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I. Compliance Policies and Procedures Chapter

a.  Compliance Policies and Procedure Chapter Introduction

i. CDC Policies and Procedures

 1. Vaccine Storage and Handling Policy and Procedure

 2. Vaccine Administration Policy

 3. DTapForm 

 4. Gardasil Form

 5. Hepatitis A Form

 6. Hepatitis B Form

 7. Hib Form

 8. Influenza Form

 9. IPV Form

10. MMR Form

11. Menactra Form 

12. PCV-13 Form

13. PCV-23 Form

14. Tdap Form

15. Varicella Form

16. Zoster Form

ii. CLIA Policies and Procedures

 1. CLIA Policy and Procedure

 2. Tests Granted Waived Status Under CLIA

iii. Employee Policies and Procedures

 1. Contents of Employee File

 2. Employee Offer Letter

 3. Employee Handbook Table of Contents

 4. Employee Handbook

 5. Nonsolicitation, Nondisclosure, & Confidentiality Agreement

 6. Medical Administrative Assistant Job Description 

 7.Medical Assistant Job Description

 
iv.  HIPAA Policies and Procedures

Sub Sections: Privacy Policies | Security Policies | Forms | Training | Risk Assessment

1. Privacy Policies

 a. Patient Access to Protected Health Information

 b. Accounting of Disclosures

 c. Amendment of Health Information

 d. Business Associates

 e. Individual Right to Request Confidential Communication

 f. De-Identification

 g. Designated Record Set

 h. Designation of Privacy Officer/Contact Person/Office

i. Destroying/Disposal of PHI

 j. Privacy and Security Standards Training

  

 n. Notice of Privacy Practices for PHI

 o. Personal Representatives

 p. Privacy Complaints and Inquiries

 q. Privacy Officer Job Description

 r. Record Retention and Documentation

 s. Release of Information-Authorization

 t. Restriction on Use and Disclosure of PHI

 u. Sanctions

2. Security Policies

 a. Assigned Security Responsibility

 b. Breach Notification

 c. Contingency Plan

 d. Disaster Recovery Plan

 e. Encryption

 f. Facility Access

g. Information System Activity Review

h. Information Systems Access Policy

 i. Internet and Email Usage and Monitoring

 j. Remote Access

 k. Risk Management

 l.  Security Incident Reporting Procedure

m. Security Management Process 

n. Security Officer Description

o. Transmission Security Mobile Device Policy

p. User IDs & Security Codes

q. Verification of Identity and Authority

r. Workstation Usage and Monitoring

3. Forms

 a. Acceptance Request to Access PHI

 b. Amend Accept Letter Template

 c. Amend Denial Letter Template

 d. Amend Extension Letter Template

 e. Amend Response to Denial

 f. Request for Amendment Correction PHI

 g. Authorization to Obtain Health Information

 h. Authorization to Release Health-Information

 i. Business Associate Agreement 

 j. Computer & Electronic Media Disposal Log

 l. Disclosure Tracking Log

 m. Employee Access List

 n. Facility Repair/Maintenance Log

 o.  Hardware Tracking Log

 p.   Multi Media Request Form

 
 

 t.   Privacy & Security Policy Training Checklist

 u.  Patient Privacy Complaint Report Form

 v.   Request for an Accounting of Disclosures

 w. Request PHI Confidential Communication

 x   Request to Access, Inspect, and Copy PHI

 y.  Request for Remote Access Form

  z.  Security Incident Report

 aa. Vendor and Visitor Sign-In Log

 4. Training

 a. Protecting Privacy and Security of Health Information (Power Point)

 b. Protecting Privacy and Security of Health Information-Post test

5. Risk Assessments

 a. Risk Analysis and Management Tool/Electronic Devices and Systems

 b. Assessment/Privacy Walk-Through Check List 2017

 c. Assessment/Privacy Walk-Through Check List 2016

 d. Security Standards Checklist

6.  BAA Facts

 
 v. OSHA Policies and Procedures

 1. OHSA Compliance Manual 

PLEASE NOTE;

The entire OSHA Compliance Manual is contained in one download. There is no need to click on links below separately to access the OSHA Manual. Simply click on the image to access the complete OSHA Manual. 

Table of Contents

  1. BLOODBORNE PATHOGENS EXPOSURE CONTROL PLAN (p.1)
  2. BLOODBORNE PATHOGENS EXPOSURE CONTROL POLICY (p.11)
  3. OSHA COMPLIANCE ANNUAL CHECKLIST (p.15)
  4. SHARPS SAFETY DEVICES TRIALED YEAR (p.17)
  5. SHARPS DEVICE EVALUATION FORM (p.18)
  6. SHARPS SAFETY SURVEY CHECKLIST (p.19)
  7. INFORMED CONSENT FOR HEPATITIS B VACCINE (p.20)
  8. INFORMED REFUSAL FOR HEPATITIS B VACCINE (p.21)
  9. OCCUPATIONAL EXPOSURE INJURY/INCIDENT REPORT (p.22)
  10. FOLLOW-UP TO EXPOSURE/INJURY/INCIDENT REPORT (p.23)
  11. JOB RISK DETERMINATION FORM (p.24)
  12. EXPLANATION OF AND CONSENT OR DECLINE FOR HUMAN IMMUNODEFICIENCY VIRUS (HIV) AND HEPATITIS B VIRUS TESTING OF SOURCE INDIVIDUAL FOLLOWING EMPLOYEE EXPOSURE (p.25)
  13. PHYSICIANS/INFORMANT’S CERTIFICATION (p.26)
  14. EMPLOYEE HEALTH HISTORY (p.27)
  15. EMPLOYEE INFORMED REFUSAL OF POST EXPOSURE MEDICAL EVALUATION (p.28)
  16. SUMMARY LOG OF OCCUPATIONAL PERCUTANEOUS SHARPS INJURIES (p.29)
  17. WORK RELATED SHARPS INJURY STATISTICS (p.30)
  18. BLOODBORNE PATHOGENS STANDARD PRE-TEST (p.31)
  19. BLOODBORNE PATHOGENS STANDARD POST-TEST (p.32)
  20. HAZARD COMMUNICATION PLAN (p.35)
  21. HAZARD COMMUNICATION POLICY (p.37)
  22. HAZARD COMMUNICATION STANDARD PICTOGRAM (p.46)
  23. LISTING OF HAZARDOUS CHEMICAL SUBSTANCES (p.47)
  24. EMPLOYEE INFORMED REFUSAL OF POST ACCIDENT/INJURY- (NON-PATHOGEN EXPOSURE) (p.48)
  25. EMPLOYEE INITIAL AND REFRESHER TRAINING – BLOODBORNE PATHOGENS AND HAZARD COMMUNICATION (p.49)
  26. ELECTRICAL SAFETY CONTROL PLAN (p.50)
  27. ELECTRICAL SAFETY POLICY (p.51)
  28. MONTHLY ELECTRICAL HAZARD INSPECTION CHECKLIST (p.53)
  29. ERGONOMICS CONTROL PLAN (p.54)
  30. ERGONOMICS POLICY (p.55)
  31. GENERAL ERGONOMICS RISK FACTOR CHECKLIST (p.59)
  32. EMPLOYEE ERGONOMIC INJURY RISK ASSESSMENT SURVEY (p.60)
  33. ERGONOMIC SAFETY SURVEY RESULTS (p.62)
  34. WORKPLACE VIOLENCE CONTROL PLAN (p.63)
  35. VIOLENCE IN THE WORKPLACE POLICY (p.64)
  36. WORKPLACE VIOLENCE SURVEY (p.69)
  37. VIOLENCE IN THE WORKPLACE SURVEY RESULTS (p.71)
  38. VIOLENCE IN THE WORKPLACE ASSESSMENT (p.72)
  39. WORKPLACE VIOLENCE INCIDENT REPORT (p.76)
  40. TUBERCULOSIS EXPOSURE CONTROL PLAN (p.77)
  41. TUBERCULOSIS EXPOSURE CONTROL POLICY (p.84)
  42. EMPLOYEE PPD TESTING FORM (p.94)
  43. EMPLOYEE TB EXPOSURE POTENTIAL AND RISK DETERMINATION FORM (p.95)
  44. EMPLOYEE TB EXPOSURE POTENTIAL AND RISK DETERMINATION (p.97)
  45. TB OCCUPATIONAL EXPOSURE INJURY/INCIDENT REPORT (p.98)
  46. EXPLANATION OF AND CONSENT OR DECLINE FOR TB TESTING OF SOURCE INDIVIDUAL FOLLOWING EMPLOYEE EXPOSURE (p.99)
  47. PRACTICE TB RISK DETERMINATION FORM (p.100)
  48. PRACTICE TB RISK DETERMINATION CRITERIA FORM (p.101)
  49. TB STANDARD POST TRAINING PROGRAM TEST (p.104)
  50. TB PRE/POST TRAINING TEST ANSWER KEY (p.106)
  51. EMPLOYEE INITIAL AND REFRESHER TRAINING RECORD- MYCOBACTERIUM TUBERCULOSIS TRAINING (p.107)
  52. NEW REPORTING REQUIREMENTS (p.109)

  

II. Intra-Office Workflow Policies and Procedure
Chapter

a. Intra-Office Workflow Policies and Procedure Chapter Introduction

i. Ancillary Billing Policy and Procedure
ii. Ancillary Billing Sheet (ABS)
iii. Annual Letter to Medicare Patients for Private Contracting for Medical Services
iv. Beginning and End of Day Checklist Policy and Procedure for Staff
v. Contract for Services Provided to Medicare Beneficiaries
vi. General Billing Policy and Procedure
vii. Helpful Tips Document for Patients (pdf/not numbered)
viii. How to Enter Medication Inventory Policy and Procedure
ix. Late Cancellation/Missed Appointment Policy and Procedure
x. Medication Sample Dispensing Policy and Procedure
xi. Medication Sample Dispensing Labels
xii. Medication Sample Dispensing Log
xiii. Patient Testimonial Release Form
xiv. Policy and Procedure for Scanning Paper Charts into EHR
xv. Policy and Procedure for Scheduling Patients
xvi. Policy and Procedure for Sign Out
xvii. Policy and Procedure to Order Medication(s)for Dispensary Inventory
xviii. Consent to Medical/Surgical Office Procedure
xix. Scanning/Uploading Paper into EHR Policy and Procedure
xx. Script for Questions Regarding DPC by Category
xxi. Sign Out Form
xxii. Staff Policy and Procedure for Telephone Advice/Calls from Patients
xxiii. Weekly Pharmacy Ordering Log

 

III. Physician Workflow Policies and Procedures Chapter

a. Physician Workflow Policies and Procedures Chapter Introduction

i. Communication Between PCP and Behavioral Health Specialist Policy and Procedure
ii. Communication Between PCP and Specialist Policy and Procedure
iii. Daily Work-Flow Policy and Procedure
iv. Dispensary Policy and Procedure
v. Patient Agreement
vi. Informed Consent for Opioid Therapy
vii. Informed Consent for Stimulant Therapy
viii. New Patient Enrollment Policy and Procedure (General)
ix. New Patient Enrollment Policy and Procedure (GHFHC)
x. Office Visit Policy and Procedure
xi. Opioid Prescribing Policy and Procedure
xii. Ordering Laboratory, Radiology, Referral Policy and Procedure
xiii. Patient Agreement Appendix #1
xiv. Patient Agreement Appendix #2
xv. Patient Agreement for ADHD Management with Stimulant
xvi. Patient Agreement for Pain Management with Opioid
xvii. Patient Visit Sheet (PVS)
xviii. Reporting of Laboratory Test Results Policy and Procedure
xix. Reporting of Radiology Test Results Policy and Procedure
xx. Reporting of Specialist Referrals and Reports Policy and Procedure
xxi. Scheduling Request (SR)
xxii. Stimulant Prescribing Policy and Procedure

**Opioid Abuse Screening Tool/SOAPP Version 1.0-14 Q link (ACTUAL FORM NOT IN THIS MANUAL, MUST GO TO LINK BELOW TO DOWNLOAD) https://cabhp.asu.edu/sites/default/files/reiter-screening.pdf

 

IV. Templates for Correspondence Chapter

a. Templates for Correspondence Chapter Introduction

i. 48 Hours for Administrative Issues
ii. Abnormal Labs
iii. Against Medical Advice
iv. Cancellation of Membership by Patient (1.) and by Physician (2.)
v. Cancellation of Membership Prior to End of 6 Month Term
vi. Chart Transfer
vii. Consultant Follow Up
viii. Disclaimer for Emails
ix. Failed Payment #1
x. Failed Payment #2
xi. Failed Payment #3
xii. Fax Cover Sheet
xiii. Follow Up on Recent Illness #1
xiv. Follow Up on Recent Illness #2
xv. Immunization Follow Up
xvi. Late Cancellation/Missed Appointment
xvii. Letter to Patients/DPC Transition #1
xviii. Letter to Patients/DPC Transition #2
xix. Letter to Patients/DPC Transition #3
xx. Letter to Patients/DPC Transition #4
xxi. Mammogram/Breast Ultrasound Results
xxii. Medication Refill(s)
xxiii. Monthly Charity Letter
xxiv. New Patient Enrollment
xxv. Normal Lab/Imaging Results
xxvi. Open Enrollment Letter
xxvii. Overdue for Office Visit/30 Day Supply of Meds
xxviii. Patient Discharge Letter for Non-Payment
xxix. Prescription Ready
xxx. Receipt of Old Records
xxxi. Templates for Emails Requesting Online Reviews from Patients

 

V. Advertising Examples for Direct Primary Care

a. Advertising Examples for Direct Primary Care Introduction

i. 2016 Cost Savings Data from GHDFC
ii. Case Study: Medicare Cost Savings for Medications
iii. Cost Savings Case Studies
iv. Dear Small Business Owner
v. DPC Coupled with Insurance
vi. DPC Power Point for Patient Town Hall Meeting (not lettered)
vii. DPC Power Point for Chamber of Commerce/Businesses (not lettered)
viii. Employer Town Hall Announcement
ix. Facebook Case Studies #1
x. Facebook Case Studies #2
xi. GHDFC Letterhead (not lettered)
xii. Letter to Health Sharing Ministries
xiii. Letter to Patients Requesting Permission to Share Online Office Review
xiv. Medically Informative Posts (MIP’s) for social media/bulk emails to patients
xv. Patient Appreciation Events
xvi. Presentation Supporting State DPC Legislation
xvii. Published Articles About DPC
xviii. Generic Medication Cost Comparison Table
xix. Marketing Contents for GHDFC Patient Welcome Folder