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Positive Outlook – Issue 18.0 – Jun 2017

FAQ

  1. Do I need a policy and procedure manual for my practice?

A comprehensive policy and procedure program in the provider office practice setting can promote patient safety, improve the quality of care, and serve to mitigate liability exposure. The American Society for Healthcare Risk Management indicates that it is important to consider definitions of policies, procedures and guidelines when developing guidance documents for your practice.

For a list of suggested physician office policies & procedures, please call our risk management department who will be happy to assist you in preparing your manual.

  1. What is the best way to manage repeated No-Shows?

A no-show appointment is generally defined as “when a patient fails to appear for a scheduled appointment and does not notify the practice.” Other than emergency situations, the patient will be billed a pre-determined fee. Posting a sign in the waiting room should be considered. New patients should be informed of the policy at the time they establish care with the practice.

Cancellations differ from no-shows in that the patient gives advanced notice that they are unable to keep the appointment. No-show appointments can cause financial issues on the practice and can negatively impact another patient who needs the appointment for medical treatment. Strategies to reduce no-show rates have proven to increase revenue and ensure appointments are kept. To guarantee patient compliance, a written policy should be visible to all patients at the time of the sign up with the practice. For help developing your No-Show Policy, please call our risk management department.

Document The Question The Document Answers Purpose Of Document
Guidelines What is recommended? Provides additional recommended guidance for specific disease entity
Procedure What do I do? Establishes proper steps to take
Standard What is required? Assigns quantifiable measures
Policy Why do I need to do this? A guiding principle to set direction in an organization

 


FAQ: Medical Malpractice Concerning Narcotic Pain Medication Addiction

FAQ: If a patient gets addicted to a narcotic pain medication, who’s fault is it and could it be considered medical malpractice?

To figure out if a patient’s addiction to pain medications constitutes medical malpractice, you have to prove that the patient’s doctor was negligent. This means that the doctor did not act reasonably in treating the patient.

Opiate overdosing is a growing problem in the United States. As a result, the number of addicted people continues to increase throughout the country as do opiate-related suicides and deaths.  In Montgomery County, PA, where Positive Physicians Insurance Company is based, the death toll by opiate overdosing increased by 123% this year.

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IME Insurance Malpractice Suit-Adams vs. Gelman

Adams v. Gelman, concerning IME Insurance, was decided on November 10, 2016. The case involved three insurance claimants who jointly filed a lawsuit against a Delaware physician claiming that his work for insurance companies over decades, and perceived bias in favor of those companies, amounted to fraud, breach of fiduciary duty, battery, racketeering, and conspiracy. The trial court dismissed the case, determining not only that the physician’s actions were protected by the legal principle of witness immunity but also that none of these claims were legally valid. Plaintiffs appealed on the issue of fraud only and the Delaware Supreme Court affirmed, agreeing with the lower court that the physician’s actions did not amount to fraud.

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Between a Rock and a Hard Place

What do you do when the patient whips out their Smartphone and states they want to record you?

This definitely raises the possibility of a red flag. But, do you want to tell the patient no and look like you are hiding something or are not being tech savvy?

This except from a Medscape article outlines the question: “Doctor, would it be okay with you if I tape record our conversation today?” The doctor’s first reaction is likely to be negative. He or she may feel a lack of trust or a sense of suspicion. READ MORE.


Patients’ Use of Social Media: E-rating of Doctors

The general practitioner (GP) was ‘googling’ his name when he came across the following review about him:

“The worst GP I have ever seen. I took my daughter to see him when she was very sick. He missed the diagnosis and was deliberately rough with her. It was like we were imposing on his time. I’d ask a taxi driver for medical advice before seeing this GP. Never see him if you are ill – or well.” The GP was very distressed. He did not know who had made this comment about him. He wanted to know what he could do to have the online comment deleted. READ MORE.


Seven Tips for Avoiding HIPAA Penalties in 2015

By Kim C. Stanger

HIPAA violations may result in penalties of $100 to $50,000 per violation, depending on the conduct at issue. If the violation results from “willful neglect” the party is subject to mandatory fines of $10,000 to $50,000 per violation. A single data breach may result in numerous violations. READ MORE.


Confused by Confidentiality?

A Primer on 42 CFR Part 2

Just about anyone who has ever received medical care has heard of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), the law that regulates the use and disclosure of Protected Health Information (PHI) held by “covered entities” such as health plans. But far fewer are familiar with the special privacy protections afforded to alcohol and drug abuse patient records by 42 Code of Federal Regulations (“CFR”) Part 2. READ MORE.