The Essential Physical Therapy Private Practice Policy .

Transcription

The Essential PhysicalTherapy Private PracticePolicy & Procedure ManualNANCY BECKLEY & ASSOCIATES LLC

SINGLE USE LICENSE AGREEMENTPLEASE READ THE FOLLOWING LICENSE AGREEMENT ("AGREEMENT") CAREFULLY BEFORECONTINUING. WITH YOUR ACCEPTANCE, THIS IS A LEGAL CONTRACT BETWEEN NANCY BECKLEY &ASSOCIATES, LLC. ("NBA") AND YOU ("YOU")BY CLICKING ON THE "ACCEPT" BUTTON, OR BY DOWNLOADING, ACCESSING OR USING THECONTENT, YOU ACCEPT ALL OF THE TERMS AND CONDITIONS OF THIS AGREEMENT AND AGREE TOBE BOUND BY THIS AGREEMENT.IF YOU DO NOT ACCEPT THE TERMS OF THIS AGREEMENT, YOU ARE NOT PERMITTED TO USE THECONTENT. IN SUCH CASE, CLICK THE "CANCEL" BUTTON.The license granted in this AGREEMENT is only for the personal use of an individual healthcareprovider or consumers. License agreements for all other professionals, consultants andorganizations must be arranged through NBA. Please contact NBA at (414) 478-4376.1. Content. The NBA informational content and any information accompanying thisAGREEMENT, provided to you, whether by download or in any other form (collectively the"Content") are licensed, not sold, to you by NBA for use only under the terms of thisAGREEMENT, and NBA reserves all rights not expressly granted to you.2. License. Subject to the terms and conditions of this AGREEMENT, you are granted a limitednon-exclusive, non-transferable, revocable license to use one copy of the Content. ThisAGREEMENT does not allow the Content to be copied, distributed or sold.3. License Restrictions. You may NOT do any of the following yourself, or through any thirdparty, and you may not permit or enable any third party to do any of the following (exceptas and only to the extent any of the following restrictions are prohibited by applicable law):(A) copy the Content; (B) modify or create derivative works based on the Content; (C) sell,license, sublicense, distribute, disclose, permit access to, or transfer to any third party,whether for profit or without charge, any portion of the Content, or, in particular, withoutlimiting the generality of the foregoing, distribute the Content on any media, make theContent accessible to the public or third parties, whether over networks, electronic bulletinboards, websites, or otherwise, or allow any third party to use the Content; (F) publish orotherwise communicate any review of, or information about, the performance of theContent to any third party without the prior written consent of NBA;4. Copyright and Other Restrictions. The Content is the property of NBA, and is protected bycopyright and other intellectual property laws. Except for the rights expressly grantedabove, this AGREEMENT transfers to you no right, title, or interest in the Content or anycopyright or proprietary right therein. None of the Content may be reproduced,transcribed, transmitted in any form or by any means (electronic, mechanical, photocopied,recorded, or otherwise), resold, or redistributed without the prior written consent of NBA.5. Use of Professional Judgment.Page 1 of 52020 Nancy Beckley & Associates LLC. All Rights Reserved. Nancy Beckley & Associates (NBA) has taken a great deal of care to include current policy and regulatory information inthis book. NBA makes no real or implied guarantee that by using this book and sample policies that you will meet all legal and regulatory requirements and will not acceptresponsibility for any liability, loss or damage resulting from use of this sample document. As with any model policy, the document should be carefully reviewed and customized foryour organization. No information provided in this document should be used as a substitute for the advice of competent legal counsel.

A. The Content is intended to serve as a concise initial reference and NOT as acomplete reference source. The Content does NOT include information concerningindividual state requirements related to the delivery of healthcare care servicesand/or governance of healthcare regulated entities.B. Accreditation standards and federal, state and local regulatory standards aresubject to change, and as applicable you should consult a variety of sources andnot rely solely on the Content.6. DISCLAIMER OF WARRANTIES.A. YOUR USE OF THE CONTENT IS AT YOUR SOLE RISK. NBA ASSUMES NO LIABILITYFOR THE CONTENT. YOU ASSUME FULL RESPONSIBILITY FOR THE APPROPRIATE USEOF THE CONTENT.B. THE CONTENT IS PROVIDED "AS IS," WITH ALL FAULTS AND WITHOUT WARRANTYOF ANY KIND.C. NBA DOES NOT WARRANT THAT THE CONTENT WILL MEET ANY ACCREDITATIONSTANDARD OR STATE OR FEDERAL REQUIREMENTS.D. NO SALESPERSON OR OTHER REPRESENTATIVE OF ANY PARTY INVOLVED IN THEDISTRIBUTION OF THE CONTENT IS AUTHORIZED TO MAKE ANY WARRANTIES WITHRESPECT TO THE CONTENT. ORAL STATEMENTS DO NOT CONSTITUTEWARRANTIES, SHALL NOT BE RELIED UPON BY YOU, AND ARE NOT A PART OF THISAGREEMENT.Page 2 of 52020 Nancy Beckley & Associates LLC. All Rights Reserved. Nancy Beckley & Associates (NBA) has taken a great deal of care to include current policy and regulatory information inthis book. NBA makes no real or implied guarantee that by using this book and sample policies that you will meet all legal and regulatory requirements and will not acceptresponsibility for any liability, loss or damage resulting from use of this sample document. As with any model policy, the document should be carefully reviewed and customized foryour organization. No information provided in this document should be used as a substitute for the advice of competent legal counsel.

Terms & ConditionsAuthorization and RestrictionsThe purchaser of the “The Essential Physical Therapy Private Practice Policies &Procedures” (Manual) is authorized to duplicate materials in the following manner subjectto the Single Licensing Agreement.The purchaser may: Duplicate and/or print the Adobe Acrobat (PDF) documents including all policiesand procedures provided in this format for your own use within the originalpurchaser’s private practice. You must purchase a copy of the Manual for eachseparate private practice entity. For purposes of this authorization, a privatepractice is defined as private practice and all enrolled locations. If you own, orparticipate in another private practice entity, another Manual must be purchased ifyou choose to use it in that practice. Please contact us directly to clarify whetherthis authorization will be extended or whether additional copies will be required. Modify the policies and procedures and documents that have been included in(Word 2016) to include language specific to your own practice and for any futurechanges in law, regulation, and accreditation standards. Incorporate excerpts from the Manual into the policies and procedures of your ownpractice. Insert your practice logo in any document headers.The purchaser may not: Reproduce and/or distribute, in whole or in part, any portion of this manual forsale, redistribution or inclusion in other printed text without prior written consentof the author above and beyond the authorization described above, whether or notsuch activities are for profit. Reproduce and/or distribute, in whole or in part, any portion of this manual for usein educational activities, seminars or educational publications without the priorwritten consent of the author above and beyond the authorization describedabove, whether or not such activities are for profit. Incorporate, in whole or in part, any portion of this manual into other documents,manuscripts, or texts without prior written approval of the author. Purchase this manual for use as a consultant with more than one client. If you are aconsultant, please contact us for a licensing arrangement.Page 3 of 52020 Nancy Beckley & Associates LLC. All Rights Reserved. Nancy Beckley & Associates (NBA) has taken a great deal of care to include current policy and regulatory information inthis book. NBA makes no real or implied guarantee that by using this book and sample policies that you will meet all legal and regulatory requirements and will not acceptresponsibility for any liability, loss or damage resulting from use of this sample document. As with any model policy, the document should be carefully reviewed and customized foryour organization. No information provided in this document should be used as a substitute for the advice of competent legal counsel.

IntroductionThank you for purchasing The Essential Physical Therapy Private Practice Policy andProcedure Manual. (“Manual”)This Manual was developed using current resources and includes references to bothcompliance obligations and clinical practice responsibilities. The information is believed tobe current at the time of publication and is intended to assist with the development ofpolicies and procedures for your practice.As you review and revise the documents provided, we strongly recommend that youadditionally review and incorporate state specific laws and regulations as it relates to thepractice and oversight of Physical Therapy. This Manual includes general personnelPolicies. It is our experience that in addition to federal laws governing employment, thereare also state laws governing personnel and employment that should be incorporated intoyour final version of this Manual. We recommend the use of experienced consultants whospecialize in the areas of human resources, information technology, and other areasimpacted by specific state laws, and the services that you offer.The Manual is intended to serve as a foundation for policies and procedures specific toyour Therapy Practice. Given varying state requirements the Manual does not includereference to “all” state regulations. As such we again recommend that you review staterequirements that are applicable to services provided in your Practice.All Books in this Manual are provided both in Adobe PDF and Word 2016. You may editdocuments in Word based on your acceptance of the Single Use License Agreement andthe Terms & Conditions Authorization and Restrictions included herein.Nancy Beckley & Associates (NBA) has taken a great deal of care to include current policyand regulatory information in this book. NBA makes no real or implied guarantee that byusing this book and sample policies that you will meet all legal and regulatory requirementsand will not accept responsibility for any liability, loss or damage resulting from use of thissample document. As with any model policy, the document should be carefully reviewedand customized for your organization. No information provided in this document should beused as a substitute for the advice of competent legal counsel.We encourage you to access and utilize other resources from our website:https://NancyBeckley.com/StoreWe wish you success in using this Manual to create your own “Best Practice” policies.Thank you for choosing our product.Page 4 of 52020 Nancy Beckley & Associates LLC. All Rights Reserved. Nancy Beckley & Associates (NBA) has taken a great deal of care to include current policy and regulatory information inthis book. NBA makes no real or implied guarantee that by using this book and sample policies that you will meet all legal and regulatory requirements and will not acceptresponsibility for any liability, loss or damage resulting from use of this sample document. As with any model policy, the document should be carefully reviewed and customized foryour organization. No information provided in this document should be used as a substitute for the advice of competent legal counsel.

How This Manual is OrganizedThis focus and organization of this Manual is based upon a “Best Practice” approach toaddress the needs of the Therapy Practice. The Manual is written in Book format with aless formal approach, allowing for flexibility in customization.This Manual is organized into 4 Books:1. Administration & Compliance2. Environment & Safety3. Patient Care & Quality4. Personnel & Human ResourcesEach Book contains Chapters which can be used as a stand-alone policies to address aspecific area of need or when combined with current policies to assist you in achieving aCompliance-oriented framework to your Therapy Practice policies and procedures.This Manual is not intended, nor will it meet Medicare Certification or Accreditationrequirements for Hospitals, Skilled Nursing Facilities, Rehab Agencies, CORFs, or HomeHealth Agencies. We have not provided references or citations to Medicare Conditions ofParticipation, or Accreditation Standards.About Your Downloaded ProductAll of our products are downloadable products only. When you downloaded this productfrom our website, you have downloaded the full manual in PDF format and individual files,organized in Chapters in Word 2016 format.Page 5 of 52020 Nancy Beckley & Associates LLC. All Rights Reserved. Nancy Beckley & Associates (NBA) has taken a great deal of care to include current policy and regulatory information inthis book. NBA makes no real or implied guarantee that by using this book and sample policies that you will meet all legal and regulatory requirements and will not acceptresponsibility for any liability, loss or damage resulting from use of this sample document. As with any model policy, the document should be carefully reviewed and customized foryour organization. No information provided in this document should be used as a substitute for the advice of competent legal counsel.

Administration & Compliance12020 Nancy Beckley & Associates LLC. All Rights Reserved. Nancy Beckley & Associates (NBA) has taken a great deal of care to include current policy and regulatory informationin this book. NBA makes no real or implied guarantee that by using this book and sample policies that you will meet all legal and regulatory requirements and will not acceptresponsibility for any liability, loss or damage resulting from use of this sample document. As with any model policy, the document should be carefully reviewed and customizedfor your organization. No information provided in this document should be used as a substitute for the advice of competent legal counsel.

Administration . 6Mission, Vision and Values . 6Governing Body and Bylaws . 6Organization Structure. 7Licensure and Certification . 7Policies and Procedures . 8Ethics . 8Conflict of Interest . 9Confidentiality of Proprietary Business Information . 9Compensation Arrangement with Referral Sources (Physicians) . 10Contract Management and Oversight . 11Document retention, Preservation, and Destruction of Clinical and Business Records . 11Hours of Operation . 14Keys and Access Controls . 14Building and Equipment Leases . 15Incident Reporting . 15Open Lines of Communication. 16External Communications . 17Publishing and Media Communications . 17Advertising and Sponsorships . 17Clinical Operations . 18Nondiscrimination and Accessibility in Clinical Operations. 18Notice of Nondiscrimination and Accessibility . 18[COMPANY] shall provide free aids and services to people with disabilities to communicateeffectively, such as: . 18Scheduling of Federal Healthcare Program Patients . 19Cash and Wellness Services: Collection of Payment. 19Compliance . 20Compliance Program Administration . 20Compliance - Standards, Policies and Procedures . 2122020 Nancy Beckley & Associates LLC. All Rights Reserved. Nancy Beckley & Associates (NBA) has taken a great deal of care to include current policy and regulatory informationin this book. NBA makes no real or implied guarantee that by using this book and sample policies that you will meet all legal and regulatory requirements and will not acceptresponsibility for any liability, loss or damage resulting from use of this sample document. As with any model policy, the document should be carefully reviewed and customizedfor your organization. No information provided in this document should be used as a substitute for the advice of competent legal counsel.

Compliance - Screening and Evaluation . 21Compliance Communication, Education, and Training . 22Compliance - Monitoring, Auditing, and Reporting. 22Compliance - Discipline for Non-Compliance . 23Compliance - Investigations and Remedial Measures . 23Compliance - Fraud, Waste, and Abuse Prevention . 27Compliance Risk Assessment . 28Compliance – Red Envelope Policy . 28Federal Health Care Programs . 30Medicare Enrollment . 30Medicare Services and Use of Space Regulations . 30Compliance with Medicare Coverage, Billing and Payment . 30Referral Source Education Spending . 31Finance . 32Generally Accepted Accounting Principles . 32Payroll, Schedule, Deductions, Overtime, Compensation . 32Expense and Mileage Reimbursement . 32Use of a Company Credit Card . 32Professional & Business Courtesies . 33Contract and Invoice Billing . 36Cash Billing (Collection). 36Cash Management/Debt Management . 37Billing Oversight . 37Accounts Receivable (Collections) Resolutions . 38Benefits Verification. 39Patient Financial Hardship . 39Payment Plan . 40Collection of Patient Responsibility . 41Submission of Unresolved Patient Balances to a Collection Agency . 41Small Balances. 4232020 Nancy Beckley & Associates LLC. All Rights Reserved. Nancy Beckley & Associates (NBA) has taken a great deal of care to include current policy and regulatory informationin this book. NBA makes no real or implied guarantee that by using this book and sample policies that you will meet all legal and regulatory requirements and will not acceptresponsibility for any liability, loss or damage resulting from use of this sample document. As with any model policy, the document should be carefully reviewed and customizedfor your organization. No information provided in this document should be used as a substitute for the advice of competent legal counsel.

Overpayment Refunds . 42Antitrust . 42Annual Budgeting . 43Medical and Billing Record Request Invoicing . 43Biller Education and Training . 45HIPAA Privacy. 46Confidentiality of Protected Health Information. 46Privacy - Administrative Requirements . 46Privacy - Business Associates . 48Privacy - Permitted Uses and Disclosures . 49Privacy - Uses and Disclosures - Authorization and Minimum Necessary. 53Privacy - Amendment of Protected Health Information . 55Privacy - Disclosure and Accounting . 56Privacy - Notices and Other Individual Rights. 56Privacy - Response to Privacy Breach . 58Privacy - Business Associate Agreement Template . 62HIPAA Security . 63Security Administrative - Assigned Security Responsibility . 63Security Administrative – Business Associate Written Contract . 63Security Administrative – Corrective Action & Sanctions . 63[OPTIONAL] Security Administrative - Credit Card Processing and Payment Card Industry DataSeurity Standard (PCI DSS) . 64Security Administrative - Data Backup Plan . 67Security Administrative - Disaster Recovery Plan . 67Security Administrative - Emergency Mode Operation and Recovery . 68Security Administrative - System Activity Review . 68Security Administrative - Login Monitoring . 69Security Administrative - Password Management . 69Security Administrative - Protection from Malicious Software . 69Security Administrative - Response and Reporting . 7042020 Nancy Beckley & Associates LLC. All Rights Reserved. Nancy Beckley & Associates (NBA) has taken a great deal of care to include current policy and regulatory informationin this book. NBA makes no real or implied guarantee that by using this book and sample policies that you will meet all legal and regulatory requirements and will not acceptresponsibility for any liability, loss or damage resulting from use of this sample document. As with any model policy, the document should be carefully reviewed and customizedfor your organization. No information provided in this document should be used as a substitute for the advice of competent legal counsel.

Security Administrative - Risk Assessment . 70Security Administrative - Risk Management . 71Security Administrative - Security Reminders . 72Security Administrative - Technical and Non-Technical Evaluations. 72Security Administrative - Workforce Authorization . 72Security Physical - Access and Validation . 72Security Physical – Accountability . 73Security Physical - Contingency Safeguards . 73Security Physical - Data Backup and StoragE . 74Security Physical - Disposal or Reuse of Device Media ePHI . 74Security Physical - Security Maintenance Record . 74Security Physical - Workstation Use . 74Security Technical - Audit Controls . 75Security Technical - Automatic Logoff . 75Security Technical - Emergency Access . 75Security Technical – Encryption . 75Security Technical - Integrity Controls . 76Security Technical - Mechanism to Authenticate ePHI . 76Security Technical - User Identification and Authentication . 7652020 Nancy Beckley & Associates LLC. All Rights Reserved. Nancy Beckley & Associates (NBA) has taken a great deal of care to include current policy and regulatory informationin this book. NBA makes no real or implied guarantee that by using this book and sample policies that you will meet all legal and regulatory requirements and will not acceptresponsibility for any liability,

The purchaser of the “The Essential Physical Therapy Private Practice Policies & Procedures” (Manual) is authorized to duplicate materials in the following manner subject to the Single Licensing Agreement. The purchaser may: Duplicate and/or print the Adobe Acroba