Description
Downloadable and customizable templates of OFFICE Documentation, Policies, and Procedures for your practice.
Office Policies & Procedures Manual
- Office opening and closing procedure ……………………………………………………………………………………… 2
- Patient information policy …………………………………………………………………………………………………….. 4
- Patient scheduling procedure ……………………………………………………………………………………..…….… 5
- Emergency services policy & procedure …………………………………………….……………………………………… 7
- Patient communication policy and procedure ……………………………………………………………………………… 8
- Insurance verification procedure ……………………………………………………………….……………………….… 10
- Patient check-in procedure …………………………………………………………………………….………………….. 12
- Usual and customary fee list & discounts policy …………………………………………………………………………. 15
- Patient payment policies ………………………………………………………………………………………..………….. 17
- Patient check-out procedure ……………………………………………………………………………………….………. 19
- Cancellation policy and procedure …………………………………………………………………………………..…….. 21
- No-show policy and procedure …………………………………………………………………………………..…………. 23
- Patient consent policies and procedures ………………………………………………………………………………….. 25
- Patient records request policy and procedure ………………………………………………………………..………….. 27
- Accepted insurance plans policy …………………………………………………………..…….………………….…….. 29
- Superbill submitting to the insurance biller procedures ………………………………………………………..……….. 30
- Insurance payment reconciliation …………………………………………………………………………………………. 31
- Rejected claims resubmission procedure ………………………………………………………………………..………. 33
- Equipment inspection procedure ………………………………………………………………………………………….. 35
- Patient complaints & concerns procedure ………………………………………………………………………………… 37
- Policy and procedure for managing patients who are non-compliant with healthcare advice ………………………. 39
- Acupuncture standard episode of care flow procedure ………………………………..………………………………… 42
- TCHM standard episode of care flow procedure ………………………………………………………………………… 45
- Inventory ordering, storage & expiration inspection procedure ……………………………………………….……….. 47
- TCHM compounding & dispensing policy and procedure ……………………………………………………………….. 50
- Adverse events tracking, responding, and reporting procedure ……………………………………………………….. 52
- Workforce training plan ……………………………….…………………………………………………………………….. 56
Office Manual Templates
- Acupuncture Council Informed Consent ….. 2
- Acupuncture Council Arbitration Agreement …… 3
- American Acupuncture Council Informed Consent for In-Person Services During Covid-19 Public Health Crisis ….. 4
- Informed Consent and Liability Waiver, Including TCHM & Telehealth ….. 6
- Patient Consent Regarding Diagnostic Exam …. 8
- Consent for Use and Disclosure of Reproductive Health Information …… 9
- Authorization for Disclosure of Health Information ….. 10
- Authorization for Release of Medical Records …… 11
- Disclosures of Patient Information Log ….. 12
- Restriction of Use or Disclosure of Protected Health Information ….. 13
- Consent to Leave Voice or Text Messages …… 14
- Patient Consent for Medical Photography Publication …… 15
- Social Media Informed Consent ….. 16
- Notice of Privacy Practices …… 17
- Patient Insurance Information Form …… 20
- INSURANCE Payment Policy & Assignment of Benefits ….. 21
- CASH Payment Policy ….. 23
- Credit/Debit Card Pre-Authorization Form ….. 24
- Good Faith Estimates ….. 25
- OFFICE Use – Insurance Verification Form ….. 27
- Advance Beneficiary Notice of Non-coverage (ABN) …….. 28
- GA Modifier Consent Form (Advance Beneficiary Notice (ABN) ……. 29
- Medical Record Amendment/Correction Request …… 30
- Office Copy – TCHM – Compounded IN-Office …… 31
- Label Custom TCHM – Office Dispensed – Patient Copy …… 32
- Raw/Crud TCHM Cooking Directions Handout …….34
- Letter of Denial Appeal ……. 36
- Letter to Patients Who Cancel or Fail to Keep Appointments …… 37
- Letter to Patients Who Fail to Follow Up on Labs/Tests …… 38
- Facsimile Cover Sheet …… 39
- TCHM Adverse Event Complaint Report ……. 40
- Complaint Form …… 41
- Dispensary Training Log …… 42
- Equipment Inspection Log …… 43
- Office Supply Ordering Form …… 44
- Inventory Ordering, Form …… 45
- Inventory Ordering, Storage & Expiration Inspection Log …… 46