Medical Office Policy and Procedure Manual

Medical Office Policy and Procedure Manual

Company Name, Inc. 1234 Second Ave. San Diego, CA 92101, USA

Tel: +1. 858.321.1234 Fax: +1. 858.321.5678 info@

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Medical Office Policy and Procedure Manual

Revision History

VERSION 1.0

DATE

EDITED BY

NOTES

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Medical Office Policy and Procedure Manual

Contents

Introduction ............................................................................................ 11

About Cardiology Medical Group ............................................................................... 11 Changes to This Manual ............................................................................................ 11 Cardiology Medical Group Values.............................................................................. 12

Physicians............................................................................................... 13

Introducing Your Physicians ...................................................................................... 13 Physicians' Hours of Work ......................................................................................... 13 Locum Arrangements................................................................................................. 13

Staff ......................................................................................................... 15

Business Manager Job Description............................................................................ 15 Office Assistant Job Description ................................................................................ 16 Immunization ............................................................................................................. 17 Bonding of Employees ............................................................................................... 17 When the Physician Is Away...................................................................................... 17 Continuing Education................................................................................................. 17 License Recertification............................................................................................... 18 Providing Advice without a License............................................................................ 18 Dating Patients .......................................................................................................... 18 Manual Handling Techniques..................................................................................... 18

Patient/Physician Relationship ............................................................. 21

Patient Rights and Responsibilities ............................................................................ 21 Complaints................................................................................................................. 22

Medical Office Facility Standards ......................................................... 25

General Information ................................................................................................... 25

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Medical Office Policy and Procedure Manual

Staff Room................................................................................................................. 25 Smoking .................................................................................................................... 26 Checklists .................................................................................................................. 26

Office Visits............................................................................................. 29

Appointment Scheduling Guidelines .......................................................................... 29 Emergency and Priority Cases................................................................................... 30 Appointment Status Change ...................................................................................... 30 Appointment Status Change, No Show Policy ........................................................... 30 Appointments for Specialists or Consultant Physicians .............................................. 31 Checking in Patients .................................................................................................. 31 New Patient Registration ........................................................................................... 32 Insurance Validation .................................................................................................. 32 Patient Emergencies/Triage....................................................................................... 33 Calling Patients from the Waiting Room..................................................................... 34 Office Encounter Forms ............................................................................................. 35 Payment Methods...................................................................................................... 36 Health Services Information ....................................................................................... 37 Telephone Evaluation, After Hour Telephone ............................................................ 37 No Show Policy.......................................................................................................... 38 Noncompliant Patients ............................................................................................... 39 Terminating the Physician-Patient Relationship ......................................................... 39

Consent Policies .................................................................................... 43

Consent Policies (with or without Representative) and Minor ..................................... 43 Refusal of Treatment ................................................................................................. 54 Emergencies and Consent......................................................................................... 57

Prescriptions .......................................................................................... 61

Refilling Prescriptions ................................................................................................ 61 Preauthorizing Prescriptions ...................................................................................... 62

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Medical Office Policy and Procedure Manual

Prescriptions That Require Prior Authorization ........................................................ 62 5-Day Supplies without Prior Authorization .............................................................. 63 Initiating the Prior Authorization Request ................................................................. 63 Requirements for Prior Authorization Review .......................................................... 63 Automated Prior Authorization Approvals ................................................................ 63 Clinical Review Process .......................................................................................... 64 Denials .................................................................................................................... 64 Maintaining Medicines ............................................................................................... 65 Narcotic Drug Controls............................................................................................... 66 Initiation of Opioid Treatment................................................................................... 66 Evaluation following a 90-Day Period of Usage ....................................................... 67 Pharmaceuticals at the Office .................................................................................... 68 Proper Maintenance and Storage of Drugs.............................................................. 68 Cytotoxic Drugs ....................................................................................................... 69

Reporting Violence and Abuse ............................................................. 71

Immunity .................................................................................................................... 71 Guidelines for Assessment ........................................................................................ 71 Documentation of Abuse............................................................................................ 72 Reporting ................................................................................................................... 73 Penalties.................................................................................................................... 73 Physicians Domestic Violence Training ..................................................................... 73 Reporting Child Abuse/Neglect .................................................................................. 73

Diagnosis ................................................................................................................ 75 Reporting................................................................................................................. 75 Immunity.................................................................................................................. 76 Penalties ................................................................................................................. 76 Employee Statements ............................................................................................. 76 Reporting Elder and Dependent Adult Abuse............................................................. 76

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Medical Office Policy and Procedure Manual

Abuse ...................................................................................................................... 76 Physical Abuse ........................................................................................................ 77 Sexual Assault......................................................................................................... 77 Sexual Abuse .......................................................................................................... 77 Physical Abuse Indicators........................................................................................ 77 Fiduciary Abuse....................................................................................................... 78 Neglect .................................................................................................................... 78 Abandonment .......................................................................................................... 79 Isolation................................................................................................................... 79 Dependent Adult Abuse........................................................................................... 79 Endangered Adults Laws......................................................................................... 81

Patient/Office Safety .............................................................................. 85

Patient Injuries at Cardiology Medical Group ............................................................. 85 Office Security ........................................................................................................... 90 Office Data Security ................................................................................................... 90

General Guidelines.................................................................................................. 90 E-mail Communication ............................................................................................ 91 Red Flag Rule Identity Theft Compliance Program .................................................. 91 OSHA Resources ...................................................................................................... 94 OSHA 300 Log .......................................................................................................... 94 Workplace Violence Prevention ................................................................................. 95 Medical Services and First Aid................................................................................... 95

Emergency Plan Procedures................................................................. 97

General Emergency, Disaster, and Safety Procedures .............................................. 97 Emergency Plans....................................................................................................... 97

Evacuation .............................................................................................................. 97 Transfer of Patient to Ambulance ............................................................................ 98 Earthquake ............................................................................................................ 101

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