Policies

Policy

Policy

Effective

Number

Title

Date

TABLE OF CONTENTS – Section 1

GENERAL ADMINISTRATION – Section 2

1.001

Clinical Operations

05/14/04

Attach 2.2

Patient and Staff Safety

Attachment

Attach 2.3

Outpatient Clinic Safety Checklist

Attachment

Attach 2.5

Professional Services Contracting

Attachment

1.002

Treatment of Incarcerated Patients

04/01/02

1.003

Use & Transmission of Patient Information Using Online Resources

05/14/04

1.004

Superbill Update & Review

05/14/04

14.130

UNT Health Dress Code

10/11/2011

14.140

Utilization of Scribes

05/27/2010

14.240

Compliance Training

01/26/2012

14.305

Patient Grievance Procedure

07/08/2010

1.007

Notice Concerning Comments, Suggestions and Concerns

04/01/02

14.306

Patient Disengagement

02/28/12

Attach 2-6

Checklist for Patient Disengagement

Attachment

1.009

Irate Patient

05/14/04

1.010

Provider Third-Party/MCO Participation

05/14/04

Attach 2-8

Managed Care Decision Chart & Timeline

Attachment

1.0011

Worker’s Compensation Training & Provider Eligibility

09/01/03

14.100

Policy on the Performance of Outside Clinical Practice Activity (Moonlighting)

03/29/12

14.101

Leave Request Process and Coverage of Clinical Assignments

01/22/09

14.514

Government Investigations

10/27/11

14.516

Routine Audits of Health Care Claims

08/30/12

PATIENT REGISTRATION – Section 3

14.104

Patient Registration

06/13/11

2.002

Consent to Treatment – Emancipated Minor

04/01/02

14.401

Consent to Treatment

04/04/09

2.004

Patient Waiting Time for Scheduled Appointments

05/14/04

14.151

Eligibility for the Group Practice Discount Program

03/29/2010

Attach 3-1

Current Federal Poverty Income Guidelines

Attachment

Attach 3-2

Automatic Sliding Scale Fee Determination Form

Attachment

Attach 3-3

Documents of Validation for Eligibility Determination List

Attachment

Attach 3-4

Setting up Group Practice Discounts in Signature

Attachment

Attach 3-5

Eligibility Determination Procedures for the Group Practice Discount Program

Attachment

14.160

Advance Beneficiary Notice of Non-Coverage

05/29/2012

2.006

Managed Care Specialty Referrals & Authorization

05/14/04

2.007

Patient Greeting

05/14/04

14.402

Informed Consent

04/04/09

2.009

Consent to Treatment – Minor

05/14/04

APPOINTMENT SCHEDULING – Section 4

14.108

Interpretation Services

02/28/13

Attach 4-1

Language Assistance Telephone Translation Form

Attachment

Attach 4-2

Language Assistance Telephone Translation Guidelines

Attachment

3.003

Late Show for Scheduled Appointment

05/14/04

3.004

Patient Appointment “No-Show”

05/14/04

14.103

Patient Appointment Scheduling

03/29/2010

3.006

Walk-in Patients

05/24/04

14.102

Telephone Etiquette

10/11/12

MEDICAL RECORDS – Section 5

14.110

Telephone Message and Return Phone Calls

7/11/2012

4.003

Medical Record Transfer

04/01/05

4.004

Security and Confidentiality of Medical Records

04/01/02

4.005

Medical Record Report Filing

04/01/02

4.006

Medical Record Report Availability

04/01/02

4.007

Medical Record Retention

05/14/04

4.008

Temporary Medical Records

04/01/02

4.009

Thinning of Medical Records

05/14/04

4.010

Advance Directives

05/24/04

4.011

Creation of Medical Records

05/14/04

4.012

Content and Format – Medical Record

05/14/04

4.013

Medical Records

05/24/04

4.015

Medical Records – Approved Abbreviation List

05/14/04

4.016

Medical Records – Authentication

05/14/04

4.021

Retention of Billing Records and Business Office Documents

09/01/03

Attach 5-5

Do Not Use Medical Abbreviations

05/14/04

Attach 5-6

Medical Abbreviations

05/14/04

14.201

Notice of Privacy Practices

10/27/11

14.202

Accounting of Disclosures of PHI

10/10/2011

14.203

Amendment of Protected Health Information

10/10/2011

14.204

Authorization for Release of Protected Health Information

10/10/2011

14.205

Specially Protected Medical Records

10/10/2011

14.206

Confidential Channel Communication Request

10/10/2011

14.207

Personal Representatives

10/10/2011

14.208

Patient Access to Health Information

10/10/2011

14.210

Limited Data Sets

10/10/2011

14.211

Right of an Individual to Request Restriction of Uses and Disclosures of Protected Health Information (PHI)

01/26/2012

14.212

Verification of Individuals Requesting PHI

10/11/2012

14.213

Permitted Uses and Disclosures of PHI: Victims of Abuse, Neglect or Domestic Violence

01/26/2012

14.214

Permitted Uses and Disclosures of PHI: Judicial and Administrative Proceedings

01/26/2012

14.215

Permitted Uses and Disclosures of PHI: Law Enforcement Purposes

01/26/2012

14.216

Permitted Uses and Disclosures of PHI: Research Purposes

01/26/2012

14.217

Permitted Uses and Disclosures of PHI: Health Oversight Agencies

01/26/2012

14.218

Permitted Uses and Disclosures of PHI: To Avert a Serious Threat to Health and Safety

01/26/2012

14.219

Uses and Disclosures of PHI for Fundraising

01/26/2012

14.220

Uses and Disclosures of PHI for which Authorization is Required: Marketing

01/26/2012

14.221

Mitigating Violations of HIPAA and Privacy-related Policy and Procedures

10/11/2012

14.222

Minimum Necessary Disclosures of PHI

01/26/2012

14.223

Faxing Protected Health Information (PHI)

01/26/2012

14.224

De-identification of PHI

01/26/2012

14.225

Permitted Uses and Disclosures of PHI: Coroners, Medical Examiners and Funeral Directors

11/29/2012

14.250

Electronic Protected Health Information (PHI) HIPAA Compliance

01/26/2012

14.525

Cloning of Medical Information

10/11/2012

14.605

EHR Contingency Policy

01/26/2012

14.606

Abstraction and Scanning

01/26/2012

14.607

Standard Fees for Medical Record Release

01/26/2012

FRONT-END PATIENT ACCOUNTING – Section 6

5.001

Coding & Charge Entry

05/14/04

5.002

Collection of Patient Payments

05/14/04

5.003

Patient Check-Out

05/27/04

5.004

Charge Master/Fee Schedule

05/14/04

5.005

Delinquent Balance

05/24/04

5.006

Charge Credit

05/14/04

5.007

Master File

05/24/04

5.008

Refund

05/24/04

5.009

Return Mail

05/27/04

5.010

Manual Adjustments to Accounts and A/R Write-Off

05/27/04

5.011

Claims Manager

05/27/04

Attach 6-1

Claims Manager Edit Exception Form

Attachment

Attach 6-2

Routing Criteria of Claims Manager Edit Exception

Attachment

5.012

POS (Point of Service)

05/27/04

5.013

Cash Drawer Reconciliation

05/14/04

5.014

Signature Point of Service Bill Corrections

12/01/01

5.015

Accounts Receivable Write-Off, Discount Code Definitions, Applications and Reporting

04/29/04

5.016

Referral Tracking

05/14/04

5.017

Student Health

05/14/04

Attach 6-3

Student Health Protocol

Attachment

14.105

Encounter Tracking

08/25/10

14.230

Physician Shadowing

01/26/2012

14.518

Covering Provider

12/07/10

14.520

New Hire Physician

10/27/11

14.521

Incident – To Billing

08/25/10

Attach 6-4

Incident – To Billing Flowchart

Attachment

14.522

Locum Tenens

01/26/2012

14.523

Billing for Durable Medical Equipment and Supplies

08/30/12

14.524

Electronic Health Record Code Selection and Prompt Functions

08/03/12

5.022

Safeguards to Protect Health Information

04/14/03

CASH HANDLING – Section 7

6.001

Cash Handling

04/01/04

Attach 7-1

Instructions for Establishment of Clinic Change Fund

Attachment

Attach 7-2

Spot Purchase Order (On-line)

Attachment

Attach 7-3

Requisition Order Form (On-line)

Attachment

Attach 7-4

Instructions for the Completion of the Change Fund Custodian Receipt

Attachment

Attach 7-5

Instructions for Completion of Year-End Change Fund Attestation

Attachment

Attach 7-6

Year End Change Fund Attestation Form

Attachment

Attach 7-7

Instructions for Completion of Daily Audit Summary

Attachment

Attach 7-8

Daily Audit Summary Form

Attachment

Attach 7-9

Instructions for Completing UNTHSCFW Receipt

Attachment

Attach 7-10

UNTHSCFW Receipt Form

Attachment

Attach 7-11

Instructions for Completion of Incident Report

Attachment

Attach 7-12

Incident Report Form

Attachment

Attach 7-13

Instructions for Completion of Daily Safe Log

Attachment

Attach 7-14

Daily Safe Log Form

Attachment

Attach 7-15

Procedures for Processing Credit Card Payments

Attachment

Attach 7-16

Credit Card Payment Authorization Form

Attachment

Attach 7-17

Reconciliation Instructions for Credit Card Statements

Attachment

Attach 7-18

Instructions for Completion of the Monthly Deposit/Batch Discrepancy Log

Attachment

Attach 7-19

Deposit/Batch Discrepancy Log Form

Attachment

Attach 7-20

Instructions for Completion of Payment Agreement Form

Attachment

Attach 7-21

Payment Agreement Form

Attachment

6.002

Patient Accounts Receivable Discounts

05/14/04

6.003

Return Check

05/14/04

BACK-END PATIENT ACCOUNTING – Section 8

14.515

Compliance Audit Refund Process

10/27/11

7.002

MSRDP Business Office Signature Access

09/01/03

Attach 8-1

Signature Account Request Form

Attachment

7.003

MSRDP Business Office Miscellaneous Deposit

05/14/04

QUALITY MANAGEMENT – Section 9

Copies of QM Policies & Procedures

OTHER POLICIES & PROCEDURES – Section 10