WCC appointments.

Scope: This rule applies to an available 10:00 AM or 2:00 PM AWE slot, not automatically to every opening on the schedule.

Immunizations

Requirement 1	The patient must be a current established patient of SCHC.
Requirement 2	The patient must have completed a Well Child Check within the past year.
Both Requirements Met	Schedule a Nurse Visit for immunizations.
Not a Current Patient	First offer an appointment to establish care, or advise the patient to contact Siskiyou Public Health at 530-841-2134 for immunization options.
No WCC Within the Past Year	Schedule a Well Child Check. The patient may receive the needed immunizations during that appointment.

Nurse Visit rule: Use a standalone Nurse Visit for immunizations only when the patient is established and has completed a WCC within the past year.

Pain Care Follow-Ups

Appointment Timing	Schedule approximately 28 days after the previous pain care appointment. When adjustment is necessary, scheduling slightly earlier is preferable to scheduling late.
Virtual Visit Limit	The patient may have two consecutive VVV appointments. The third appointment must be in person.
Visit Frequency	Pain care follow-ups may be required monthly or every three months, depending on provider instructions.
Where to Confirm Frequency	Check sticky notes, chart notes, patient cases and any scheduling tickler.
When Unclear	Send a patient case to PCP Staff to confirm the required visit frequency.
Secondary Date Check	You may check when the most recent pain prescription was sent to confirm timing. When a provider-created tickler clearly states when to schedule, this additional check is usually not needed.

Do not bypass the established timing or visit type solely because a patient reports that they have taken their last pill and need an immediate appointment. Confirm the schedule using the chart and provider instructions.

Walk-In Requests

Clinic Message	SCHC accepts urgent walk-ins throughout the day.
Patient Details	Confirm the patient's name and date of birth, then ask what the patient would like to be seen for.
Triage Check	Determine whether the reason for the visit falls under the clinic's Triage Process.
If Triage Is Required	Follow the Triage Process before scheduling or advising the patient to walk in.
If Triage Is Not Required	Check for an appropriate open appointment and offer it when available to reduce unnecessary wait time.
No Suitable Appointment	Advise the patient that urgent walk-ins are accepted throughout the day.
Wait-Time Reminder	Do not guarantee a specific wait time or that the patient will be seen immediately.

Suggested response: “We accept urgent walk-ins throughout the day. I would first like to check whether there is an open appointment time to help reduce any unnecessary wait time. May I have the patient's name, date of birth and what they would like to be seen for?”

Procedures

Provider	Scheduled provider
Duration	30 minutes
Friday Scheduling	Procedures may be scheduled on Fridays.
Exceptions / Restrictions	Do not schedule at 9:00 AM, 1:00 PM or 4:00 PM.

Evening Virtual Visits

Allowed Time	5:00 PM to 7:00 PM — VVV only
Duration	15 minutes
Appropriate Visits	Acute or single-problem visits
Not Permitted	No annuals, WCCs or chronic-problem visits.
Available Slots	Exactly 4
Reserved Slot	Keep 1 slot available daily for a same-day or walk-in add-on.

New Patient / Transfer of Care

Provider	All providers unless a provider-specific rule states otherwise.
Limit per Provider	2 combined New Patient / Transfer of Care appointments per day
Wellness Count	These appointments do not reduce the daily wellness appointment total.
Exceptions / Restrictions	Exceeding the daily limit requires supervisor approval and documentation in an Athena patient case.

Exceptions and Athena Documentation

Requested Exception	Describe what is being requested and why it falls outside the standard rule.
Approving Supervisor	Record the supervisor's name.
Appointment Details	Include the appointment type, provider, date and time.
Additional Instructions	Document any instructions or conditions provided by the supervisor.

Reference guideClinic-wide

Terminology & Acronyms

A searchable reference for common clinic scheduling terms and abbreviations used in the Process Hub.

OwnerNot assigned

Version0.1

Effective dateNot assigned

Review triggerWhenever terminology or clinic usage changes

Reference use: Terms explain how wording is used in this Process Hub. When a term is unclear in a patient-specific situation, confirm with the appropriate supervisor or PCP Staff.

Common Terms

Term	Meaning in the Process Hub
PHC	Partnership HealthPlan
WCC	Well Child Check
AWE	Medicare Annual Wellness Exam
MAP / WAP	Annual medical appointment labels used in SCHC scheduling.
VVV	A fully virtual visit appointment label used in SCHC scheduling.
PCP Staff	The primary care provider staff team used for patient cases and follow-up.
ERAF	A referral or authorisation that may be required before scheduling when a Partnership patient is not assigned to SCHC.
TAR	An authorisation request used when additional visits are medically necessary beyond the standard allowance.
TOC	Transfer of Care
Family PACT	A clinic appointment program currently scheduled with FNP Jeff at McCloud under the provider rules in this guide.

QUICK RESOURCES

Helpful Links

Open frequently used clinic and public program resources in a new tab.

A Athena EMROpen athenaOne / AthenaNet for scheduling, patient cases and clinic workflows.Open Athena → P Partnership HealthPlanProvider resources, manuals, forms, directories and program information.Open Partnership → M Medi-Cal Provider ResourcesOfficial California provider information, enrollment, billing and coverage resources.Open Medi-Cal →

Security reminder: External sites open in a new tab. Use only approved clinic credentials and do not save passwords on shared devices.

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