This 485-page toolbox of ‘how-to’ policies and procedures for the efficient management of medical groups and other providers. Improve productivity, day to day medical practice management. Pay for Performance measures. Resources include a ‘how-to’ chapter on ‘concierge’ or retainer practices. Forms and other tools. Web sites. Authoritative references.  

1. Find Industry reports, Company profiles
ReportLinker and Market Statistics
>> Get this Report Now by email!
Medical Group Practice-Policies and Procedures
Published on January 2011
Report Summary
This 485-page toolbox of ‘how-to’ policies and procedures for the efficient management of medical groups and other
providers. Improve productivity, day to day medical practice management. Pay for Performance measures. Resources include a
‘how-to’ chapter on ‘concierge’ or retainer practices. Forms and other tools. Web sites. Authoritative
references.
Table of Content
Introduction to the Manual; Policy on Policies; Medical organization P & P for a Provider Manual; Annual policy review memo
format
The Provider’s Toolbox - Your Medical Organization’s Core Information insert section for - Introduction and welcome;
History - our origins and evolution; Mission and vision statements; Organization chart; List of staff providers/office locations; List of
contracted providers; in-network; Administrative and Medical Committees; Communication Resource List [Translation; vision/hearing
impaired assists]; Managed Care Contracts list with contact person and phone #
Credentialing Tools - Credentialing introduction; P & P; High risk providers; Provider sanctions
Peer:Peer Evaluations - Evaluation forms for physicians in same and other specialty areas.
Privileges - Introduction; forms
Ambulatory Care/Medical Office Site/Survey Visit criteria - P & P; extensive detailed survey standards check list; Authorization
and release form for medical office site visits
Peer Review - Peer Review Plan; Professional Affairs Committee; Confidentiality Agreements; Peer Review Severity Levels/Point
System; Peer Review References and Resources
Education and Training - Physician and Staff Education; Seminar/Conference Request Form; New Employee Orientation - Medical
Offices; Patient Education pathway example; Prevention and Counseling - Examples; Health Education; Minimum Standards;
PacifiCare of California
Medical Practice Management Tools - Physician employment contract issues - non-compete clauses or restrictive covenants; The
Minnesota model; The solo medical practice model; Physician compensation; Pay for Performance (P4P); Primary Physician; Job
Description and Work Standards - policy & procedure; Mentor Policy; Home and work site physician services; Computer order entry;
Computers in exam rooms;
Medical Group Practice-Policies and Procedures Page 1/6

2. Find Industry reports, Company profiles
ReportLinker and Market Statistics
Annual Review of Fees, Codes, Policies; Contract issues; Billing tips - Code correctly!;
Telemedicine/ 'Virtual Medicine' programs; Primary Physician Coordinated Care Policy; Operational Measures to Track/Evaluate
Group Practice Performance; Letters of Condolence; Office Visits, Primary Physician, by Diagnosis; Physician staffing requirements
(by population served); Physician recruitment policy and procedures; Coverage for physician absences;
Common Obstacles to Effective Medical Group Performance; Office staffing requirements; Admitting Physician(s) for Acute Hospital
Services; MGMA medical group "best performer" characteristics; (‘Hospitalist’); Physician Extender Standards; Fraud &
Abuse Issues for Ambulatory Surgery Centers (ASC) ; Physician Retention - benchmarks and strategies; Medical practice
‘split-ups’ - considerations; Professional dress to meet patient expectations; Moonlighters;
Provider Profiles - P & P; Case mix adjustment for provider profiles;; Feedback; Steps to improve productivity, resource
management, physician/patient satisfaction ; Ambulatory encounter/visit benchmark data. ¨
Medical Records - General Policies and Procedures for Medical Records; Medical Record Documentation Standards; Office
visit/Encounter forms Medical Record Log - example; Release of Medical Record Information; Psychotherapy notes; Confidentiality
Issues; Authorization to Transfer Medical Records; formats; Affidavit to accompany medical records; Staff signature/initials sheet;
Making changes to a medical record; Medical Record Documentation Standards; Affidavit to accompany medical records; Patient
rights to copy records; Confidential Fax Transmission Format; Unsolicited test results, P & P, example letter formats; Notification
letter to patients regarding test results of possible concern; Electronic Medical Records; Medical Records Retention Policy; Online
Medical Records; Medical Records Storage - Security Requirements; References and Resources, Medical Records and Coding Web
Site Resources ¨
Consents for Treatments - Informed consent policy; Development process for consent forms; Brochure for patients; Procedures
requiring informed consent; Procedures for obtaining informed consent; Procedure consent form; Refusal of treatment form, AMA
Policy and Procedure; HIV testing; consent and payment procedures; Interpreter's statement; Consent for immunizations; Consent for
photography during a surgical procedure; General Consent for surgery; anesthetics and other medical services formats; Consent for
sterilization form; Consent for Oral Contraceptives (the pill); Prostate Needle Biopsy consent form; Rubber band ligation; hemorrhoids;
Telemedicine consent form; DNR/withholding of treatment order form; Gastroscopy form; PEG consent
Office Services Management Toolbox - Office Services Management; Patient-centered care model; Brand Name Identify/Welcome
Letter; PacifiCare Welcoming Letter; Welcome calls; HIPAA summary, HIPAA web sites, HIPAA checklist; Sign-in sheets;
Access for Non-emergency Care; Group visits; Access to Care and Access Time for Appointment Standards; Auditing access times;
Wait Times Policy; After Hours Services; ‘On Call’ Policy and Procedure; Frequent callers: a high risk group for
utilization of care; Telephone log; ‘Walk-in’ Patient Triage; Time Allocation for Routine Primary Care Visits;
Address for All Adult Patients and Visitors; Chaperone in Exam Room for Pelvic Exams; Messages; MDHub.com; Communication
with Hearing Impaired Patients; Communication with Patients and Visitors - Limited English Proficiency; Transport of Patients to Area
Hospitals; Admitting Process: Office to Hospital; Vital Signs and Weights; Ambulatory/Office-based Surgery;
Telephone Access and ‘Hold’ Time; Telephone Calls from Patients; Smoke-free Environment Policy; Appointment
Scheduling Policy; Missed or ‘No Show’ Appointment Policy; Reschedule Notification Letter format; Appeal process for
missed appointment charge;
Patient Registration; Registration Form; Payment policy and Assignment of Benefits, Acknowledgment form; Insurance payment (or
nonpayment) release agreement form; Handout for Medicare Patients (re: nonparticipating provider); Waiver of liability/Financial
Responsibility statement, general, form; Waiver of liability for Medicare statement, form; Collection policy; Lien attachment form;
References for former employees; Shred for confidentiality; Locum tenens physicians - billing; credit cards;
Medical Group Practice-Policies and Procedures Page 2/6

3. Find Industry reports, Company profiles
ReportLinker and Market Statistics
Patient Rights and Responsibilities; Advanced Directives; ‘Living Will’ Declaration; example; Physician Request for
Transfer of Care; Discharge of terminated patients presenting for medical care, P&P; Nursing Services policies and procedures;
Billing for 'Incident to' Services; Billing for ‘Concurrent’ Inpatient Services; Outpatient surgery instruction sheet;
Document retention - P & P; Median number of ambulatory encounters per physician, by specialty; Major reasons for outpatient visits,
all US , 2000; Medical Practice Web Site - an essential tool; Medical Management/Practice Web Sites ; Scribes - Non-physicians
acting as scribes for physicians; References and resources for Office Management
Unsnarling Patient's Medical Bills
Emergency Care Overview; Emergency Care Committee; ACLS Certification; Emergency ‘On-site’ Triage Policy;
Emergency Telephone Triage; Office Emergency/Code Blue Policy and Procedure; Code Blue; Evaluation of Code Blue Response;
‘Stat Nurse’ Call; Electrocardiograms; Physical Abuse Policy;
Emergency Equipment; Adult Crash Cart: Required Content List; Crash Cart/Defibrillator Check List; Urgent Care Flow Algorithm;
Specialty Referral by UCC Physician Algorithm; Priority Care Appointment following UCC Visit; UCC Patient; Disposition Algorithm;
Pre-Admission Function/ER Algorithm;
Office Pharmaceutical/DME Policies and Procedures - Introduction; P & T Committee; Formulary; Drug Samples; Procedure for
Stock Drugs; Procedure for Samples; Distribution and Storage of Schedule II Drugs; Outdated Drug Inspection and Removal; Orders
for Medications; Tests and Treatments; Pharmaceutical Standards; Controlled Substance Reorder/Refill Guidelines; Referral to UCC
for Parenteral Medication Administration; Administration of Injection; Ordering Provider not Present; Treatment of Mild Reaction to
Any Substance; Treatment of Anaphylaxis; Preparation and Administration of Antineoplastic Agents; Mandatory Therapeutic
Substitution Example; Altered/falsified Prescriptions P & P; Peak Expiratory Flow Meters - to monitor asthma care at home;
Tamper-Resistant Prescription Policy for Medicaid;
Risk Management and Safety - Risk Management; Safety and Infection Control: Master Policy; Facilities and Environment; policy;
CPR Training Policy example; Tracking Significant Abnormal Diagnostic Results; Facility Disaster Plans; Bomb Threat Emergency;
Earthquake Safety; Electrical Emergency; Fire Emergencies; Fire Safety; Risk Manager/Patient Relations Manager Responsibility
Policy; Safety Standards Policy; Customer concern form
Infection Control - Infection Control Committee; Exposure Control Plan; Universal Precautions; Training program with exam;
Infection Control Policy - Ambulatory Care; Bloodborne Pathogens; Universal precautions; Infection control records, form; Infection
control personnel policy; In-service acknowledgement form; Designation of Clean and Not-Clean/‘Dirty’ Patient Care
Items & Equipment; Air Decontamination; Dirty-Clean Work Flow Policy; Refrigerator: Maintenance/Monitoring Policy; Linen:
Handling; Storage; Transportation and Processing; Soap/Lotion Containers; Cleaning Examination Rooms; Cleaning toys;
Handwashing; Biohazard Medical Waste Management; Waste Management: Authority and Responsibility; Enforcement of the Waste
Management Plan; Decontamination; Disinfection and Sterilization of Equipment; High Level Disinfection Policy; Glutaraldehyde
Potency Testing Policy; Autoclave Sterilization Policy; Autoclave: Biological Monitoring; Cleaning and Servicing; Autoclave Recall and
Outdate Procedures; Storage of Sterile Supplies;
Communicable Disease: Managing Known or Suspected Patients; HIV: Post-Exposure Evaluation; HIV: Testing/Release of
Information; HIV Test: Information and consent form; Authorization: release of information related to HIV testing; Communicable
Disease: Reporting; Hepatitis B Vaccine Declination forma; Hepatitis B Vaccination: Post-exposure Evaluation; Hepatitis B:
Informational pamphlet; Hepatitis B Vaccine: Informed Consent Form; Tuberculosis Control Plan; Creutzfeldt-Jackob Disease (CJD)/v
CJD with other Transmissible Spongiform Encelphalopathies; Skin disinfection to prevent catheter-related blood-stream infection;
Screening for Methicillin Resistant Staph Aureus (MRSA); VRSA (Vancomycin Resistant Staphylococcus Aureus); VRSE
(Vancomycin Resistant Staphylococcus Epidermidis); VISA (Vancomycin Intermediate Staphylococcus Aureus); VISE (Vancomycin
Intermediate Staphylococcus Epidermidis); Vancomycin Resistant Enterococcus (VRE) Detection; Reuse of Disposable Items -
Policy; Blood borne pathogens - exposure determination record; Animal guests in the medical environment; Infection Control:
References and Resources
Medical Group Practice-Policies and Procedures Page 3/6

4. Find Industry reports, Company profiles
ReportLinker and Market Statistics
Quality Improvement Toolbox - Patient Satisfaction Surveys (Service Evaluation - forms to use); Risk Management/Patient
Relations Policy; Ethics Manual - link; Health care apologies/Medical error admissions; Skilled vs. Custodial (non-skilled) Levels of
Care Services; Custodial Level of Care: Informational Hand-out sheet; Home Health Referral Procedures; Mammogram follow-up tool;
Clinical Performance Measures, ‘Pay for Performance’ and Gain-sharing programs; Physicians Office Quality
Improvement Tool Kit; Sentinel events reporting - P&P; Quality-related web sites; Quality references and resources; Norton
Healthcare Physician Office Quality Monitor.
Case Management - Introduction; CM policy; CM: SNF; CM: Home Health and Hospice Services; Discharge Planning - policy and
procedure; Homebound program; High risk screens; New patient screens: Indicators; trigger; action; CM Outcome Measures; High
risk case detection; Congestive heart failure CM; Hospital Director; CM Services; position description; Case Manager; position
description; Discharge Planner; position description; Screening case manager candidates; Case Management duties; CM References
and other resources.
Utilization Management/’Back Office’ Toolbox - Major challenges for UM cost control; Medicare is targeting costly
physicians; Capitation fundamentals; Benefit and eligibility determination verification; Financial Responsibility Guarantee Form;
Eligibility FAQs; Waiver of Co-payments P & P; Appeal of Denial Policy; Grievance Tracking P&P; Authorization approval notification
form; Authorization denial notification form; Outpatient Surgical Procedures Authorization; Transitional Care Center Policy; Diagnostic
Referrals; streamlined process; Diagnostic radiology referral form for streamlined process; Authorization of special services;
Submission of encounter data and claims; Coordination of benefits; Third party liability; Sanctions and Fines - Utilization
Management; UM Committee Meeting Attendance Requirements; Quarterly Primary Physician Dinner Meeting Attendance
Requirement; Specialty Pre-Admission Authorization; Primary Physician Notification; Utilization check lists; Common reasons for
denials; Appeals process and procedure; Provider Sanctions and Fines: QI Committee; Fine Notification Form; The Hippocratic Oath
Concierge or Retainer Practices - Introduction, financial models; History; State insurance regulators; Ethical guidelines, (AMA);
Considerations before launching a retainer practice; Processes necessary to establish a retainer practice; Core issues in a retainer
agreement or contract ; Guests, relatives and friends; Example letters to patients; Example letter to professional colleagues; Brochure
example.
Financial Management Benchmarks - Medical Practice Administrative Costs
References, Resources, Links - inserted throughout the manual following most sections.
Appendices - Business/Clinical medical records retention guidelines; Health-law links; OIG alert; Provider alert - Physician
involvement in diagnostic clinics; Disability certifications;. Medical Director/Medical supervision responsibilities Alternative practice
models - cash-only practices; Admission Orders, Standardized; Physician issues affecting efficient quality practice; Physician
surrogates, extenders; Physician-Hospital Joint Ventures; Buying or selling a practice; Communication - Complaint Management
Medical Group Practice-Policies and Procedures Page 4/6

5. Find Industry reports, Company profiles
ReportLinker and Market Statistics
Fax Order Form
To place an order via fax simply print this form, fill in the information below and fax the completed form to:
Europe, Middle East and Africa : + 33 4 37 37 15 56
Asia, Oceania and America : + 1 (805) 617 17 93
If you have any questions please visit http://www.reportlinker.com/notify/contact
Order Information
Please verify that the product information is correct and select the format(s) you require.
Medical Group Practice-Policies and Procedures
Product Formats
Please select the product formats and the quantity you require.
Digital Copy--USD 275.00 Quantity: _____
Contact Information
Please enter all the information below in BLOCK CAPITALS
Title: Mr Mrs Dr Miss Ms Prof
First Name: _____________________________ Last Name: __________________________________
Email Address: __________________________________________________________________________
Job Title: __________________________________________________________________________
Organization: __________________________________________________________________________
Address: __________________________________________________________________________
City: __________________________________________________________________________
Postal / Zip Code: __________________________________________________________________________
Country: __________________________________________________________________________
Phone Number: __________________________________________________________________________
Fax Number: __________________________________________________________________________
Medical Group Practice-Policies and Procedures Page 5/6

6. Find Industry reports, Company profiles
ReportLinker and Market Statistics
Payment Information
Please indicate the payment method, you would like to use by selecting the appropriate box.
Payment by credit card Card Number: ______________________________________________
Expiry Date __________ / _________
CVV Number _____________________
Card Type (ex: Visa, Amex…) _________________________________
Payment by wire transfer Crédit Mutuel
RIB : 10278 07314 00020257701 89
BIC : CMCIFR2A
IBAN : FR76 1027 8073 1400 0202 5770 189
Payment by check UBIQUICK SAS
16 rue Grenette – 69002 LYON, FRANCE
Customer signature:
Please note that by ordering from Reportlinker you are agreeing to our Terms and Conditions at
http://www.reportlinker.com/index/terms
Please fax this form to:
Europe, Middle East and Africa : + 33 4 37 37 15 56
Asia, Oceania and America : + 1 (805) 617 17 93
Medical Group Practice-Policies and Procedures Page 6/6