Medical Back Office Management

Preface

Policy on Policies

Office Services Management

Brand Name Identity/Welcome Letter

PacifiCare�s Welcoming Letter

HIPAA policies, procedures, resources, web links

Confidential, Privacy example policy

Access for Non-emergency Care

Access to Care and Access Time for Appointment Standards

After Hours Services

�On Call� Policy and Procedure

Telephone log

�Walk-in� Patient Triage

Address for All Adult Patients and Visitors

Chaperone in Exam Room for Pelvic Exams

Communication with Hearing Impaired Patients

Communication with Patients and Visitors � Limited English Proficiency

Transport of Patients to Area Hospitals

Admitting Process: Office to Hospital

Telephone Access and �Hold� Time

Record for Telephone Calls from Patients

Smoke-free Environment Policy

Appointment Scheduling Policy

Missed or �No Show� Appointment Policy

Reschedule Notification Letter format

Appeal process for missed appointment charge

Patient Registration

Registration Form

Payment Policy acknowledgment form

Insurance payment (or non-payment) release agreement form

Lien attachment form

Third party liability information sheet

Emergency �On-site� Triage Policy

Emergency Telephone Triage

Office Emergency/Code Blue Policy and Procedure

Code Blue

�Stat Nurse� Call

Physical Abuse Policy

Patient Rights and Responsibilities

Advanced Directives, policy

�Living will� Declaration � example

Physician Request for Transfer of Care

Letter to patient � example

Discharge of terminated patients presenting for medical care, P&P

Nursing Services

Capitation fundamentals

Benefit and eligibility determination verification

Identification card

Financial Responsibility Guarantee Form

Eligibility FAQs

Eligibility and Benefits Verification � P & P

Waiver of Co-payments � P & P

Appeal of HMO Denial � procedure

Grievance tracking

Submission of encounter data and claims

Coordination of Benefits

Third party liability

Preadmission review

Sanctions and Fines � Utilization Management, P & P

Provider Sanctions and Fines: QI Committee

Fine Notification Form

Record retention guidelines

Ambulatory Care Site/Survey Visit Preparation Tools

Site visit policy/procedure

Criteria/list examples

Authorization and release form for medical office site visits

Risk Management/Patient Relations

Patient compliance
Report of occurrence
Safety Standards
Customer Concern Form

Medical Records

General Policies and Procedures for Medical Records
Medical Record Documentation Standards
Release of Medical Record Information, P & P, CA law
Psychotherapy Notes
Confidentiality Issues
Authorization to Transfer Medical Records, example formats
Affidavit to accompany medical records
Staff initials/signature sheet
Corrections to a medical record - policy
Confidential Fax Transmission Format
Unsolicited test results, P & P, example letter formats
Online Medical Records
Medical records retention policy
Medical records storage - security requirements
References and Resources � Medical Records
Medical Records and Coding � Web Sites