Name of RHC
Rural Health Clinic Policy & Procedure Manua=
l
Updated: Date of Update
&=
nbsp; On
Date of Update, the Annual Evaluation Committee of Name of RHC updat=
ed
the rural health clinic policy and procedure manual of the clinic.
&=
nbsp;
&=
nbsp;
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Name |
Title |
Signature |
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Name of RHC Physici= an |
Medical Director |
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Nurse Practitioner<= /span> |
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Office Manager |
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Nonmember |
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Mark R. Lynn= |
Healthcare Consulta= nt |
|
Name of RHC
Rural Health Clinic
POLICY AND PROCEDURES MANUAL
Introduction
This policy manual is s= pecific to the operation of the rural health clinic in Your City, Your State and supplements the policies and procedure guidance provided in other policy and procedure manuals prepared by Name of RHC.= Your Medical Director makes a sustained and substantial effort to ke= ep the rural health clinic in full compliance with applicable State, Federal (OSHA, CLIA, etc.) and this policy manual is one of the tools that helps en= sure compliance. This policy manua= l only address items specific to rural health and does not address other issues wh= ich are more appropriately addressed in other forms of guidance. Such guidance includes the followi= ng list of resources:
=
&nb=
sp; 1.
=
&nb=
sp; 2.
=
&nb=
sp; 3.
= &nb= sp; = &nb= sp; =
If the guidance in the = Rural Health Clinic policy manual is found to conflict or differ from guidance in some other policy manual, the specific guidance should be brought to the attention of the Office Manager who will resolve the conflict through appropriate channels based upon the specific situation. This manual should be reviewed on = an annual basis by the Medical Director, Mid-Level Practitioner, Office Manager and the annual evaluation committee and such review should be documented.
Condition I:<=
span
style=3D'mso-tab-count:2'> &=
nbsp; Complian=
ce
with Federal, State and Local Laws
100 Compliance with Federal,
State and Local Laws
= <= /p>
The C=
linic
will make a sustained and substantial effort to be in full compliance with =
all
applicable State, Federal (OSHA, CLIA, etc.), and local.
110 Policy and Procedure Re=
view
The O= wner of the clinic is NAME OF RHC PHYSICIAN dong business as Name of RHC in Your Ci= ty, Your State and is responsible for the operation of the clinic. This clinic = is organized under the laws of Your State as a for-profit sole proprietorship.= The Medical Director, Mid level Practitioner, Office Manager, and &nb= sp; non-clinic personnel will review and approve the policy and procedures of the clinic annually.
Name of RHC is the Medic= al Director and is responsible for the overall direction of the facility. The = Office Manager is responsible for the business functions and the overall function = of the clinic operation, including scheduling and supervising billing and cler= ical personnel. The Mid-level practitioner position reports to the Medical Director for Medical/operation= al issues and to the Office Manager for business office matters. The Organization chart is presente= d as Appendix A in Section 11 of this manual.
The clinic is under the = Medical Direction of Name of RHC The responsibility of the Medical Director(s) is further delineated in the policy section headed "Physician Responsibility".
The c= linic has a Midlevel Practitioner on site at least fifty percent of its scheduled days of operation. The clinic maintains other ancillary support staff as required by patient volumes. The office Manager schedules and supervises clinical and ancillary personnel. The office hours of the clinic are= as follows:
Clinic Hours of Operation
&n= bsp; = ; Monday Tuesday Wednesday Thursday Friday Saturday Sunday
&n=
bsp; =
; 8
to 5 =
8 to 5
8 to 5 =
;
8 to 5
8 to 5
Physician Office Schedule
&n= bsp; = ; The schedule for Name of RHC, medical director for the facility, is as follows:
&n= bsp; = ; &n= bsp; = ; &n= bsp;
&n= bsp; = ; &n= bsp; Monday Tuesday Wednesday Thursday Friday Saturday Sunday
&n=
bsp; =
; &n=
bsp;
Mid-Level Office Schedule
&n= bsp; = ; The work schedule for the clinics Mid-Level practitioner, is more than 50% of t= he time the clinic is open and is as follows:
&n= bsp; = ; &n= bsp;
&n= bsp; = ; &n= bsp; Monday Tuesday Wednesday Thursday Friday Saturday Sunday
&n=
bsp; =
; =
The Physician, Midlevel Practitioner and other members as required, annually review the policies and procedures of the clinic. This review includes all patient care policies and is performed before approval = is made.
Healthcare Business Spec= ialists will perform an annual evaluation of the program, which will include both utilization review of services, policy and procedure update, medical record review of open and closed records and quality review of records. This annual evaluation will be per= formed with the annual evaluation &nbs= p; committee that will include the medical director of the clinic, Mid-Level practitione= r, office manager, a nonmember of the clinic staff, Executive Director of the corporation, and a representative from Healthcare Business Specialists. The Annual Evaluation Committee is comprised of the following people:
= &nb= sp;
= &nb= sp; Name of RHC &= nbsp; &nbs= p; &= nbsp; &nbs= p; Medical Director
&nbs= p; &= nbsp; &nbs= p; &= nbsp; &nbs= p; &= nbsp; &nbs= p; &= nbsp; &nbs= p; Nurse Practitioner
&nbs= p; &= nbsp; &nbs= p; &= nbsp; &nbs= p; &= nbsp; &nbs= p; &= nbsp; &nbs= p; Office Manager
&nbs= p; &= nbsp; &nbs= p; &= nbsp; &nbs= p; &= nbsp; &nbs= p; &= nbsp; &nbs= p; Nonmember
&nbs= p; &= nbsp; &nbs= p; Mark R. Lynn = &nb= sp; = &nb= sp; Healthcare Consultant
120 Anti-Discrimination Pat=
ient
Policy
The services provided by= the Name of RHC or any other operations it might in the future support, are available to all persons desiring those services regardless of race, color, national origin, religion, age, physical or mental handicap.<= /p>
125 Personnel Summary
&n=
bsp; =
; The
following table is a listing of the professionally licensed employees of
|
<= o:p> N= ame |
<= o:p> P= osition |
H=
ire D= ate |
E=
nd D= ate |
L=
icense N= umber |
R=
enewal D= ate |
|
Name of RHC |
MD |
|
|
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|
NP |
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|
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LVN |
|
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=
130 Physician Documentation=
The documentation for Name of RHC is located behind the tab = &nb= sp; for Professional Licensure located in the Credentials File.
= &nb= sp; State License
&n= bsp; = ; &n= bsp; Diploma
&n= bsp; = ; &n= bsp; Curriculum Vitae
&n= bsp; = ; &n= bsp; Drug Enforcement Authority Prescriptive Permit
&n= bsp; = ; &n= bsp; State Prescriptive Permit
&n= bsp; = ; &n= bsp; Hospital Privileges
Certification of Liabili=
ty
Insurance according to Facility Policy is located &=
nbsp; behind
the tab for Liability insurance.
140 Midlevel Practitioner
Documentation
The documentation for the Midlevel Practitioner is located behind the tab for Professional Licensure = in the Credentials File.
&n= bsp; = ; &n= bsp;
&n= bsp; = ; &n= bsp; State License
Board of Examiners' Lett= er approving as a Midlevel Practitioner
&n= bsp; = ; &n= bsp; Diploma
&n= bsp; = ; &n= bsp; Curriculum Vitae
&n= bsp; = ; &n= bsp; Certification of Liability Insurance according to Facility Policy
150 Professional Nursing or
Licensed Personnel Documentation
=
&nb=
sp;
The documentation for any Licensure of RN’s, LPN’s, or Medical Assistants is located behi= nd the tab for Professional Licensure in the Credentials File.
&n= bsp; = ; &n= bsp;
&n= bsp; = ; &n= bsp; State License
&n= bsp; = ; &n= bsp; CPR Certificate
&n= bsp; = ; &n= bsp; Continuing Education Information &nbs= p;
&n=
bsp; 160 &=
nbsp; Ancillary
Professional Personnel Documentation (Lab/X-Ray)
=
&nb=
sp;
= The documentation for any Licensure of any laboratory professional or &= nbsp; &nbs= p; radiological professional is located behind the tab for Professional = &nb= sp; = Licensure in the Credentials File.
&n= bsp; = ; &n= bsp;
&n= bsp; = ; &n= bsp; State License
&n= bsp; = ; &n= bsp; CPR Certificate
&n=
bsp; =
; &n=
bsp; Continuing
Education Information &nbs=
p; &=
nbsp; &nbs=
p; &=
nbsp;
170 CLIA/X-Ray Certification
Documentation
=
= The documentation for the laboratory (CLIA) or X-Ray equipment is &= nbsp; &nbs= p; located behind the tab for Professional Licensure in the Credentials File.
&n= bsp; = ; &n= bsp; CLIA Certificate: =
&n= bsp; = ; &n= bsp; X-Ray: &= nbsp; NA
&n=
bsp; =
; &n=
bsp;
&n=
bsp; <=
span
style=3D'font-size:14.0pt'>
Condition II:=
&=
nbsp; Location
of Clinic
200 Map showing Location of=
the
RHC
&n= bsp; = ; The documentation for the location of the clinic is located = ; &n= bsp;
&n= bsp; = ; &n= bsp; In Appendix B.
=
&nb=
sp;
210 &=
nbsp; Letter
from the State Department of Health determining clinic is eligible for
certification.
The documentation for the approval of the rural health clinic status for Name of RHC was in the first rural health policy and procedure manual and cannot be located.
=
&nb=
sp;
220 &=
nbsp; Medically
Underserved Area and/or Health Professional Shortage Area designation
documentation.
= The documentation for the underserved status of the area can be obtained &= nbsp; &nbs= p; by calling or writing:
&n= bsp; = ; &n= bsp; = ; Mr. David Brand
&n= bsp; = ; &n= bsp; = ; Division of Shortage Designation
&n= bsp; = ; &n= bsp; = ; Bureau of Primary Health Care
&n=
bsp; =
; &n=
bsp; =
;
&n=
bsp; =
; &n=
bsp; =
;
&n= bsp; = ; &n= bsp; = ; Telephone: (301) 594-3813
230 The physical address and
phone/fax number of the clinic
= &nb= sp; = Name of RHC
&n=
bsp; =
; &n=
bsp; =
;
&n= bsp; = ; &n= bsp; = ; Your City, Your State 93610
&n= bsp; = ; &n= bsp; = ; Telephone Number: (559) 665-0275
&n=
bsp; =
; &n=
bsp; =
; Fax
Number: (559) 665-7126
Condition III=
: &=
nbsp; Physical
Plant and Environment
300 City, county or Fire
Marshall's Inspection Report
The documentation for th= e Fire Marshall's report is located behind the tab titled Preventive Maintenance a= nd is obtained every three years.
310 Maintenance Program
The Office Manager will = check periodically to insure that the staff is maintaining the building in accord= ance with the following guidelines:
&n= bsp; = ; Maintenance Items &n= bsp; = ; &n= bsp; Maintenance Schedule
&n= bsp; = ; Custodial Services (interior) = &nb= sp; = &nb= sp; Daily
&n= bsp; = ; Custodial Services (exterior) = &nb= sp; = &nb= sp; Mont= hly
&n= bsp; = ; Mechanical and air handling &nb= sp; = &nb= sp; = A= nnually
&n= bsp; = ; System adjustment &nb= sp; = &nb= sp; = &nb= sp; Annually
&n= bsp; = ; Inspect fire extinguisher &n= bsp; = ; &n= bsp; = ; Monthly
&n= bsp; = ; Inspect and test general medical &= nbsp; &nbs= p; &= nbsp; &nbs= p; Daily
&n= bsp; and laboratory equipment
&n= bsp; = ; Inspect existing sign age &n= bsp; = ; &n= bsp; = ; &n= bsp; Annual
&n= bsp; = ; Termite inspection &nb= sp; = &nb= sp; = &nb= sp; = Annual
&n= bsp; = ; Exterminator services = ; &n= bsp; = ; &n= bsp; = ; Annual
The preventive maintenan= ce plan is maintained in the clinics Log Book that has copies of the preventive maintenance plan for the clinic and includes control for laboratory services and temperature logs for refrigerators and freezers. Copies of the Maintenance Log and Control Logs are inclu= ded in the Preventive Maintenance Tab.
Any contracted maintenan= ce service contracts will be evidenced by a contract for these services behind= the preventive maintenance Tab and copies of relevant invoices will be maintain= ed for one year and then placed in the Outdated RHC Policy Manual File.
&n= bsp; = ; Specific Equipment will have a preventive maintenance program.
320 Storage and Care of Sup=
plies
and Equipment
Laboratory and other med= ical equipment are calibrated daily before the equipment is used. See Log Book.<= /p>
is contracted to provide external laboratory services and provides a daily cou= rier service to collect specimens. Test reports are provided on = hard copy through a telecommunications hookup within 24 hours. Positive values w= ill be called directly into the medical center in as short a time as possible. Information on the laboratory is as follows:
_________= ________________
_________= ________________
_________= ________________
Preventive maintenance inspection and testing pr= ogram is to insure:
A. That the equipment is operating properly. If it is a measuring instrument, its output should have satisfactory fidelity and accuracy. If it = is a therapeutic instrument it should deliver accurately and safely the therapeu= tic effect at the proper time. (V= alues of proper operation should be furnished by the supplier)
B. That equipment and all accessories, cables, and power cords are safe.
C. That the equipment is mechanically in good condition with no missing parts, loose 'switches or knobs, and no broken glass.&n= bsp; Casters should be free and lubricated (if required) so that mobile equipment will not tip or make unpleasant noises.
D. That a full set of accessories, spare recording paper, and other consumable supp= lies necessary for operation is available with the equipment.
E. = All operating manuals are reading accessible to person operating equipment.
F. = Maintenance manuals are provided for engineering.
G. That the optimum reliability and life of the equipment is obtained by carrying o= ut manufacturer's recommended maintenance procedures.
H. &= nbsp; Th= at the equipment and its accessories are clean, untarnished, and of good appearance, both for sanitary reasons and to improve confidence in the equipment and the part of the user, the patient, and observers.
&= nbsp;
ELECTRICAL INSTRUMENTAT=
ION
SAFETY INSPECTION & TEST PROCEDURES
&= nbsp; Prior to testing any patient care or non-patient care equipment for electrical safety, = ; it shall be visually inspected for any physical defects, such as damaged fords= or plugs, missing or broken knobs or switches, etc. Any defects found will be corrected immediately. It shall also be checked to see that all cables, accessories, and consumable supplies are readily available.
&=
nbsp; &nbs=
p; DEFINITION: Electro medical equipment shall be defin=
ed as
that &n=
bsp; =
; &n=
bsp;
330 Manufacturer's recall of
supplies
{ = ; On receipt of a drug recall, clinic personnel will immediately inspect all medication areas for the affected lot numbers.
&n= bsp; = ; { = ; Affected medication will be immediately removed from stock and = &nb= sp; &= nbsp; destroyed or returned as directed.
&n= bsp; = ; { = ; A drug recall file will be maintained indicating all actions taken.
{ = ; A device recall will be handled in the same manner as a drug recall.
340 Biomedical Waste Plan
This plan prescribes min= imum sanitary practices relating to the identification, segregation, handling, labeling and storage of biomedical waste.&= nbsp; Such practices are necessary to ensure that waste is properly manage= d in order to eliminate the exposure of employees, patients, and the public to disease-causing agents. This = plan also describes required training of personnel involved with biomedical wast= e, and indicates how spills or leaks of biomedical waste should be cleaned up = and disinfected.
&n= bsp; = ; I. &= nbsp; Normal Protocol
Biomedical waste shall be identified and segregated from other solid waste at the point of origin wit= hin this facility.
&n= bsp; = ; &n= bsp; Biomedical waste shall not be mixed with hazardous waste.
Biomedical waste that is= mixed with radioactive material shall be managed and disposed.
&n= bsp;
Any other solid waste, w= hich is neither hazardous nor radioactive in character, mixed with biomedical waste, shall be managed as biomedical waste.
&n= bsp; = ; &n= bsp; A. Identification
Biomedical waste is defi= ned as any solid or liquid waste that may present a threat of infection to humans. The term includes, bu= t is not limited to, non-liquid tissue and body parts from humans and other primates; laboratory and veterinary wastes which contain human disease -cau= sing agents; discarded sharps; and blood, blood products, and body fluids from humans and other primates. The following are also included:
(a)
(b)
(c)
Also included as biomedi= cal waste are sharps, which are devices that are capable of puncturing, lacerat= ing, or otherwise penetrating the skin. These devices include, but are not limited to needles, scalpels and needles attached to disposable syringes.&n= bsp; Also included are intact or broken glass and intact or broken hard plastic, when contaminated with blood or other body fluids. Suction canisters, or similar disp= osable medical items, filled with blood or body fluids that are gelled by a polymerizing agent prior to on-site transport may be handled and packaged as non-sharp biomedical waste.
&n= bsp; = ; &n= bsp; B. = Segregation
Biomedical waste, except= sharps, shall be packaged in red bags that meet the strength specifications. Also, red bags shall have a 6-inch biological hazard symbol imprinted on them, unless the bag is 19" x 14= " or smaller, when a 1-1/2" symbol shall suffice. All bags also shall be imprinted w= ith the phrase "Biohazard", "Biohazardous Waste", "Biomedical Waste", or "Infectious Waste".
Discarded sharps shall be segregated from all other waste and shall be placed directly into sharps containers that meet the specifications.&n= bsp; Sharps containers (and sharps-container holders or sleeves for wall mounting, if they are used) shall be marked with a biomedical hazard symbol that is at least 1-1/2" across and with the phrase.
A 275-pound bursting str= ength, double-walled corrugated cardboard box may be used as a sharps container for contaminated items made of glass or hard plastic. The box shall be lined with a larg= e, labeled red bag.
Biomedical waste may be = put down a drain into a sewer system if the waste is in a liquid or semi-so lid form= , if aerosol formation from the waste material is minimal, and if protective app= arel is worn by the person discharging the material into the sewer.
&n= bsp; = ; &n= bsp; C. Handling
Filled red bags are fill= ed sharps containers shall be sealed at the point of origin.
Persons handling sealed = red bags or sharps containers, or cleaning spills or leaks of biomedical waste, shall wear personal protective equipment, as required by OSHA.
Non-sharp biomedical was= te shall be red-bagged at the point of origin. Sharps shall be put into sharps containers at the point of origin.
Nothing shall ever be re= moved from a red bag or from a sharps = ; container.
All red bags shall be containerized in preparation for off-site transport. Home health agencies shall transpo= rt red bags from clients' homes to the home office in sanitizable containers that = are marked with a 6-inch symbol and the phrase. Sharps containers may be transport= ed without further containerization.
Sharps containers shall = not be overfilled and, when inserting sharps into the containers, the opening shal= l be observed to make sure nothing is sticking out.
Contaminated needles sha= ll never be cut, bent, or recapped, except when recapping is required by the procedu= re being performed. If recapping is done, it shall be done one-h= anded, or by using a recapping device.
&n= bsp; = ; &n= bsp; D. Labeling
Labels need to be placed= on transport containers (boxes or tubs), = ; and shall have printed on them this facility's name, address and a date. The date is not required on anythi= ng if biomedical waste is removed from the facility at least once every 15 days.<= /p>
Red bags, including thos= e used to line boxes or tubs, shall be labeled on the same day that they are put i= nto use. If small red bags are pl= aced into a labeled, large red bag (box liner) prior to off-site transport, then= the small bags need to be dated only, if the waste is picked up monthly. If the waste is picked up at least= once every 15 days, then no date or other labeling is required on these small red b= ags that go into a large, labeled, red box liner.
&n= bsp; = ; &n= bsp; = ;
Boxes and tubs shall be =
labeled
and dated (the date may not be required) prior to off-site transport. A
registered biomedical waste transporter may provide labels that are generat=
or-specific,
such as bar codes, for red bags, sharps containers, and outer containers.
&n= bsp; = ; &n= bsp; = ; Labeling shall be done! If labels are = not available, see your = ; &n= bsp; = ; &= nbsp; supervisor immediately.
&n= bsp; = ; &n= bsp; E. = Storage
Storage of biomedical wa= ste shall not be for a period greater than 60 days. The 60-day time period shall comme= nce when the first non-sharps item of biomedical waste is placed into a red bag= or sharps container, or when the sharps container is closed. Our Biomedical waste will be remov= ed from our facility by BFI, a registered transport company. We will keep all records provided = to us by our transporter for a minimum of three (3) years.
Biomedical waste must be= stored in designated areas that are located away from pedestrian traffic. Therefore, our biomedical waste sh= all be stored in the laboratory.
Our storage area(s) shal= l be made accessible only to authorized personnel by keeping the door(s) locked = at all times.
Our storage containers s= hall be marked with a biological hazard = ; symbol that is at least 6 inches across and also with the phrase "Biohazard", "Biohazard Waste", "Biomedical Waste", or "Infectious Waste".
&n=
bsp; =
; &n=
bsp; =
;
Our storage area(s) shal= l be free to vermin and insects, and shall be maintained in a sanitary condition= .
If we choose to store our biomedical waste in an outdoor area, the area will meet all the above crite= ria and in addition will be &= nbsp; designated by a biological hazard symbol that is at least 6 inches across, and will be secured against vandalism.
&n= bsp; = ; &n= bsp; F. = On-site Transfer
Sealed red bags and clos= ed sharps containers shall be transferred from the point of origin to the stor= age area by persons wearing gloves, and any other appropriate protective clothi= ng required by OSHA.
&n= bsp; = ; &n= bsp;
Every effort shall be ma= de to insure that sealed red bags and closed sharps containers are not broken open during on-site transfer between the point of origin and the storage area.
Red bags and sharps cont= ainers shall not be put down trash chutes, nor shall they be moved by use of autom= ated transfer methods.
There shall be neither r= ecycling efforts nor intentional removal of biomedical waste from red bags or sharps containers.
&n= bsp; = ; II. = Training
All new employees who de= al with biomedical waste shall be given initial &nb= sp; trai= ning in the concept and function of our waste-handling system before their duties commence. Employees wh= o deal with biomedical waste shall be updated after a rule change or waste-handling system change, and in addition shall attend an annual refresher trai= ning session with regard to biomedical waste.
All training phases (ini= tial, updates and annual refresher training) shall take into consideration the following aspects of biomedical waste management: identification, segregati= on, handling, labeling, storage, on-site transfer, training of employees and contingency plans for cleaning up and disinfecting spills and/or leaks of biomedical waste.
Training records signed = by employees shall be kept for all participants in all training sessions, and shall be maintained on-site for a minimum of three (3) years.
Specifically, in our fac= ility, training will be accomplished in the following manner: Prior to undertaking tasks invo= lving exposure to biomedical waste, and at least yearly thereafter, employees will read this biomedical waste plan and will be walked through our biomedical w= aste handling and disposal system, when they will be encouraged to ask any quest= ion involving our system. Trainee= s will sign a training record after each training session, which will be kept for = at least 3 years.
&n= bsp;
<= /span>III. Conti= ngency Plan for Spills
In case of a leak or spi= ll of biomedical waste, any solid material shall be picked up and put into appropriate containers by people wearing gloves and any other appropriate clothing. Sharps shall be pic= ked up using hemostats or other appropriate tools, and not hands.
&n= bsp;
&n= bsp; = ;
The contaminated surface= (s) then shall be cleaned with a solution of industrial strength detergent to remove visible soil, before being disinfected by one of the following methods: a) Steam for a minimum of 30 secon= ds; b) Rinsing for at least 3 minutes with a hypo chlorite (bleach) solution containing at least 100 parts per million available free chlorine; or iodine solution containing at least 25 parts per million available iodine; or c) U= se of chemical germicides that are tub= erculocidal and are registered by the Environmental Protection Agency as hospital disinfectants.
Specifically, in our fac= ility, we will use the following method to disinfect a leak or spill of biomedical waste:
&n= bsp; = ; &n= bsp; Clean with CitruGuard wearing special gloves.&nb= sp; All waste &n= bsp; = ; &n= bsp; = ; &= nbsp; materials will be placed in the red -bag hazardous material bag. = &nb= sp; = &nb= sp; = <= span style=3D'mso-tab-count:4'> &= nbsp; &nbs= p; &= nbsp; &nbs= p;
Liquid waste created by = any such disinfect ion operation shall be disposed of down a drain into a sewer syst= em.
Reusable containers for = holding red bags (waste baskets or cans, kick-buckets, etc.) shall be sanitized each time the red bag is changed out, by either method a), b) or c) above. Home health agencies shall use one= of these methods to sanitize their containers for transporting red bags, after= each use.
360 Drugs and Biological St=
orage
Plan
All storage, handling, a= nd administration of drugs and biologicals shall be under the supervision of t= he Medical Director. This indivi= dual is responsible for assuring that medications and treatment materials, both prescription and nonprescription are stored properly and securely.
In order to assure that = drugs and biologicals are properly cared for, the following steps are taken:
1. = All medications are to be kept plainly labeled which may involve periodic re-la= beling in the event of illegibility. Contents from illegibly marked medications are not to be used.
2. = All drugs and biologicals are stored according to instructions on the package.<= span style=3D'mso-spacerun:yes'> Efforts are taken to protect such = drugs and biologicals from damage and exposure to moisture, heat, light and air.<= /p>
&n= bsp; = ; 3. = Distinctive labels to mark poisons are used.
4. = To insure against deterioration, stock is rotated when a fresh supply comes in. Old reserves are moved to= the front and used before new supplies. Upon receipt of new stock, expiration d= ates are checked on old stock and those expired drugs and biologicals are dispos= ed of in the appropriate manner.
5. = Drugs and biologicals are handled by authorized personnel only as designated by t= he Medical Director.
6. = No unauthorized person is allowed to handle or have access to drugs and biologicals which are stored in the clinic.
&n= bsp; = ; 7. = No controlled substances are maintained at the clinic.
&n= bsp; = ; 8. = Authorized personnel only shall administer drugs and biologicals.
9. = Before administering a drug or biological, the label on the container is checked t= hree times: Once before the contai= ner is handled, one after the <= /span>container is removed from the storage area, and once immediately before &= nbsp; administration.
10.
11.
361 Pharmaceutical Core Lis=
t for
Emergency Crash Cart
For=
a
listing of the emergency kit drugs see the listing attached to the Kit.
362 Access and security of =
drugs
&n= bsp;
363 &=
nbsp; Maintenance
of Records Drug Storage Area Inspection Sheet/Documentation for Expired
Medications/Drug Disposal Procedure
Extreme care must be exe= rcised that no expired medications are dispensed &= nbsp; &nbs= p; &= nbsp; for patient use or allowed to remain in the clinic.
=
= ~ = ; The clinic personnel will check monthly all medication physically &= nbsp; &nbs= p; &= nbsp; &nbs= p; for dated items and remove all expired packages from the shelves.
&= nbsp; &nbs= p; ~ = ; If the expired items indicated no usage over a six-month period, &= nbsp; &nbs= p; &= nbsp; &nbs= p; &= nbsp; this fact will be called to the attention of the Medical Director who &= nbsp; &nbs= p; &= nbsp; &nbs= p; will make judgment about replacement.
&= nbsp; &nbs= p; ~ = ; Expired controlled drugs will be disposed of following the = &nb= sp; = &nb= sp; &= nbsp; Your State State Board of regulati= ons.
&= nbsp; &nbs= p; ~ = ; Expired non-controlled medication will be placed in a biohazard = &nb= sp; = &= nbsp; bag and picked up on an "at request" basis.
&n= bsp; = ; ~ = ; Medication will be inventoried on an as needed basis to assure that &= nbsp; &nbs= p; &= nbsp; adequate supplies are available.
=
~ =
; The
expiration dates on all medication will be monitored monthly &=
nbsp; &nbs=
p; &=
nbsp; &nbs=
p; and
documented.
=
&nb=
sp; Recording
for Refrigerator Temperatures
=
&nb=
sp; A
sample of the refrigerator and Freezer temperature log is in the &=
nbsp; &nbs=
p; &=
nbsp; tab
labeled Preventive Maintenance and this is performed daily.
380 Fire and Evacuation Pla=
n
=
&nb=
sp;
= Floor Plan of Building and Exits
=
&nb=
sp; =
= &nb= sp; Please see Preventive Maintenance Tab for Fire and Evacuation = &nb= sp; &= nbsp; Floor plan.
390 Non-medical Emergency P=
lan
The Midlevel Practitione= r shall be in charge during a non-medical emergency. In his/her absence the Office Mana= ger is in charge. The following items shall be readily available: flashlight with fresh batteries, battery powered radio and an emerge= ncy first aid kit.
&n= bsp; = ; Drills:
Annual non-medical emerg= ency drills shall be carried out and documented.
&n= bsp; = ; 1. = Fire
The fire plan for the cl= inic is to be used in case of an actual emergency.= It &nb= sp; will be placed on clinic bulletin boards for reference.
&n= bsp; = ; &n= bsp; Procedures:
1. = Evacuation Routes - Always use the closest route that is available to evacuate the clinic. Routes and exits are = drawn on the attached diagram.
Please = see Preventive Maintenance Tab for Fire and &nb= sp; = &nb= sp; &= nbsp; Evacuation Floor plan and evacuation Route.
2. = Employee/Patient Plan - All employees and patients are to meet in front of the clinic immediately following the evacuation.
&n= bsp; = ; &n= bsp; = ; 3. = Responsibilities -
A. Patient evacuation and accountability: Receptionist: To evacuate from waiting rooms and rest rooms - Nurses from exam rooms, offices, staff rest room, lab and lounge.
&n= bsp; = ; &n= bsp; = ; &n= bsp; B. = Employee Roll Call: Office Manager
C. Calling the Fire Department: Whoever = finds the fire call Your City Fire Department at 911.
D. Fire Extinguisher Operators: Receptionist, Nurse, Midlevel Practitioner and/or Physician.
E. = Removing key and essential data diskettes and efforts to secure all records: Office Manager.
F. = Turning off equipment and closing doors: Last person out.
&n= bsp; = ; &n= bsp; = ; &n= bsp; G. Use common sense always!
&n= bsp; = ; The safety program is everyone's responsibility, however, it is the Office &= nbsp; &nbs= p; &= nbsp; Managers responsibility to direct the program.
&n= bsp; = ; General Fire and Fire Extinguisher Information
&n= bsp; = ; There are three types of fires: =
Class= A: &= nbsp; Fires involving paper, wood and similar solid combustible materials.
&n= bsp; = ; &n= bsp; Class B: = ; Fires involving flammable liquids.
&n= bsp;
&n= bsp; = ; &n= bsp; Class C: = ; Fires involving electrical equipment.
There are several types = of fire extinguishers. Each type is u= sed on a different sort of fire:
1. = Water pump can: Class A - Do not us= e on electrical fires, or flammable liquid.
&n= bsp; = ; &n= bsp; 2. = Carbon Dioxide: Class B and C fires.=
&n= bsp; = ; &n= bsp; 3. = Water or Antifreeze Extinguisher: C= lass A
&n= bsp; = ; &n= bsp; 4. = Dry Chemical Extinguisher: Class = A, B, or C fires
&n= bsp; = ; &n= bsp; 5. = Multi-user Extinguishers: Class A, B, or= C fires
&n= bsp; = ; Use of Fire Extinguishers
1. = Remove extinguisher from shelf. Pull= the pin, breaking the plastic seal ring. Direct hose to base of fire.
2. = The range of extinguishers is 5-30 feet. Do not attempt to use extinguishers on fires that are unsafe to appr= oach at this range.
3. = The discharge time of extinguishers is 5-30 seconds. Use the extinguisher in brief blast= s, stopping to see if you have been effective, thus saving the time for repeat= ed attempts. Locate the area not= under control and try again.
&n= bsp; Locations of Fire Extinguishers
Locations of fire exting= uishers are designated in the diagram located in the Preventive Maintenance Tab for Fire Extinguisher Designation Diagram.
&n= bsp; = ; &n= bsp; = ;
&n= bsp; = ; Fire Safety Instructions
&n= bsp; = ; &n= bsp; 1. = Do not shout "FIRE"!!! Avoid panic.
&n= bsp; = ; &n= bsp; 2. = Evacuate patients in immediate danger.
&n= bsp; = ; &n= bsp; 3. = Contain the fire by closing the door.
&n= bsp; = ; &n= bsp; 4. = Call Your City Fire Department at 911. &nbs= p;
&n= bsp; = ; &n= bsp; 5. = Follow clinic procedures for individual responsibilities.
The greatest danger in b=
uilding
fires is panic. In case of fi=
res,
remember; do not shout "FIRE".&n=
bsp;
This causes confusion and leads to panic. It is the duty of every employee to
prevent patients from becoming unnecessarily frightened in any emergency.
= 2. = Tornado, Hurricane and Severe Thunderstorm
Lightening, flash floods, tornadoes and down bursts typically accompany thunderstorms. Tune a radio to receive weather bulletins when weather appears threatening. In the event of threatening weathe= r ask staff, patients and other visitors to remain inside the clinic. Avoid using the phone.
&n= bsp; = ; &n= bsp; Procedures:
&n= bsp;
In the event a tornado t= hreatens the medical clinic building, proceed according to the following plan:
a. = A tornado WATCH stating that tornadoes are probable will be received by staff= through radio or other means. Remain = inside the clinic.
(1)
(2)
(3)
&n= bsp; = ; &n= bsp; = ; &n= bsp; (4) Regular activities will be continued.
(5) b. =
A
tornado WARNING stating that a tornado has actually been sighted will be
received by staff by radio or by local law enforcement officials. (1) (2) (3) (4) The Office Manager will
turn off all utilities &n=
bsp; =
; possible. (5) (6) (7) (8) c. =
If
there is NO WARNING, but a tornado is sighted approaching the medical clini=
c,
staff will direct patients to do the following and then do so themselves:
=
&nb=
sp; =
&nb=
sp; =
&nb=
sp; =
&nb=
sp; =
&nb=
sp; =
&nb=
sp; =
&nb=
sp; =
(1) (2) (3) &n=
bsp; =
; &n=
bsp; =
; &n=
bsp; (4) Do Not
attempt to open windows. &=
nbsp; &nbs=
p; &=
nbsp; &nbs=
p; &=
nbsp; &=
nbsp; &nbs=
p; (5) Get
under heavy furniture, if available. (6) &n=
bsp; =
; &n=
bsp; =
; &n=
bsp; (7) Remain
in position until the tornado passes. (8) =
<=
o:p> d. =
In
the event of severe thunderstorms, proceed according to the following plan.=
(1) (2) (3) (4) (5) e. =
In
the event of a Hurricane WATCH the Office Manager will monitor weather
advisories for worsening conditions. &n=
bsp; =
; &n=
bsp; =
; f. &=
nbsp; In
the event of a Hurricane WARNING: (1) (2) (3) (4) (5) (6) &n=
bsp; =
; 3. =
Snow
and Ice Snow and ice conditions =
can
usually be forecast in advance so that emergency action can be initiated be=
fore
such conditions affect the medical practice. It is not anticipated that snow an=
d ice
conditions will affect the medical clinic building, but transportation to t=
he
office may be effected. In su=
ch an
event, proceed according to the following plan: a. =
The
Office Manager will receive notification by radio or some other means of
hazardous road conditions due to snow and ice. b. =
The
Office Manager will make a decision to close, delay, or open and notify the
staff and owner(s) and a decision will be made as to the status of the clinic. c. =
In
the event of closing, the receptionist should try to contact all patients a=
nd
request the local radio stations, to announce the clinic's closure and prob=
able
time of reopening. &n=
bsp; =
; 4. =
Bomb
Threat In the event a bomb thre=
at is
received at the medical clinic, proceed according to the following plan: &n=
bsp; =
; &n=
bsp; Procedure: a. =
A
bomb threat may be received by various means, but will usually be by teleph=
one. b. =
The
recipient of the call will attempt to obtain for such information, which
includes: &n=
bsp; =
; &n=
bsp; =
; { =
; time
and date reported &n=
bsp; =
; &n=
bsp; =
; { =
; how
reported &n=
bsp; =
; &n=
bsp; =
; { =
; exact
words of caller &n=
bsp; =
; &n=
bsp; =
; { =
; caller's
description of the bomb and its location &n=
bsp; =
; &n=
bsp; =
; { =
; caller's
identity and why he/she placed the bomb &n=
bsp; =
; &n=
bsp; =
; { =
; description
of the caller's voice c. =
The
recipient of the call will immediately notify the Office Mgr., Medical Dire=
ctor
and/or Midlevel Practitioner, but no one else. d. =
The
Office Manager or Medical Director and/or Midlevel Practitioner will
immediately notify the local law enforcement officials. &n=
bsp; =
; &n=
bsp; =
; County Police Department &n=
bsp; =
; &n=
bsp; =
; Telephone: (559) &n=
bsp; =
; &n=
bsp; =
; (SHERIFF)
Department &n=
bsp; =
; &n=
bsp; =
; Telephone: (559) &n=
bsp; =
; &n=
bsp; =
; Your
&n=
bsp; =
; &n=
bsp; =
; Telephone: (559) e. =
No
search of the premises will be made by the medical clinic personnel. However, unusual items should be n=
oted
and reported to the law enforcement search team. f. &=
nbsp; The
Office Manager or designee will inform all patients and staff of the bomb
threat and begin evacuation proceedings.&n=
bsp;
To avoid the risk that the bomb threat is real, the building will be
evacuated in all cases. g. =
Staff
will assist all patients from the building and then themselves evacuate the
building through the appropriate exits as conditions may suggest. h. =
If
time permits, staff should see that a few windows are opened and the doors =
are
propped open when leaving the building. i. &=
nbsp; The
Office Manager or designee will see that everyone evacuates at least 500 fe=
et
from the building. &n=
bsp; =
; j. &=
nbsp; The
Office Manager or designee will inform the law enforcement officials of any
missing persons. k. =
No
personnel shall conduct any search for missing persons. This should be left up to the appr=
opriate
officials. l. &=
nbsp; Patients
and staff will not return to the building until it has been declared safe by
appropriate authorities. &n=
bsp; 5. =
Earthquake &n=
bsp; 1. =
Move
individuals inside the clinic to an inner wall, under heavy desks or inside
supported doorways when possible. &n=
bsp; =
; &n=
bsp; 2. =
Take
an initial body count. &n=
bsp; =
; &n=
bsp; 3. =
Keep
all individuals away from glass. &n=
bsp; =
; &n=
bsp; 4. =
Do
not allow persons to run in and out of the clinic, as most &=
nbsp; &nbs=
p; &=
nbsp; injuries
occur at and around outer doorways. &n=
bsp; =
; &n=
bsp; 5. =
Do
not use open flame items. &n=
bsp; =
; &n=
bsp; 6. =
Be
prepared for after shocks following the initial tremor. 7. =
Account
for and check persons in the clinic for injury. Proceed as in a medical emergency =
as
necessary. 8. =
Check
for fumes, electrical shorts and water and sewage breakage. Shut off any malfunctioning utilit=
ies. &n=
bsp; =
; &n=
bsp; 9. =
Do
not use the phone except for genuine emergencies. &n=
bsp; =
; &n=
bsp; 10. Clean=
up
drug and chemical spillage. The electrical breaker b=
ox is
located in the closet. Call the City of &n=
bsp; =
; 5. =
Nuclear
Emergency In the event that a nucl=
ear
emergency threatens the medical clinic, proceed according to the following
plan. &n=
bsp; =
; &n=
bsp; Procedure a. =
Upon
notification of the threat of a nuclear emergency, the office manager will
attempt to gain further information either by radio or by other means that =
may
seem appropriate. &n=
bsp; =
; &n=
bsp; b. =
The
receptionist will inform all patients and staff. c. =
If
there is sufficient time for patients and staff to get home before &=
nbsp; the
blast: (1) &n=
bsp; =
; &n=
bsp; =
; (2) Patients
and staff will go home. d. =
If
there is not sufficient time for patients and staff to get home before the
blast, the Office Manager or designee will instruct patients and staff to:<=
/p>
(1) &n=
bsp; =
; &n=
bsp; =
; (2) Do
not look at the blast. &n=
bsp; =
; &n=
bsp; =
; (3) Lie
prone on the floor. &n=
bsp; =
; &n=
bsp; =
; (4) Take
shelter under heavy pieces of furniture. e. =
If
there is sufficient time for patients and staff to go home after the blast,=
but
before fallout arrives: (1) &n=
bsp; =
; &n=
bsp; =
; (2) Patients
and staff will go home. &n=
bsp; =
; &n=
bsp; f. &=
nbsp; Fallout
shelter areas in the community include: &n=
bsp; =
; &n=
bsp; =
; Location &=
nbsp; &nbs=
p; &=
nbsp; &nbs=
p; &n=
bsp; =
; &n=
bsp; =
; &n=
bsp; =
; Condition IV:=
&=
nbsp; Organizational
Structure 400 We believe that the estab=
lishment
of the Name of RHC, in Your City, Your State as a Certified Rural Health Cl=
inic
will make quality entry level pediatric&nbs=
p; care
available and financially accessible to all persons in the community. The addition of a Midlevel Practit=
ioner
allows Your Medical Director to =
; provide
quality care in a cost effective manner. As a Certified Rural Heal=
th
Clinic we will be able to provide a wide range of =
ancillary
services while still maintaining continuity through shared medical &=
nbsp; records. The clinic acts as an entry point =
for
healthcare services in the &nbs=
p; &=
nbsp; &nbs=
p; community. This helps to ensure that individu=
als in
need of healthcare obtain the &=
nbsp; &=
nbsp; necessary
type and amount of care. &n=
bsp; =
; &n=
bsp; =
; Name
of RHC is a sole proprietorship located in the state of &n=
bsp; =
; &n=
bsp; =
; Your
State. The organization was est=
ablished
exclusively to establish, maintain, and operate suitable facilities to prov=
ide
primary medical care for persons suffering from illness or disabilities wit=
hin
the service area. 1. =
To
administer healthcare of the highest quality to all clients; to practice
disease prevention and health maintenance. 2. =
To
provide comprehensive care by making available a wide range of healthcare
services. 3. =
To
maintain continuity of care by designing and maintaining a logical system of p=
aper
flow and record keeping. 4. =
To
educate patients regarding disease process, the treatment program and
appropriate interventions for potential problem situations. 5. =
To
allow the Physician(s) the flexibility to provide primary care to all citiz=
ens
of 6. =
To
maintain and increase a primary care program to provide preventative care a=
nd
health care education to citizens desiring those services, especially for t=
hose
who have limited access to adequate medical care of Lincoln county and
surrounding areas. 7. =
To
continually improve and expand the quality and comprehensives of services by
placing the practice in the hands of qualified, responsible health care professionals who will work in
cooperation with other public and private health resources. 8. =
To
develop and maintain medical care outcome standards which reflect the stand=
ards
of national medical organizations, the laws, rule and regulation of the Sta=
te
of 9. =
To
maintain an organization that can support quality medical care through the
recruiting and retention of excellent medical care personnel. 10. Clinic Organization=
al Chart The
organizational chart for Name of RHC is located in =
&nb=
sp; =
the
Tab labeled Appendices. 420 Clinic's Owners &=
nbsp; The
clinic’s owner is: &n=
bsp; =
; &n=
bsp; =
; Name
of RHC &n=
bsp; =
; &n=
bsp; =
; Your
City, Your State Condition V:<=
span
style=3D'mso-tab-count:2'> &=
nbsp; Staffing
and Staff Responsibilities 500 Job Descriptions/Perfor=
mance
Evaluations =
&nb=
sp; =
&nb=
sp; Physician/Medical
Director Phys=
ician
Responsibility This agreement includes
providing Medical Directorship, professional supervision to the Midlevel
Practitioner and to provide medical care to the patients of the clinic. Supervision shall inclu=
de
maintaining an appropriate set of standing orders, providing on site
consultation, providing telephone back-up consultation and reviewing patient
records against an appropriate standard of care. Job De=
scription Job Title: &nbs=
p; &=
nbsp; Medical
Director/Physician Department: &nb=
sp; =
Rural
Health Clinic I. =
Basic
Job Summary: A licensed professional P=
hysician
who is responsible for the clinical direction of patient care at the medical
clinic. II. =
; Qualifications: &n=
bsp; A. Education/Registrations: &n=
bsp; =
; 1. =
&n=
bsp; =
; 2. =
Currently
licensed in Your State. &n=
bsp; =
; 3. =
Must
have current Federal DEA and State DEA as appropriate to &=
nbsp; &nbs=
p; &=
nbsp; Your
State regulations. &n=
bsp; =
; 4. =
Must
be in good standing with the Your State Board of Medical &=
nbsp; &nbs=
p; &=
nbsp; &=
nbsp; Licensure. &n=
bsp; B. =
Experience: 1. =
Preferably
(5) five years in private or group practice: Pediatrics, family practice, general practice or internal
medicine. &n=
bsp; Principal
Duties and Responsibilities: &n=
bsp; A. Co-Directs
the Quality Assurance Program in accordance with the clinic. B. =
Oversees
Midlevel Practitioner to assure clinical competence. May discipline up to and including
termination, according to the clinic.
The clinic completes annual Midlevel Practitioner and Office Manager
evaluations. C. Provides
clinical evaluation of nursing, lab and x-ray personnel employed by the D. Annually
reviews clinic written policies and makes recommendations for revision. &n=
bsp; E. =
Provides
medical direction for the clinic medical care activities. F. =
In
conjunction with the Midlevel Practitioner, reviews Nursing Protocols and
revises as necessary. &n=
bsp; G. Provides
direct medical care and consultation to the patients of the clinic. H. Must
be at the clinic as scheduled according to contractual agreement. This agreement provides that the
Physician will be available, at minimum, 40 hours during a one-week period.=
I. &=
nbsp; Must
make certain that the Midlevel Practitioner has Physician back-up available
when Physician is not present at clinic. &n=
bsp; J. &=
nbsp; Assists
with annual program evaluation and chart audit. &=
nbsp; K. Works
cooperatively with the rural health clinic Office Manager in =
providing
clear medical record documentation. Physical Demands &n=
bsp; ‰ May
be exposed to patient elements &n=
bsp; ‰ Prolonged,
extensive or considerable standing/walking Physician services are defined as, "services th=
at are
performed by a Physician at the clinic by a Physician whose agreement with =
the
clinic provides that she/he will be paid for such services". =
&nb=
sp; =
=
Midlevel
Practitioner Job
Description Job Title: &nbs=
p; &=
nbsp; Midlevel
Practitioner Department: &nb=
sp; =
Rural
Health Clinic I. =
Basic
Job Summary: A registered nurse/ Nurse
Practitioner certified as a Midlevel Practitioner responsible for the deliv=
ery
of quality patient care, working under the supervision of a Physician. II. =
; Qualifications: &n=
bsp; A. Education: &n=
bsp; =
; 1. =
High
school graduate &n=
bsp; =
; 2. =
Graduate
of approved School of Nursing &n=
bsp; =
; 3. =
Registered
as a Midlevel Practitioner (NP, PA, etc.) &n=
bsp; =
; 4. =
Current
Your State License &n=
bsp; B. =
Training: &n=
bsp; =
; 1. =
Hospital
orientation program &n=
bsp; =
; 2. =
Current
CPR certification &n=
bsp; C. Experience: &n=
bsp; =
; 1. =
Minimum
of 5 years acute care nursing and 1 year as Midlevel =
&nb=
sp; =
Practitioner,
or; &n=
bsp; =
; 2. =
3
years as a Midlevel Practitioner III. &nbs=
p; Duties: &n=
bsp; A. Technical
Skills: &n=
bsp; =
; 1. =
Able
to perform thorough patient history and physical assessments &=
nbsp; &nbs=
p; &=
nbsp; including
psycho/social, on all age/sex classifications. 2. =
Able
to diagnose disease states and administer appropriate treatment. &n=
bsp; =
; 3. =
Knows
own limits and consults with Physician as appropriate. 4. =
Able
to order, perform and interpret laboratory and x-ray procedures as &=
nbsp; appropriate. &n=
bsp; B. =
Utilization
of Clinical Staff: 1. =
Able
to make efficient use of Clinical Assistants and Medical Assistants skills =
and
abilities. &n=
bsp; C. Communication
Skills: &n=
bsp; =
; 1. =
Develops
rapport with patients and families. &n=
bsp; =
; 2. =
Works
well with clinic staff, including Physician. &n=
bsp; =
; 3. =
Participates
in staff meetings to identify and solve clinic problems. &n=
bsp; =
; &n=
bsp; D. Documentation
Skills: 1. =
Documents
assessment and treatment plan clearly and concisely in patient =
chart,
in a timely fashion. &n=
bsp; =
; 2. =
Documents
charge documents clearly and fully. &n=
bsp; E. =
Teaching: &=
nbsp; &n=
bsp; &n=
bsp; =
; 1. =
Makes
provisions and arrangements for necessary patient teaching, &=
nbsp; &nbs=
p; whether
completed by self or delegated. &n=
bsp; F. =
Other: 1. =
Reviews
clinic policies, procedures and standards (clinical and non-clinical) and
offers recommendations for revision at least annually. 2. =
Maintains
cooperative attitude with clinic personnel, physicians, patients and famili=
es
as needed to enhance continuity of care and a positive working environment.=
&n=
bsp; =
; 3. =
As
requested by the Medical Director and/or Physician in charge. 4. =
Maintains
established departmental policies and procedures, objectives, quality assur=
ance
program and safety standards. &n=
bsp; =
; 5. =
Assists
Physician(s) with chart completion. 6. =
Maintain
established clinic procedures, objectives and safety policies. &n=
bsp; =
; 7. =
Performs
all other duties as assigned. IV. =
; Job
Relationships: &n=
bsp; A. Supervises: &n=
bsp; =
; 1. =
Medical
Assistants &n=
bsp; B. Supervised By:
&n=
bsp; =
; 1. =
Clinically
- Physician in charge &n=
bsp; =
; 2. =
Administratively
- clinic Office Manager &n=
bsp; =
;
Physical Demands &n=
bsp; ‰ Regularly
exposed to risk of blood borne pathogens &n=
bsp; ‰ Exposed
to unpleasant elements &n=
bsp; ‰ Lift,
position, pushes and/or pulls and transfers patients &n=
bsp; ‰ Lifts
supplies and equipment &n=
bsp; ‰ Light
physical effort (lift/carry up to 20 pounds) =
&nb=
sp; =
=
Office Manager Job De=
scription Job Title: &nbs=
p; &=
nbsp; Office
Manager Department: &nb=
sp; =
Rural
Health Clinic I. =
Basic
Job Summary Coordinate and supervise =
the
billing, collection and cashiering function of the clinic. &n=
bsp; Reconcile
accounts receivable balances to general ledger, control accounts as
directed. Coordinates all off=
ice
services and related activities of registration, cashiering, billing,
collections and data processing.
Coordinates operations with facility units and Medical Staff. Perform functions associated with
patients treated, retrieval and re-file of medical records and prepares rel=
ease
of medical information for authorized receivers. II. =
; Principal
Duties and Responsibilities: A. Implement
appropriate billing and collection procedures, ensuring that the accounts
receivable records are kept in accordance with established procedures. B. =
Maintain
appropriate internal controls over accounts receivable and cash receipt
functions. Monitor activities=
with
collection agencies, insurance companies, computer center, patient and
physicians. Keep abreast of a=
ll
reimbursement billing procedures. C. Maintains
cooperative attitude with clinic personnel, physicians, patients and famili=
es
as needed to enhance continuity of care and a positive working environment.=
D. Maintains
established departmental policies and procedures, objectives, quality assur=
ance
program and safety standards. &n=
bsp; E. =
Maintains
departmental reports and records and collects statistical data for &=
nbsp; &=
nbsp; administrative
and regulatory purposes. F. =
Supervises
office services including telephone, reception, filing, collection of patie=
nt
accounts, logging and key punch. G. Supervise
the charge posting, billing and collection operation, advising Medical Dire=
ctor
on the day-to-day implementation and interpretation to insure compliance wi=
th
all policies and procedures. H. Implement
controls to insure appropriate submission, billing and payment cycles. I. &=
nbsp; Establish
appropriate procedures for follow-up on billing and collection on all overd=
ue
accounts. Prepare monthly rep=
ort of
open accounts for submission to Medical Director. J. &=
nbsp; Supervise,
train/orient business office personnel.&nb=
sp;
Plan and coordinate monthly education programs for the clinic. K. Collects
and records quality assurance statistical data according to established
collecting criteria. Establis=
hes
and maintains files and records on an ongoing basis. &n=
bsp; Retrieves
records for release of information and copying. Duplicates documents and forms as
directed and mails to outside individuals and agencies. L. =
Assist
in care and maintenance of department equipment and supplies. Justify needs and purchases. Document maintenance schedules for
department equipment. Document
cleaning and maintenance schedules for the clinic. M. Destroys
outdated records on a periodic basis following clearly defined procedures f=
or
retention and destruction. &n=
bsp; N. Assists
Physician(s) and Midlevel Practitioner with chart completion. &n=
bsp; O. Maintain
established clinic procedures, objectives and safety policies. &n=
bsp; P. =
Performs
all other duties as assigned. POSITION QUALIFICATIONS Minimum Education:&n=
bsp; =
; High
School Minimum Experience:&=
nbsp; 2
years in Physician business office Speci=
al Skills: &=
nbsp; &nbs=
p; Ability
to communicate effectively, must be able to type 60 words per minute. Must be proficient in using typewr=
iter,
computer terminal, personal computer, copy machines and calculator. Must be able to balance figures, c=
ompile
statistics, compose letters/memorandums, coordinate meetings, develop office
procedures, and establish filing systems and research information. Physical Demands &n=
bsp; ‰ Light
physical effort (lift/carry up to 20 pounds) &n=
bsp; ‰ Regularly
exposed to risk of blood borne pathogens &n=
bsp; ‰ Exposed
to unpleasant elements. =
&nb=
sp; =
=
Clinical Assistant I Job De=
scription Job Title: &nbs=
p; &=
nbsp; Clinical
Assistant I Department: &nb=
sp; =
Rural
Health Clinic I. =
Basic
Job Summary: &n=
bsp; Provide
patient care to clinic patients, under supervision of Office Manager. II. =
; Principal
Duties and Responsibilities: &n=
bsp; A. Consult
with and keep supervisor informed of clinic activities, needs and &=
nbsp; &nbs=
p; &=
nbsp; problems
related to patient care. B. =
Comply
with established patient care standards.&n=
bsp;
Maintain established clinic &n=
bsp; policies,
procedures, objectives, quality assurance, safety, environmental and infect=
ion
control. Follow established
routines and utilize supplies and equipment in a cost-effective manner. Maintain a clean, orderly, safe
environment for patients and personnel. C. Cooperate
with other personnel to achieve department objectives and maintain good
employee, interdepartmental and public relations. Maintain patient rights and
confidentiality of patient information and abide by established communicati=
ons
code. D. Greet
patients and escort to exam room.
Take and record vitals and patient &=
nbsp; medical
information in chart. Prepare
patient and room for examination.
Assist Midlevel Practitioner and/or Physician in procedures as neces=
sary
(administrators injections as ordered).&nb=
sp;
Complete ordered laboratory procedures. Communicate results to Midle=
vel
Practitioner or Physician.
Discharge patient to receptionist / biller with Physician/Midlevel
Practitioner orders and prescriptions. Clean and disinfect rooms and equipm=
ent
as appropriate. Restock suppl=
ies,
linens, equipment and check for defects and outdating. &n=
bsp; E. =
Attend
required meetings, in-services, and educational programs. F. =
Maintain
professional growth and development through seminars, workshops and
professional affiliations. &n=
bsp; G. Other
duties as assigned. Working Conditions: Prolonged standing and
walking. Lifting and moving
patients, equipment and supplies Repeated bending, stooping and squatting.<=
span
style=3D'mso-spacerun:yes'> Exposed to all patient elements.
Knowledge, Skills, Experience Required: Completion of LPN registr=
ation or
course for nursing assistants or on-the-job training. CPR update. Sufficient previous clinical exper=
ience
(during training) in Physician office/medical clinic. Physical Demands: &n=
bsp; ‰ Regularly
exposed to risk of blood borne pathogens. &n=
bsp; ‰ Exposed
to unpleasant elements. &n=
bsp; ‰ Lift,
position, pushes and/or pulls and transfers patients. &n=
bsp; ‰ Lifts
supplies and equipment. &n=
bsp; ‰ Light
physical effort (lift/carry up to 20 pounds). &=
nbsp; &nbs=
p; &=
nbsp; Clinical Assistant II Job
Description Job Title: &nbs=
p; &=
nbsp; Clinical
Assistant II Department: &nb=
sp; =
Rural
Health Clinic I. =
Basic
Job Summary: Provide professional pati=
ent care
under supervision in clinic, according to established standards and practic=
es. II. =
; Principal
Duties and Responsibilities: A. Consult
with and keep supervisor informed of activities, needs and problems. B. =
Comply
with established patient care standards.&n=
bsp;
Maintain established clinic policies, procedures, objectives, quality
assurance, safety, environmental and infection control. Follow established routines and ut=
ilize
supplies and equipment in a cost-effective manner. Maintain a clean, orderly, safe
environment for patients and personnel. C. Cooperate
with other personnel to achieve department objectives and maintain good
employee, interdepartmental and public relations. Maintain patient rights and
confidentiality of patient information and abide by established communicati=
ons
code. D. Clinical
duties include the following: file
x-ray and lab reports or staple reports to records. Maintain record files. Set up scheduled procedures. Fill out forms for procedures. E. =
Other
duties or responsibilities for delegation include the following: restock supplies and equipment, cl=
ean
equipment after use, wrap instruments for sterilization, set up and clean
tables and work area according to established procedures, dispose of soiled
linens and waste, alert supervisor to defective supplies and equipment, arr=
ange
for replacement, take vitals and record patient information, provide
instruments and supplies as needed and assist with emergency procedures as
directed, administer medications and perform treatments as directed, write
charges, discharge patients to receptionist/biller with Physician or Midlev=
el
Practitioner orders and prescriptions, complete x-ray and lab procedures as=
ordered and attend
required meetings, in-services, educational programs. F. =
Maintain
professional growth and development through seminars, workshops and
professional affiliations. &n=
bsp; G. Other
duties as assigned. Working Conditions: Prolonged standing and
walking. Exposed to patient
elements. Lifting equipment a=
nd
patients. Repeated bending,
stooping and squatting. Knowledge, Skills, Experience Required: Graduate of an accredited=
program
for licensed practical nurses or sufficient previous clinical experience in
Physician office/medical clinic.
CPR update. Physical Demands: &n=
bsp; ‰ Regularly
exposed to risk of blood borne pathogens. &n=
bsp; ‰ Exposed
to unpleasant elements &n=
bsp; ‰ Lift
position, pushes and/or pulls and transfers patients. &n=
bsp; ‰ Lifts
supplies and equipment. &n=
bsp; ‰ Light
physical effort (lift/carry up to 20 pounds). =
&nb=
sp; =
=
Receptionist Job De=
scription Job Title: &nbs=
p; &=
nbsp; Receptionist Department: &nb=
sp; =
Rural
Health Clinic I. =
Brief
Summary: Greet and assist patients=
and
visitors, answer telephone, schedule appointments, file, and collect paymen=
ts. II. =
; Principal
Duties and Responsibilities: &n=
bsp; A. Greet
all patients and visitors cheerfully. &n=
bsp; B. =
Answer
telephone, triage calls, and maintain a log of same. &n=
bsp; C. Schedule
appointments and referrals to other providers. D. Register
patients, help with the completion of necessary forms, and direct to the
appropriate staff person if needed. &n=
bsp; E. =
Complete
encounter forms upon arrival and checkout. &n=
bsp; F. =
Pull
charts of the patients to be seen the following day. G. Provide
Physician, Midlevel Practitioner, clinical assistants, and Office Manager w=
ith
copy of daily schedule each morning. H. Collect
fees from patients for services rendered, if due, and also any outstanding =
balance. &n=
bsp; I. &=
nbsp; Reconcile
receipts at end of day and prepare deposit. &n=
bsp; J. &=
nbsp; Maintain
neat, clean, and professional work area. &n=
bsp; K. ALWAYS
KEEP ALL PATIENT INFORMATION CONFIDENTIAL! &n=
bsp; L. =
Maintain
established department policies, procedures, objectives, quality &=
nbsp; &nbs=
p; &=
nbsp; assurance,
safety, environmental and infection control. M. Assist
in care and maintenance of department equipment and supplies. Alert Office
Manager to any equipment malfunction. &n=
bsp; N. Attend
in-services and other required meetings. O. Enhance
professional growth and development through in-service meetings, educational
programs, etc. P. =
Perform
other duties as assigned by Office Manager and/or Medical Director. General Skills and Qualifications: a) =
Ability
to deal with the public, patients, and fellow staff in a position of modera=
te
stress. &n=
bsp; b) =
Ability
to handle busy, multi-line telephone in a pleasant and professional &=
nbsp; &nbs=
p; &=
nbsp; manner. &n=
bsp; c) =
Must
possess typing and/or data processing skills. &n=
bsp; d) =
Knowledge
of medical terminology helpful. &n=
bsp; e) =
Experience
in physicians office preferred. &n=
bsp; f) &=
nbsp; Desire
to learn. &n=
bsp; =
; &=
nbsp; &nbs=
p; Billing/Insurance Specialists Job De=
scription Job Title: &nbs=
p; &=
nbsp; Billing/Insurance
Specialists Department: &nb=
sp; =
Rural
Health Clinic I. =
Brief
Summary: &n=
bsp; File
claims, bill patients and third parties, performs those duties associated w=
ith &=
nbsp; collections. II. =
; Principal
Duties and Responsibilities: &n=
bsp; A. Assumes
responsibility for all or part of accounts receivable. &n=
bsp; B. =
Research
all information to complete billing process. &n=
bsp; C. Follow
up accounts until zero balance. &n=
bsp; D. Answer
all inquiries regarding assigned accounts. &n=
bsp; E. =
Process
and distribute copies of billings as required. &n=
bsp; F. =
ALWAYS
KEEP ALL PATIENT INFORMATION CONFIDENTIAL! &n=
bsp; G. Maintain
established departmental policies, procedures, objectives, quality &=
nbsp; as=
surance,
safety, environmental and infection control. H. Assist
in care and maintenance of department equipment and supplies. Alert Office
Manager and/or Medical Director to equipment malfunction, etc. &n=
bsp; I. &=
nbsp; Maintain
required records, reports, files. &n=
bsp; J. &=
nbsp; Attend
in-services and other required meetings. K. Enhance
professional growth and development through in-service meetings, educational
programs, etc. &n=
bsp; L. =
Keep
abreast of all reimbursement policies and procedures. M. Prepare
and distribute end of month accounts receivable reports to immediate Office
Manager and/or Medical Director. &n=
bsp; N. Other
duties as assigned by Office Manger and/or Medical Director. General Skills and Qualifications: &n=
bsp; a) =
Ability
to deal with the public, patients, and fellow staff in a pleasant and &=
nbsp; &nbs=
p; &=
nbsp; professional
manner. &n=
bsp; b) =
Knowledge
of CPT and ICD coding systems preferred. &n=
bsp; c) =
Basic
typing and word processing skills required. &n=
bsp; d) =
Answers
telephone in a pleasant and professional manner. &n=
bsp; e) =
Knowledge
of anatomy, physiology, and medical terminology helpful. Physical Demands &n=
bsp; ‰ Light
physical effort (lift/carry up to 20 pounds). &n=
bsp; ‰ Regularly
exposed to risk of blood borne pathogens &n=
bsp; ‰ Exposed
to unpleasant elements 510 Retention of Clinic Rec=
ords =
Accounting &=
nbsp; &nbs=
p; &=
nbsp; &nbs=
p; Retention
Period &=
nbsp; &nbs=
p; Accounts
payable: invoices and credits &n=
bsp; =
; &n=
bsp; 3
years &=
nbsp; &nbs=
p; &=
nbsp; (if
no audits are pending) &nb=
sp; =
&nb=
sp; =
&nb=
sp; 3
years &=
nbsp; &nbs=
p; Accounts
receivable: ledger cards (unpaid) &nbs=
p; &=
nbsp; &nbs=
p; &=
nbsp; 3
years &=
nbsp; &nbs=
p; Accounts
receivable: ledger cards (paid) =
&=
nbsp; &nbs=
p; &=
nbsp; 3
years &=
nbsp; &nbs=
p; Accounts
receivable: trial balances =
; &n=
bsp; =
; &n=
bsp; =
; 3
years &=
nbsp; &nbs=
p; Accounts
receivable: interim reports &nbs=
p; &=
nbsp; &nbs=
p; &=
nbsp; &nbs=
p; 3
years &=
nbsp; &nbs=
p; Bank
statements, reconciliation's, stop- payment notices, =
3
years &=
nbsp; &nbs=
p; &=
nbsp; canceled
checks, other than payroll =
; &n=
bsp; =
; &n=
bsp; &=
nbsp; &nbs=
p; Capital
asset records =
&nb=
sp; =
&nb=
sp; =
3 years &=
nbsp; &nbs=
p; Cash-receipt
books or vouchers &n=
bsp; =
; &n=
bsp; =
; &n=
bsp; 3
years &=
nbsp; &nbs=
p; Deposit
books and slips &nbs=
p; &=
nbsp; &nbs=
p; &=
nbsp; &nbs=
p; &=
nbsp; 3
years &=
nbsp; &nbs=
p; Employee's
travel-expense reports &nb=
sp; =
&nb=
sp; =
&nb=
sp; 3
years &=
nbsp; &nbs=
p; Financial
statements &nb=
sp; =
&nb=
sp; =
&nb=
sp; =
3
years &=
nbsp; &nbs=
p; General
Ledger &=
nbsp; &nbs=
p; &=
nbsp; &nbs=
p; &=
nbsp; &nbs=
p; 3
years &=
nbsp; &nbs=
p; Journals
of charges and receipts &n=
bsp; &=
nbsp; &nbs=
p; &=
nbsp; &nbs=
p; 3
years &=
nbsp; &nbs=
p; Remittance
advices (Medicare/Medicaid) &nbs=
p; &=
nbsp; &nbs=
p; &=
nbsp; 3
years &=
nbsp; &nbs=
p; Uncollectible
accounts and related records &nb=
sp; =
&nb=
sp; =
3
years &=
nbsp; &nbs=
p; Inventory/Purchasing &=
nbsp; &nbs=
p; Acknowledgments
of orders &nbs=
p; &=
nbsp; &nbs=
p; &=
nbsp; &nbs=
p; 3
years &n=
bsp; =
; &=
nbsp; Contracts
with vendors (after termination) =
; &n=
bsp; =
; &n=
bsp; 3
years &=
nbsp; &nbs=
p; Inventory
records =
&nb=
sp; =
&nb=
sp; =
&nb=
sp; =
3
years &=
nbsp; &nbs=
p; Purchasing
orders (after termination) =
; &n=
bsp; =
; &n=
bsp; =
; 3
years &=
nbsp; &nbs=
p; Medical &=
nbsp; &nbs=
p; Professional
liability insurance policies &n=
bsp; =
; =
Indefinitely Patients'
medical records (inactive) &=
nbsp; &nbs=
p; Indefinitely &=
nbsp; Patients'
medical records (deceased) =
; &n=
bsp; =
; <=
/span>Indefinitely &=
nbsp; &nbs=
p; &=
nbsp; &nbs=
p; Patient
Visits &=
nbsp; &nbs=
p; Appointment
records =
&nb=
sp; =
&nb=
sp; =
One
year &=
nbsp; &nbs=
p; Patient
service slips =
&nb=
sp; =
&nb=
sp; =
O=
ne
year &=
nbsp; &nbs=
p; Recall
records =
&nb=
sp; =
&nb=
sp; =
&nb=
sp; One
year 520 Clinic Schedule =
=
Medical
coverage for clinic will be during the following office hours: &n=
bsp; =
; Day &=
nbsp; &nbs=
p; Physician =
PA &=
nbsp; &nbs=
p; &=
nbsp; &nbs=
p; &=
nbsp; Hours &=
nbsp;
Hours &n=
bsp; =
; &n=
bsp; =
; Monday &=
nbsp; &nbs=
p; &n=
bsp; =
; Tuesday &=
nbsp; &nbs=
p; &n=
bsp; =
; Wednesday &=
nbsp; &n=
bsp; =
; Thursday &=
nbsp; &nbs=
p; &n=
bsp; =
; Friday &=
nbsp; &nbs=
p; &n=
bsp; =
; Saturday &=
nbsp; &nbs=
p; On
Call &nb=
sp; &n=
bsp; =
; Sunday &=
nbsp; On
Call &n=
bsp; =
; The Clinic closes (does n=
ot
schedule patients) from &n=
bsp; =
; +
Physician available &n=
bsp; =
; *
Midlevel Practitioner available &n=
bsp; =
; At
least two weeks notice shall be given to the public at large in the local 525 After Hours Coverage In the event of a medical
emergency, patients seeking care when the clinic is closed. The phone will =
be
answered by the answering service and the physician or physician on call wi=
ll
be paged when appropriate. The
physician will then direct the patient medical care by phone. The Emergency
Room physicians will cover when Your Medical Director is not available. During the hours the cli=
nic is
not open, the Emergency Room Physician(s) at Regardless
of where a clinic patient is seen by either a Midlevel Practitioner or the
physician(s), it will be the responsibility of the clinic to attempt to col=
lect
payment from the patient. It is the Physician(s) or Midlevel Practitioner's
responsibility to inform the Office Manager of the time and nature of the
visit. There will be no financial responsibility of clinic to the hospital =
for
patients seen in the Emergency Department or admitted into the hospital.
Likewise, there will be no financial responsibility of clinic to the
Physician(s) or the Midlevel Practitioner(s) when these individuals see
patients and are not representing the clinic. &n=
bsp; =
; Emergency
care after hours or during clinic closures is supplied by &=
nbsp; &nbs=
p; &=
nbsp; &nbs=
p; &=
nbsp; &nbs=
p; &=
nbsp; &nbs=
p; &n=
bsp; =
; &n=
bsp; =
; &=
nbsp; &nbs=
p; &=
nbsp; &nbs=
p; =
Dr. =
&nb=
sp;
, who also provide back-up coverage for Midlevel Practitioner when t=
he
Medical Director is not available. 530 Emergency Care during C=
linic
Hours =
Preparations
for medical emergencies a. =
The
medical providers, on the basis of the medical protocols, will distinguish
between emergencies, which can be handled on-site, and those &=
nbsp; necessitating
referral. &n=
bsp; =
; b. =
The
hearing room will contain the drugs and biological outlines &=
nbsp; &nbs=
p; &=
nbsp; below
in an easily accessible location: &n=
bsp; =
; &n=
bsp; =
; (1) Decadron
mg X 4 for IV injection &n=
bsp; =
; &n=
bsp; =
; (2) Benadryl &n=
bsp; =
; &n=
bsp; =
; (3) Narcan
2 amps for IV or IM use. &n=
bsp; =
; &n=
bsp; =
; (4) D5W
500 cc for IV injection. &n=
bsp; =
; &n=
bsp; =
; (5) NS
500CC for IV. &n=
bsp; =
; &n=
bsp; =
; (6) Sodium
Bicarbonate &n=
bsp; =
; &n=
bsp; =
; (7) Syrup
of Ipecar &n=
bsp; =
; &n=
bsp; =
; (8) Epinephrine
1:1000 amps (1cc) x 1. &n=
bsp; =
; c. =
The
Minor Trauma Room will also contain the following: &n=
bsp; =
; &n=
bsp; =
; (1) Ambu
bags with adult and pediatric masks. =
&nb=
sp; =
(2) Oxygen
tank and tubing. &n=
bsp; =
; &n=
bsp; =
; (3) Airways
in sizes infant to adult &n=
bsp; =
; &n=
bsp; =
; (4) Vacuum
suction device with tubing. (5) &n=
bsp; =
; &n=
bsp; =
; (6)
Seizure stick &n=
bsp; These items shall be kep=
t in a
central location and shall be in sufficient supply necessary to treat those
emergencies. It is mand=
atory
that all employees are familiar with the location of the emergency supplies=
and
able to recognize the name of same.
It is also strongly encouraged that the staff maintain current CPR
certification. d. =
The
Medical Director develops a protocol for the staff for specific emergency
situation and reviews the protocols at least annually and has a surprise dr=
ill
at least annually. &n=
bsp; =
; In
the event of a medical emergency: Medical emergency proced=
ure at
the Clinic will be handled on a case-by-case basis, but will generally foll=
ow
the steps outlined below: 1. =
The
person encountering the emergency shall immediately notify the Physician or
Midlevel Practitioner and other staff members as warranted. 2. =
The
Physician or Midlevel Practitioner shall evaluate the emergency and treat t=
he
patient as directed in the Protocols. The Physician or Midlevel practitioner
shall enlist the aid of any of the clinic staff he/she deem necessary. 3. =
The
receptionist or assistant, when instructed, shall immediately call the
appropriate emergency response team and request that an emergency unit be
dispatched to the Clinic. The following emergency units are available depen=
ding
upon the severity of the patient: &n=
bsp; =
; &n=
bsp; a. =
EMS/Ambulance
(ground and/or air) 4. =
The
phone number for the Poison Center Hotline is (800) __________. &=
nbsp; 5. =
When
instructed, the receptionist or assistant shall notify the hospital in which
the patient is being transferred and request the appropriate Physician or
department, as directed by the Physician or Midlevel Practitioner. The numb=
ers
most often used will be: &n=
bsp; =
; &n=
bsp; A. Telephone
Number (209) 665-3781 &n=
bsp; =
; &n=
bsp; =
; The goal of the Physicia=
n or
Midlevel Practitioner is to stabilize the patient for transport to the
appropriate facility. 535 House Calls Policy Your Medical Director wi=
ll make
house calls to patients requiring attention at home if possible. 540 Clinic Holidays All holidays will be pos=
ted one
(1) week prior to closure. The clinic recognizes most national holidays suc=
h as
the following. &n=
bsp; =
; &n=
bsp; =
; &n=
bsp; &=
nbsp; &nbs=
p; Christmas
Eve &nbs=
p; &=
nbsp; &nbs=
p; &=
nbsp; ½
Day &n=
bsp; =
; &n=
bsp; Christmas &=
nbsp; &nbs=
p; &=
nbsp; &nbs=
p; Full
Day &n=
bsp; =
; &n=
bsp; New
Year’s Eve &nb=
sp; =
&nb=
sp; =
½
Day &n=
bsp; =
; &n=
bsp; New
Year’s Day &nb=
sp; =
&nb=
sp; =
Full
Day &n=
bsp; =
; &n=
bsp; Fourth
of July =
&nb=
sp; =
&nb=
sp; Full
Day &n=
bsp; =
; &n=
bsp; Memorial
Day &nbs=
p; &=
nbsp; &nbs=
p; &=
nbsp; Full
Day &n=
bsp; =
; &n=
bsp; Labor
Day &nbs=
p; &=
nbsp; &nbs=
p; &=
nbsp; Fu=
ll
Day &n=
bsp; =
; &n=
bsp; Thanksgiving &=
nbsp; &nbs=
p; &=
nbsp; &nbs=
p; Full
Day 550 Clinic Staffing Pattern=
s In the event that there =
should
be no Midlevel Practitioner or physician coverage due to vacations or
educational leave, one (1) week notice will be given prior to closure. Unexpected Midlevel practitioner a=
bsences
will be covered if staffing permits.
If no coverage exists, the receptionist shall attempt to contact all
schedule patients for that day and reschedule. 560 Physician Supervision P=
olicy Name of RHC is the Medic=
al
Director and is responsible for the establishment, implementation, review a=
nd
revision of the medical policies of the medical clinic. Provide professional supervision t=
o the
Midlevel Practitioner and to provide medical care to the patients of the
clinic. Supervision shall include
maintaining an appropriate set of standing orders, providing on-site
consultation, providing telephone back-up consultation and reviewing patient
records against an appropriate standard of care. The following Physicians=
have
been enlisted by Your Medical Director to serve as secondary supervising
Physician to the Midlevel Practitioner when he is unavailable: &n=
bsp; =
; Back-Up
Procedures The above supervising Ph=
ysician
supervises the Midlevel Practitioner as follows: &n=
bsp; =
; { =
; Insures
maintenance of an appropriate set of standing orders. =
&nb=
sp; { =
; Provides
on-site consultation on a weekly basis. { =
; Provides
telephone consultation during all of the medical clinic's office hours. { =
; Reviews
and co-signs documentation of patient encounters in patient charts in keepi=
ng
with the conditions specified by the Your State Board of Medical Examiners =
in
the document authorizing the practice of the Physician extender at the medi=
cal
clinic. 570 Personnel Policies =
See
the personnel policy and procedure manual for personnel policies. Condition VI:=
&=
nbsp; Provision
of Services 600 Rural Health Clinic Ser=
vices =
Name
of RHC provides outpatient health services adult patient from &=
nbsp; &nbs=
p; the
ages 18 and older. The services that are pr=
ovided
by the clinic include, but are not limited to the following: &n=
bsp; =
; Basic
Scope of Service: &n=
bsp; =
; 1. =
Illness
prevention &n=
bsp; =
; 2. =
Immunization &n=
bsp; =
; 3. =
Patient
health education &n=
bsp; =
; 4. =
Management
of acute and chronic illnesses &n=
bsp; =
; 5. =
Complete
physicals (routine physical examinations, including well &=
nbsp; &nbs=
p; =
&=
nbsp; child/developmental
exams) &n=
bsp; =
; 6. =
Minor
surgery &n=
bsp; =
; 7. =
Emergency
stabilization &n=
bsp; =
; 8. =
Diagnostic
laboratory procedures, including: &n=
bsp; =
; &n=
bsp; a. =
urinalysis,
by dipstick &n=
bsp; =
; &n=
bsp; b. =
Hemoglobin &n=
bsp; =
; &n=
bsp; c. =
blood
sugar &n=
bsp; =
; &n=
bsp; d. =
examination
of stool specimens for occult blood &n=
bsp; =
; &n=
bsp; e. =
pregnancy
testing (urine) &n=
bsp; =
; &n=
bsp; f. &=
nbsp; primary
culturing for transmittal to reference lab &n=
bsp; =
; &n=
bsp; G. Group
A strips - Rapid Test &n=
bsp; =
; &n=
bsp; . &=
nbsp; The basic scope of servi=
ces
include those diagnostic and therapeutic services and supplies that are
commonly furnished in a medical practice or at the entry point into the hea=
lth
care delivery system. This is
accomplished by the following direct services: { =
; Prevention
of illness and promotion of health through complete physical exams, annual
checkups, well childcare and patient education. { =
; Diagnosis
of problems presented at the medical clinic by taking health histories, doing appropriate
physical exams, lab tests, EKG's, pap smears, pregnancy tests and other
diagnostic procedures. { =
; Treatment
of immediate problems and chronic illnesses with drug =
&=
nbsp; prescriptions,
injections, and other procedures as necessary. { =
; Emergency
care for minor injuries such as cuts, wounds, animal bites and falls. Ambulance service, if needed, avai=
lable
through the local service. &nbs=
p; { =
; Counseling
regarding questions patients may have about their physical or mental health=
. { =
; Referral
of patients with special needs to medical specialists, public and private
health and social services agencies. { =
; Referral
and follow-up treatment to patients who require hospitalization, emergency =
room
care, nursing home or home medical care. { =
; Specimens
requiring testing not available at the clinic are referred to one of the
following laboratories: &n=
bsp; =
; &n=
bsp; =
; &n=
bsp; =
; &n=
bsp; =
; ____________________ 610 Other Ambulatory Servic=
es =
&nb=
sp; &n=
bsp; =
; &n=
bsp; 615 Laboratory Services LABORATORY POLICY &nbs=
p; 1. =
GENERAL
LABORATORY RULES: &nbs=
p; A. &nbs=
p; B. &nbs=
p; C. &nbs=
p; D. &nbs=
p; E. &nbs=
p; 2. =
MIDLEVEL/ASSISTANTS
RESPONSIBILITIES: &nbs=
p; A. &nbs=
p; B. &nbs=
p; C. =
Ordering
supplies. &nbs=
p; D. &nbs=
p; &=
nbsp; 1.=
=
Make
sure you have the right patient. &nbs=
p; &=
nbsp; 2.=
=
Be
certain you have sufficient quantity of the specimen. &nbs=
p; &=
nbsp; 3.=
=
Be
sure the specimen is collected using the proper method of &=
nbsp; &nbs=
p; &=
nbsp; collection and pr=
oper
tubes. &nbs=
p; &=
nbsp; 4.=
=
See
that all specimens are labeled correctly. &nbs=
p; E. &nbs=
p; F. &nbs=
p; G. &nbs=
p; 3. =
LABORATORY
PROCEDURES &nbs=
p; A. &nbs=
p; B. &nbs=
p; C. &nbs=
p; D. &nbs=
p; E. &nbs=
p; F.=
=
Clean
up: &nbs=
p; a) =
Put
the reagents away &nbs=
p; b) =
Dispose
of specimens &nbs=
p; 4. =
LABORATORY
EQUIPMENT &nbs=
p; A. &=
nbsp; 1. &n=
bsp; Equipment
must be kept in clean and proper working order. &nbs=
p; &=
nbsp; 2. =
Maintenance
should be performed and logged as directed. &nbs=
p; &=
nbsp; 3. =
Quality
control must be kept up to date and logged. <=
span
style=3D'font-size:11.0pt'> &nbs=
p; &=
nbsp; &nbs=
p; B. Microscope &nbs=
p; &=
nbsp; &nbs=
p; 1. =
Care
and Cleaning &nbs=
p; &=
nbsp; &nbs=
p; &=
nbsp; a) =
Do
not remove oculars &nbs=
p; &=
nbsp; &nbs=
p; &=
nbsp; b) =
Keep
oculars clean and free of lint &nbs=
p; &=
nbsp; &nbs=
p; &=
nbsp; c) =
Keep
cover slips and slides free from fingerprints &nbs=
p; &=
nbsp; &nbs=
p; &=
nbsp; d) =
Clean
surface of lens before and after use with lens =
; &n=
bsp; =
; paper=
&nbs=
p; &=
nbsp; &nbs=
p; &=
nbsp; e) =
Always
turn light off after use and cover with dust ` &=
nbsp; &nbs=
p; &=
nbsp; cover=
. &nbs=
p; &=
nbsp; &nbs=
p; 2. =
Usage &nbs=
p; &=
nbsp; &nbs=
p; &=
nbsp; a) =
Focus
by moving objectives away from the slide &nbs=
p; &=
nbsp; &nbs=
p; &=
nbsp; b) =
Always
observe on low power first and then switch to =
&nb=
sp; =
high<=
o:p> &nbs=
p; &=
nbsp; &nbs=
p; &=
nbsp; c) =
Place
back on low power after use &nbs=
p; &=
nbsp; &nbs=
p; &=
nbsp; d) =
When
using dry objectives and wet specimens, always =
; &n=
bsp; =
; use c=
over
slips &nbs=
p; &=
nbsp; &nbs=
p; &=
nbsp; e) =
Be
sure to adjust eyepieces according to the width of =
&nb=
sp; =
your =
eyes. &nbs=
p; &=
nbsp; &nbs=
p; C. Centrifuge &nbs=
p; &=
nbsp; &nbs=
p; 1. =
Make
sure pads are in the bottom of cylinders &nbs=
p; &=
nbsp; &nbs=
p; 2. =
Be
careful to balance tubes before turning instrument on &nbs=
p; &=
nbsp; &nbs=
p; 3. =
Do
not stop manually. &nbs=
p; &=
nbsp; &nbs=
p; D. Refrigerator &nbs=
p; &=
nbsp; &=
nbsp; 1. =
Temp
Log &nbs=
p; =
&nb=
sp; =
RHC
Waived Lab =
&nb=
sp; CLIA
Laboratory Certificate (See Professional Licenses) =
The following tests are
performed on-site at Name of RHC &nbs=
p; and
has received certification as a waived lab under the 1992 CLIA standards.
The clinic provides basic
laboratory services essential to the immediate diagnosis and treatment of t=
he
patient, including: 1. =
Chemical
examinations of urine by stick or tablet methods or both (including urine
keytone); &n=
bsp; =
; &n=
bsp; 2. =
Hemoglobin
or hematacrit; &n=
bsp; =
; &n=
bsp; 3. =
Blood
sugar; &n=
bsp; =
; &n=
bsp; 4. =
Examination
of stool specimens for occult blood; &n=
bsp; =
; &n=
bsp; 5. =
Pregnancy
tests; &n=
bsp; =
; &n=
bsp; 6. =
Primary
culturing for transmittal to a certified laboratory; &n=
bsp; =
; &n=
bsp; 620 X-Ray Services =
&nb=
sp; Patients
are referred to the hospital for X-Rays. 640 Clinic Office Policy =
TELEPHONE PROCEDURES &nbs=
p; &=
nbsp; ANSWERING
THE TELEPHONE It
is the responsibility of the receptionist to answer all incoming telephone
calls and direct the call to the appropriate party. Assistance should be provided by t=
he
Midlevel practitioner and other office staff. Long
distance business telephone calls made by employees should be documented wi=
th
the date, name and number of party called, the name of the person placing t=
he
call, and the purpose of the call. Personal
phone calls are permitted if limited in length and frequency. &=
nbsp; &nbs=
p; &=
nbsp; &=
nbsp; &nbs=
p; &=
nbsp; PREFERRED
GREETING &=
nbsp; &nbs=
p; &=
nbsp; "Name
of RHC, this is (name of person).
May I help you." Always
identify yourself by name when speaking to someone on the telephone. =
; &n=
bsp; INSTRUCTIONS Do
not answer and put the caller on hold, except under rare circumstances. If it becomes necessary to do this
frequently, bring the matter up at staff &n=
bsp; mee=
tings
and attempt to find a solution.
TAKING AND RELAYING VARIOUS TYPES OF MESSAGES
All messages should be in written form and distributed promptly. When taking calls, always obtain t= he caller's name and purpose of the call.&nbs= p; The following is a list of responses for different types of calls:
&= nbsp; &nbs= p; { = ; MEDICAL -- Before giving patient messages to the Midlevel practitioner or physician= s, always pull the patient's medical chart and clip the message to it. Message will include call back number, name of person calling and time call came in. After-the call has been returned, the message should be checked to indicate it has been taken care = of and then filed in the patient's chart.
&= nbsp; &nbs= p; { = ; NEW RX's -- When a patient calls in complaining of an illness and wants a prescription called in:
&= nbsp; &nbs= p; &= nbsp; 1) = Check to see if it is an established patient who has been seen within the last 6 months. If the patient is new= or has not been seen within the last 6 months, must make an appointm= ent.
&= nbsp; &nbs= p; &= nbsp; 2) = Get symptoms. Only take messages = for minor illnesses. If there is = any question as to whether the patient should come in, always ask a nurse, Midl= evel Practitioner or the Physician. NEVER make a medical-judgment call!
&= nbsp; &nbs= p; &= nbsp; 3) = Get name of pharmacy and a return number for the patient.
&= nbsp; &nbs= p; { = ; REFILLS -- Ask when the patient was last in the office. Unless it is just for a routine maintenance Rx, if the patient has not been in within 6 months, they must m= ake an appointment.
&= nbsp; &nbs= p; &= nbsp; &nbs= p; &= nbsp; &nbs= p; =
Get the name of their medication, the dosage, the name of their pharmacy, and t= he patient's return phone number.
Explain
that refills are called in the afternoon and that they should check with th=
eir
pharmacy after
&= nbsp; &nbs= p; { = ; TEST RESULTS -- Get the patient's name, type of test, date performed, and the location. Patients calling fo= r lab results need to be reminded that the Physician must review the results befo= re the Midlevel Practitioner can return their call. If it has been more than 2 days an= d we still do not have the test results, make a note for the nurses to check int= o.
&= nbsp; &nbs= p; &= nbsp; &nbs= p; &= nbsp;
&= nbsp; &nbs= p; { = ; CALLS FOR PHYSICIAN(S) -- When someone asks to speak to one of the doctors, tell = them the Physician is seeing patients and ask if he/she is expecting their call. Try to determine the na= ture of the call, if it is m= edical, business, or personal. Screen= calls as best as possible.
&= nbsp; &nbs= p; &= nbsp; &nbs= p; &= nbsp; &nbs= p;
&=
nbsp; &nbs=
p; &=
nbsp; If
a caller insists on speaking to a Physician and refuses to leave a &=
nbsp; &nbs=
p; &=
nbsp;
&= nbsp; &nbs= p; { = ; CALLS FOR MIDLEVEL PRACTITIONER -- These calls also need to be screened. Always ask if the Midlevel Practit= ioner is expecting their call. These calls will most often be from patients wanti= ng lab or test results or prescriptions. Handle these as instructed above unless a Midlevel Practitioner has = left specific instructions on a particular patient. You would then refer the call to t= he Midlevel Practitioner.
&= nbsp; &nbs= p; SCHEDULING PATIENTS
&=
nbsp; &nbs=
p; Scheduling
of patients will be from
When making appointments, list in the computer the patient's name, phone number,= and the reason for the visit. Lis= ting the nature of the visit will help in the allowance for walk-ins and work-in= s. If there is a question concerning = the urgency of a patient seeing the Physician before an opening is available, r= efer the call to the Midlevel Practitioner or nurse.
&= nbsp; &nbs= p; TELEPHONE APPOINTMENTS
Telephone appointments are made by the receptionist, but can be made by anyone answer= ing the phone and following proper procedure.&= nbsp; If there is a problem with the schedule or a patient must be worked in a full schedule, let the Midlevel Practitioner or nurse determine the best time for the appointment.
Ask the caller if he/she has ever been seen in the clinic before, and the reason for the visit. New patient sh= ould be instructed to arrive 10-15 minutes early to complete new patient informa= tion forms.
&= nbsp; &nbs= p; FOLLOW UP APPOINTMENTS
Follow
up appointments are to be made by the receptionist as the patient checks
PATIENT RECEPTION AND NEW PATIENT PROCEDURES
Greeting patients and visitors is the responsibility of the receptionist. All visitors and patients are to be greeted pleasantly and treated courteously.
As patients sign in, locate their medical charts and attach a charge ticket to= it if patient is new, have them complete the "new patient information for= ms and make a chart for them. Ma= ke copies of any insurance cards and update any patient information in their chart. Check computer printou= t for their account balance, &n= bsp; complete the top portion of the charge ticket, and then give the chart to the Midlev= el Practitioner.
&n=
bsp; =
; If
patients have to wait more than a few minutes beyond their scheduled &=
nbsp; &nbs=
p; &=
nbsp; appointment,
explain that the Physician has been delayed, he's out on an &nb=
sp; =
&nb=
sp; emergency
or whatever response is reasonable to reassure them. =
645 Clinic Fee Schedule
= The Clinic fee schedule is included in the Tab labeled Appendices &= nbsp; &nbs= p; &= nbsp; includes charges for the most common items.
650 Billing - Patient Charg=
es,
Payment and Collection Policy
= PATIENT CHARGES AND PAYMENTS
&= nbsp; &nbs= p; MAKING FINANCIAL ARRANGEMENTS WITH THE PATIENT
This is the responsibility of the receptionist.= The Physician should avoid any discussions with the patients regardi= ng their accounts; he should refer them to the front office.
&= nbsp; &nbs= p; PROCEDURE:
Fina= ncial arrangements must be made with all patients. However, no patient will be denied= emergency treatment because of his or her inability to pay.
&= nbsp; &nbs= p; 1. = We prefer cash at the time of treatment for all office visits. If patients question this policy, explain to them that this reduces our paper work and expenses and helps us = hold fees in line. The payment amo= unt is written on the charge ticket, and a computer generated receipt is given to = the patient as his/her receipt.
&= nbsp; &nbs= p; 2. = If the patient states he/she cannot pay in full, the receptionist should attem= pt to collect a minimum of 25% of the total charges and ask for a date when the payment for the balance can be expected.&n= bsp; Give the computer receipt of the charge ticket to the patient and ask them to mail in the payment as soon as possible. A statement will be sent to them; payment in full is expected upon receipt.
= &nb= sp; = &nb= sp; = &nb= sp; = &nb= sp;
&= nbsp; &nbs= p; 3. = Insurance patients are responsible for any portion of their bill not covered by their insurance (deductible & coinsurance, etc.) This should be explained to = the patient at the time of the first visit and arrangements made for payment of= the balance.
&= nbsp; &nbs= p; 4. = Medicaid patients are responsible for providing copies of their current Medicaid car= ds. They will be billed for non-covered services.
&= nbsp; &nbs= p; RECORDING CHARGES AM PAYMENTS
It is the responsibility of the receptionist to complete the charge sheet, col= lect the fees, and review the charge sheet for pertinent information (i.e., name, address, account number, diagnosis and correct charges) before balancing and batching the day's tickets for computer entry.
&= nbsp; &nbs= p; CASH DRAWER
A minimum of $100 cash should be allotted to the cash drawer for use in making change when patients pay on their accounts. The cash drawer should always maintain at least its $100 balance. At= the end of the day, the cash drawer should contain that day's collections plus $100. The daily deposit is to= be made out to equal that days receipts, thus leaving the $100 still in the ca= sh drawer. The cash drawer is to= be locked at the end of each business day.
&= nbsp; &nbs= p; CASH RECEIPT CONTROL PROCEDURE
&= nbsp; &nbs= p; 1. = Mail payments: List all payments on the mail payments log and attach EOB's (Explanation of Benefits) to back. Make a separate deposit. Deposit must equal the total amount of the payments.
&= nbsp; &nbs= p; 2. = In-office payments must be posted on the charge tickets and totaled at the-and of the day. A deposit will be made f= or that amount.
&= nbsp; &nbs= p; 3. = Deposits should be made daily and must always include all receipts, i.e., the deposit should be in balance and if not, an explanation must be made on the batch summary report explaining any difference.
&= nbsp; &nbs= p; CREDIT POLICY
&= nbsp; &nbs= p; 1. = All patients are required to pay cash in full for each visit, with the &= nbsp; &nbs= p; &= nbsp; &= nbsp; exception of PPO arrangements and Medicaid patients.
&= nbsp; &nbs= p; 2. = All Medicaid patients will be required to pay in full for non--covered services= at the time of service.
&= nbsp; &nbs= p; 3. = We are participating providers in the Medicaid Program, which means we will ac= cept assignment on all claims. Each patient will be responsible for any deductible and/or coinsurance amounts.<= span style=3D'mso-spacerun:yes'> If the patient has a supplemental insurance, we will file that for them.
&= nbsp; &nbs= p; 4. = For PPO patients. We will accept assignment on all claims for covered services. After we hear from insurance, we will then bill the patient for any remaining unpaid balance. Co-payments are due at the time of service.
&= nbsp; &= nbsp; 5. = If it is necessary to bill the patient, tell the patient he/she can mail in the payment and ask him/her when we can expect the payment; write that date on = the charge ticket. Give him/her t= he yellow copy of the ticket and show him/her our mailing address and the date= we expect to receive the payment. Stress to the patient that we must hear from him/her by that date.
&= nbsp;
&=
nbsp; PATIENT STATEMENTS
&nbs=
p; &=
nbsp; {
&nbs=
p; &=
nbsp; {
&nbs= p; &= nbsp; &nbs= p; 1st Statement (Age 0)= &nb= sp; No message.
&nbs=
p; &=
nbsp; &nbs=
p; 2nd
(Age 1 month) =
&nb=
sp; "Past
Due Please remit today."
&nbs=
p; 3rd
(Age 2 months) =
; &n=
bsp; "Please
contact our office today regarding your past due account!" &=
nbsp; &nbs=
p; &=
nbsp; &nbs=
p;
&nbs=
p; 4th
(Age 3 months) =
; &n=
bsp; "We
are willing to work with you to prevent &nb=
sp; =
&nb=
sp; &=
nbsp; &nbs=
p; &=
nbsp; &nbs=
p; &=
nbsp; &nbs=
p; collection
agency action."
&nbs=
p; &=
nbsp; 5th
(Age 4 months) =
; &n=
bsp; "If
not paid in 15 days, this account will be turned over for collection."=
&nbs=
p; &=
nbsp; {
&nbs=
p; &=
nbsp; {
&nbs= p; 655 Normal Daily Routine of= the Clinic
&= nbsp; &nbs= p; The following is a step-by-step outline for daily routine:
&= nbsp; &nbs= p; A. = Receptionist
&= nbsp; 1. = The receptionist will greet and "check-in" each patient.
&= nbsp; 2. = New patients must complete the "new patient" information forms, &= nbsp; &nbs= p; &= nbsp; and then a medical record is constructed for each.
&= nbsp; 3. = For previous patients, check the date on the registration form. If it = ; &n= bsp; = ; is more than one year old, have the patient complete another, or &= nbsp; &nbs= p; &= nbsp; verbally verify all the information -on the form, date and initial.
&= nbsp; 4. = Any change of address or phone number should be updated in the &= nbsp; &nbs= p; chart and a copy included in the daily batch to update the &= nbsp; &nbs= p; &= nbsp; &nbs= p; &= nbsp; computer. Remember to ask the patient if the= re are any changes to &nbs= p; &= nbsp; &nbs= p; make to his/her account.
&= nbsp; 5. = The following information should be placed on the charge ticket:
&= nbsp; &nbs= p; a) = Patient's name
&= nbsp; &nbs= p; b) = Account number
&= nbsp; &nbs= p; c) = Previous balance
&= nbsp; &nbs= p; d) = Provider to be seen
&= nbsp; &nbs= p; a) = Type of insurance (specify if Medicaid)
&= nbsp; 6. = Attach the entire charge ticket with a paper clip to the patient's &= nbsp; &nbs= p; &= nbsp; medical record, and place them in the rack for the Midlevel = &nb= sp; = &nb= sp; Practition= er.
&= nbsp; &nbs= p; B. = The Nurse
The Nurse will take the patient's medical record, call the patient to the exami= ning area and obtain and record the patient's vitals and update any medicines wi= thin the chart. The Nurse is also responsible for marking on the charge ticket any lab tests or x-rays taken.=
The medical record should then be placed in the chart holder on the door of the room in which the patient is to be examined. This allows the Provider to review= the chart prior to entering the room and also acts as a signal to the Provider = that the patient is ready for examination.
&= nbsp;
&=
nbsp; C. The
Provider (Physician or Mid-Level Practitioner
&= nbsp; &nbs= p; &= nbsp; 1. = Indicate all services rendered by either checking off the appropriate box or by ente= ring a specific dollar amount if it differs from the standard charges.
&= nbsp; &nbs= p; &= nbsp; &nbs= p; &= nbsp; &nbs= p; &= nbsp;
&= nbsp; &nbs= p; &= nbsp; 2. = List all diagnoses for patient on charge ticket.
&= nbsp; &nbs= p; &= nbsp; 3. = Indicate whether patient is being referred for further treatment, to return to the clinic for follow-up care, or dismissed home. &= nbsp;
&= nbsp;
&= nbsp; &nbs= p; &= nbsp; 4. = Indicate approximate scheduling for next appointment.
&= nbsp; &nbs= p; &= nbsp; 5. = Sign at bottom of charge ticket.
&= nbsp; &nbs= p; &= nbsp; 6. = Provider should hand the charge slip and chart to the patient and request this slip = be given to the receptionist or hand the charge ticket to the receptionist himself.
&= nbsp; &nbs= p; D. = Receptionist responsibility as patient completes appointment:
&= nbsp; &nbs= p; &= nbsp; 1. = Accept the charge slip from the patient.
&= nbsp; &nbs= p; &= nbsp; 2. = Write in the appropriate fee and/or total for the services rendered that day on t= he face of the charge slip.
&= nbsp; &nbs= p; &= nbsp; 3. = Collect the payment from the patient using the following; = &nb= sp; = &= nbsp; &nbs= p; technique: Make a direct in-office collection effort by merely = &nb= sp; = &nb= sp; saying, "Your charge today is $ ________ and your previous
&= nbsp; &nbs= p; &= nbsp; &nbs= p; Balance is $ ___= __, Ms. Jones. Your total is $ ________.
&= nbsp; &nbs= p; &= nbsp; 4. = This is all you should have to do. It is the responsibility of the patient to make a statement. The patient will either make a pay= ment or ask to receive a bill. An explanation may then be offered to the patient: "The Physician is attempting to keep fees down by collecting office charges at the time the service is rendered."
&= nbsp; &nbs= p; &= nbsp; 5. = If payment is received, it is written down in the treatment space of the charge slip and current balance updated and written in that space. A zero balance is placed in the ba= lance if there is no remaining balance.
&= nbsp; &nbs= p; &= nbsp; 6. = If no payment is received, today's charges are to be added to the previous bal= ance and the sum is to be placed in the current balance space.
&= nbsp; &nbs= p; &= nbsp; 7. = If a return appointment is necessary, consult the appointment schedule after noting Providers request and suggest to patient a suitable specific time for his next appointment. Complete an appointment card and give it to the patient along with t= heir charge slip-receipt.
&= nbsp; &nbs= p; E. = Receptionist's responsibilities at the end of the day:
&= nbsp; &nbs= p; &= nbsp; 1. = Make sure all information on each charge ticket has been = &nb= sp; = &= nbsp; &nbs= p; completed.
&= nbsp; &nbs= p; &= nbsp; 2. = Total all charges and payments. Att= ach a copy of the adding machine tape for both charges and payments. Enter totals on the Batch Summary Report, along with mail payment totals.&nb= sp; Stapl