UCAOA Policy & Procedure Manual 2017 Edition Table of … · UCAOA Policy & Procedure Manual—2017...
Transcript of UCAOA Policy & Procedure Manual 2017 Edition Table of … · UCAOA Policy & Procedure Manual—2017...
UCAOA Policy & Procedure Manual—2017 Edition
Table of Contents
100.XXX – Administration
1. 100.XXX- Advanced Beneficiary Notice (ABN) English Version 2020 Large Print
2. 100.XXX- Advanced Beneficiary Notice (ABN) English Version 2020
3. 100.XXX- ABN Spanish Version 2020 Large Print
4. 100.XXX- Absent Medical Provider
5. 100.XXX- Abuse Neglect Overview or Reporting Responsibilities
6. 100.XXX- Abuse Neglect Violence State Reporting
7. 100.XXX- Abuse Reporting- Child/ Elderly Abuse Reporting
8. 100.XXX- Abuse Child Report or Neglect
9. 100.XXX- Advanced Beneficiary Notice (ABN) Form Instructions
10. 100.XXX- Advanced Beneficiary Notice
11. 100.XXX- Advance Directives Page 2
12. 100.XXX- Advance Directives Page 1
13. 100.XXX- Animal Bite Control Form- Oakland County (sample—state or county specific)
14. 100.XXX- Animal Bite Reporting
15. 100.XXX- Animal Bite Reporting Guidelines Form- Louisiana (sample—state or county specific)
16. 100.XXX- Animal Bites Reporting- Louisiana (sample—state or county specific)
17. 100.XXX- Care Coordination Follow-Up PCP or Referring Physician
18. 100.XXX- Care Coordination Follow-Up Doc
19. 100.XXX- Care Coordination Referral Letter
20. 100.XXX- Care Coordination Sample Cover Letter PCP
21. 100.XXX- Collection Log Front Desk
22. 100.XXX- Consent In Office Procedure Form
23. 100.XXX- Disruption of Information Process
24. 100.XXX- Established Patient Intake Form
25. 100.XXX- Flag System Form
26. 100.XXX- Flag System- Managing Patient Flow
27. 100.XXX- Front Desk- Influenza Vaccine Consent
28. 100.XXX- Front Desk- Occ Med Acknowledgment of Responsibility for Charges for Workers Comp
29. 100.XXX- Front Desk- Auto Accident Claim Processing- UC
30. 100.XXX- Front Desk- Auto Acknowledgement of Responsibility for Charges
31. 100.XXX- Front Desk -Billing- Global Periods
32. 100.XXX- Front Desk- Billing- Recheck Policy
33. 100.XXX- Front Desk- Cash Pay Flu Shot- Patient Information Sheet
34. 100.XXX- Front Desk- Cash Drawer Log
35. 100.XXX- Front Desk-Chief Complaint /Consent for Treatment- Louisiana
36. 100.XXX- Front Desk- Consent for Treatment & Use of Disclosure of Protected Health Info Form
37. 100.XXX- Consent to Release of Information
38. 100.XXX- Front Desk- Customer Service Encounter
39. 100.XXX- Front Desk- Established Patient Information Short Form
40. 100.XXX- Front Desk- Established Patient Update Form
41. 100.XXX- Front Desk- External Referrals or Service Options
42. 100.XXX- Front Desk Form- for Consent and Chief Complaints
43. 100.XXX- Front Desk Form - Employee Discount Request Form
44. 100.XXX- Front Desk Form- for Notice of Receipt of Privacy
45. 100.XXX- Front Desk Form- Patient Registration
46. 100.XXX- Front Desk Form- Payment Policies
47. 100.XXX- Front Desk Form- Practice to Release Private Health Information to Third Parties
48. 100.XXX- Front Desk Form- Supplemental Claims Information
49. 100.XXX- Front Desk- Forms Request- Completion of Forms
50. 100.XXX- Front Desk- Influenza Vaccine Cash Pay Form
51. 100.XXX- Front Desk- Log Collections
52. 100.XXX- Front Desk- Log Patient Registration
53. 100.XXX- Front Desk- Medical Treatment Discount
54. 100.XXX- Front Desk- Medical Treatment Discount- Discounted Services
55. 100.XXX- Front Desk- Missing Router
56. 100.XXX- Front Desk- Occ Med Employer Authorization Form
57. 100.XXX- Front Desk- Occ Med Medical Record Form
58. 100.XXX- Front Desk- Occ Med Patient Form
59. 100.XXX- Front Desk- Occ Med Patient Registration Form
60. 100.XXX- Front Desk- Occ Med Work Status Form
61. 100.XXX- Front Desk- Occ Med Worker Intake Form
62. 100.XXX- Front Desk- Patient Call Back Forms
63. 100.XXX- Front Desk- Patient Check Out
64. 100.XXX- Front Desk- Patient Identifiers
65. 100.XXX- Front Desk- Patient Information Sample Form
66. 100.XXX- Front Desk- Patient Payments
67. 100.XXX- Front Desk- Patient Presentation of Serious Illness or Injury
68. 100.XXX- Front Desk- Patient Registration
69. 100.XXX- Front Desk- Patient Information Consent Form
70. 100.XXX- Front Desk-Patient Identification
71. 100.XXX- Front Desk- Receipt of Privacy Documents Acknowledgement
72. 100.XXX- Front Desk- Time of Service Collections V.2
73. 100.XXX- Front Desk- Time of Service Collections
74. 100.XXX- Front Desk- Visit Policy
75. 100.XXX- Front Desk- Workers Compensation Claims Policy
76. 100.XXX- Front Desk- Workers Compensation Claims Processing
77. 100.XXX- Governance- Social Media
78. 100.XXX- Governance- Clinical Work Flow
79. 100.XXX- Governance- Corporate Spending Expense Report Sample
80. 100.XXX- Governance- Corporate Spending
81. 100.XXX- Governance- Employee Recognition Committee
82. 100.XXX- Governance- Finance Capitalization
83. 100.XXX- Governance- Management Leadership Competencies
84. 100.XXX- Governance- Mission Statement
85. 100.XXX- Governance- Mission and Core Values Statement
86. 100.XXX- Governance- Operations Committee Policy
87. 100.XXX- Governance- Organizational Chart- Leadership Sample
88. 100.XXX- Governance- Organizational Hierarchy and Clinical Staffing Model
89. 100.XXX- Governance Organization Meetings
90. 100.XXX- Governance- Organization Chart
91. 100.XXX- Governance- Purpose, Governance Policy
92. 100.XXX- Governance- Scope of Service and Population Served
93. 100.XXX- Governance- Scope of Services Policy
94. 100.XXX- Governance- Social Media Policy
95. 100.XXX- Identity Theft and Red Flag Rules
96. 100.XXX- Influenza Immunization Consent Form
97. 100.XXX- Informed Consent for Procedure Form
98. 100.XXX- Informed Consent for Procedure Information
99. 100.XXX- Interpretive Services and Communication Barriers
100. 100.XXX- Interpretive Services- Louisiana and Texas
101. 100.XXX- Minors Treatment- State Specific
102. 100.XXX- Non- Retaliation Policy
103. 100.XXX- Occ Med Audiometer Calibrations
104. 100.XXX- Occ Med Direct Billing Protocol Policy
105. 100.XXX- Occ Med End of Day Staff Activities
106. 100.XXX- Occ Med Pulmonary Function Testing Machine Calibrations
107. 100.XXX- Occ Med Respiratory Fit Test Machine Calibrations
108. 100.XXX- Opening and Closing Procedures with Checklist
109. 100.XXX- Patient Call Follow Up Contact
110. 100.XXX- Patient Intake Form
111. 100.XXX- Patient Rights and Ethical Care
112. 100.XXX- Patient Rights and Responsibilities Policy
113. 100.XXX- Patient Rights Specific Request Form
114. 100.XXX- Policy/ Procedure/ Forms Management
115. 100.XXX- Policy and Procedure Process
116. 100.XXX- Policy and Procedure Request
117. 100.XXX- Policy and Procedure Template
118. 100.XXX- Prescription Secure Handling
119. 100.XXX- Privacy Practices Acknowledgement Form
120. 100.XXX- Radiology Only Process
121. 100.XXX- Radiology Only Log
122. 100.XXX- Router Form
123. 100.XXX- Signature and Initial Sample Log
124. 100.XXX- Telephone Encounter
125. 100.XXX- Terminating a Patient from the Practice
126. 100.XXX- Unable to Reach Patient About Test Results
200.XXX- Human Resources, Orientation, Competencies, Credentialing
1. 200.XXX- Behavior of Employee
2. 200.XXX- Incident Reporting Employee Policy
3. 200.XXX- Peer Review- Medical Provider
4. 200.XXX- Absenteeism and Tardiness
5. 200.XXX- Absenteeism and Sick Leave
6. 200.XXX- ACLS Requirement and Training
7. 200.XXX- ACLS BLS PALS Training
8. 200.XXX- Annual Training and Review Checklist
9. 200.XXX- Annual Training
10. 200.XXX- Appointment Approval Sample Letter
11. 200.XXX- Appointment- Authorization to Release information
12. 200.XXX- Appointment- Authorization Release Form
13. 200.XXX- Appointment- Authorization Consent to Release of Information
14. 200.XXX- Appointment- Provider Checklist
15. 200.XXX- Appointment- Reappointment Application
16. 200.XXX- Background Checks 2
17. 200.XXX- Background Check Release Organization
18. 200.XXX- Background Checks
19. 200.XXX- Behavior- Discrimination/ Harassment
20. 200.XXX- Behavior- Patient Non- Discrimination
21. 200.XXX- BLS Requirement and Training 1
22. 200.XXX- BLS Requirement and Training
23. 200.XXX- Breaks and Meals
24. 200.XXX- Breaks
25. 200.XXX- Catheterization Straight Female
26. 200.XXX- Code of Conduct
27. 200.XXX- Competencies Annual Checklist
28. 200.XXX- Competencies
29. 200.XXX- Competency- Checklist New Hire
30. 200.XXX- Competency- Clean Catch
31. 200.XXX- Competency- Digital X-Ray Images
32. 200.XXX- Ear irrigation
33. 200.XXX- Competency- Injectable Medication
34. 200.XXX- Competency- Injection IM
35. 200.XXX- Competency- Injection Subcutaneous
36. 200.XXX- Competency- Specimen Labeling and Handling
37. 200.XXX- Competency- TB Mantoux Skin Test
38. 200.XXX- Competency- Tuberculin Skin Test Mantoux
39. 200.XXX- Competency- Vital Signs
40. 200.XXX- Complaint Form Employee
41. 200.XXX- Conflict of Interest Form Attachment 1
42. 200.XXX- Conflict of Interest Attachment
43. 200.XXX- Conflict of Interest Policy
44. 200.XXX- Conflict of Interest
45. 200.XXX-Credentialing Appeals Process
46. 200.XXX- Credentialing Disclosure Claims Information Form
47. 200.XXX- Credentialing of Providers
48. 200.XXX- Credentialing- Appointment/Reappointment
49. 200.XXX- Credentialing- Initial Verification Form
50. 200.XXX- Credentialing- License Insurance Verification
51. 200.XXX- Credentialing- Practitioner Profile for Appointment Cover Sheet
52. 200.XXX- Credentialing- Provider
53. 200.XXX- Credentialing- Release and Immunity- Initial Application
54. 200.XXX- Criminal Background Checks
55. 200.XXX- Cultural Diversity
56. 200.XXX- Cultural Awareness and Sensitivity Training
57. 200.XXX- Cultural Sensitivity
58. 200.XXX- Dress and Appearance
59. 200.XXX- Drug/Alcohol Free Environment
60. 200.XXX- Electronic Devices, Use of
61. 200.XXX- Employee Change Form
62. 200.XXX- Employee File Contents
63. 200.XXX- FMLA Disability Forms
64. 200.XXX- Hepatitis Vaccine for Employees
65. 200.XXX- Incident Employee Form
66. 200.XXX- Influenza Vaccination Program for Employees
67. 200.XXX- Job Description Template
68. 200.XXX- Job Description Policy
69. 200.XXX- License Verification-Non-Provider for Louisiana
70. 200.XXX- Medical Staff Appointment-Reappointment Application
71. 200.XXX- Medical Staff Approval of Appointment- Generic Letter
72. 200.XXX- Medical Staff Delineation of Privileges
73. 200.XXX- Non-Discrimination
74. 200.XXX- Onboarding Form- HIPAA Acknowledgement
75. 200.XXX- Onboarding Form- Hepatitis B Vaccination Election
76. 200.XXX- Onboarding I9 Form- Employment Eligibility Verification
77. 200.XXX- Onboarding Provider Checklist
78. 200.XXX- Orientation- and Training- New Hire
79. 200.XXX- Orientation- Checklist Pre-Patient Care
80. 200.XXX- Orientation- Billing Checklist
81. 200.XXX- Orientation- Clinical
82. 200.XXX- Orientation- Employee
83. 200.XXX- Orientation- Physician Checklist
84. 200.XXX- Orientation- Proficiency Requirements
85. 200.XXX- Orientation- Reception Checklist
86. 200.XXX- Peer Review Medical Provider Form
87. 200.XXX- Performance Appraisal Template
88. 200.XXX- Physician Insurance Check List
89. 200.XXX- Privacy Employee
90. 200.XXX- Privileges Delineation
91. 200.XXX- Proficiencies
92. 200.XXX- Reappointment- Release and Immunity
93. 200.XXX- Re-credentialing Verification Form
94. 200.XXX- Reimbursement-CME
95. 200.XXX- Roles and Responsibilities- Medical Director
96. 200.XXX- Scheduling Change Requests
97. 200.XXX- Scheduling Time Off- Holidays
98. 200.XXX- Scheduling Time Off- Provider
99. 200.XXX- Student Letter Sample
100. 200.XXX- Student Rotation or Shadowing Policy
101. 200.XXX- Student Shadowing Form
102. 200.XXX- Student Application
103. 200.XXX- Student Checklist
104. 200.XXX- Substance Use- Prohibited
105. 200.XXX- Supervision- Advanced Practice Clinicians
106. 200.XXX- Termination from Employment Form
107. 200.XXX- Termination Involuntary Form
108. 200.XXX- Time and Attendance
109. 200.XXX- Training- Annual Training Checklist
110. 200.XXX- Training Required
111. 200.XXX- Tuberculosis Annual Questionnaire
112. 200.XXX- Tuberculosis Testing- Employee
113. 200.XXX- Tuberculosis TST Questionnaire
114. 200.XXX- Vacation, Sick, Holiday Pay Eligibility
115. 200.XXX- Vehicle Use- Release of Driving Record Form
116. 200.XXX- Vehicle Use-Safety
117. 200.XXX- Video and Audio Recording
118. 200.XXX- Warning Form
300.XXX- Clinical, General, Occ Med
1. 300.XXX- Abuse and Assault Treatment
2. 300.XXX- Chaperones
3. 300.XXX- Consent- Informed 2
4. 300.XXX- Consent- Informed Form
5. 300.XXX- Consent- Informed
6. 300.XXX- Discharge Guidelines
7. 300.XXX- Discharge Instructions Policy
8. 300.XXX- Discharge Instructions Form Template
9. 300.XXX- Ear Irrigation
10. 300.XXX- Education- Patient and Family
11. 300.XXX- EKG Operation
12. 300.XXX- Emergency Situations
13. 300.XXX- Emergency Transfers 2
14. 300.XXX- Emergency Transfers Log
15. 300.XXX- Emergency Transfers Tracking Policy
16. 300.XXX- Emergency Transfers
17. 300.XXX- Emergency Staff Responsibility During Cardiac Arrest
18. 300.XXX- Eye Irrigation
19. 300.XXX- Fast Track Patient Assessment
20. 300.XXX- Fecal Specimen Collection
21. 300.XXX- Fecal Specimen
22. 300.XXX- Gait Training/Crutch Fitting
23. 300.XXX- Hard of Hearing Patient
24. 300.XXX- Hepatitis B Acknowledgement Form
25. 300.XXX- Identifiers- Patient 2
26. 300.XXX- Identifiers- Patient
27. 300.XXX- Nasal Specimen
28. 300.XXX- Occ Med- Breath Alcohol Testing
29. 300.XXX- Occ Med- Employers Authorization for Examination or Treatment
30. 300.XXX- Occ Med- Pre-Employment/Return to Work Clearance Form
31. 300.XXX- Occ Med- Pre-Placement Examination-Pre-Employment Return to Work Combo
32. 300.XXX- Occ Med- Return to Work Examination
33. 300.XXX- Occ Med- Audiometric Testing and Screening
34. 300.XXX- Occ Med- Breath Alcohol Test Checklist
35. 300.XXX- Occ Med- Breath Alcohol Testing
36. 300.XXX- Occ Med- DOT Physical Exam 2
37. 300.XXX- Occ Med- DOT Physical Exam
38. 300.XXX- Occ Med- Grip Strength Testing
39. 300.XXX- Occ Med- Physical- Return to Work
40. 300.XXX- Occ Med- Pre-Employment Return to Work Clearance Form
41. 300.XXX- Occ Med- Pre-Placement Exam and Physical Exam Form- Two Forms
42. 300.XXX- Occ Med- Pre-Placement Physical Policy
43. 300.XXX- Occ Med- Pre-Placement Physical 2
44. 300.XXX- Occ Med- Pre-Placement Physical
45. 300.XXX- Occ Med- Pulmonary Function Testing
46. 300.XXX- Occ Med- Respirator Fit Tests
47. 300.XXX- Occ Med- Vision Screening-Titmus Ishihara
48. 300.XXX- Orders- Standing
49. 300.XXX- Orders
50. 300.XXX- Oxygen Administration
51. 300.XXX- PCP Follow Up Letter- Rochester (sample)
52. 300.XXX- Pediatric Bulb Suctioning
53. 300.XXX- Pediatric Fever Control
54. 300.XXX- Pediatric IV Therapy
55. 300.XXX- Pelvic Exam
56. 300.XXX- Physical Examinations
57. 300.XXX- Physical- Return to Work
58. 300.XXX- Physical- Sports
59. 300.XXX- Physician Inquiries- Walk-in Established Patients
60. 300.XXX- Referral Letter
61. 300.XXX- Refusal of Care Against Medical Advice-Left Exam Room
62. 300.XXX- Refusal of Care AMA Acknowledgement
63. 300.XXX- Refusal of Care Form 2
64. 300.XXX- Refusal of Care- Left Without Being Seen
65. 300.XXX- Refusal of Care
66. 300.XXX- Refusal of Treatment- Attachment
67. 300.XXX- Return to Work- School Note
68. 300.XXX- Sports Physical Form from Michigan High School Athletic Association
69. 300.XXX- Suture/Staple Removal
70. 300.XXX- Td or Tdap Consent
71. 300.XXX- Telephone Advice
72. 300.XXX- Throat Specimen
73. 300.XXX- Triage Process- Check In
74. 300.XXX- Tuberculosis Skin Test Consent and Results
75. 300.XXX- Tuberculosis Test Consent and Results
76. 300.XXX- Tuberculosis Test Log
77. 300.XXX- Tuberculosis Positive Exempt Surveillance Questionnaire
78. 300.XXX- Tuberculosis Screening Mantoux
79. 300.XXX- Urine Collection- Female Catheter
80. 300.XXX- Urine Collection- Male Catheter
81. 300.XXX- Vaccine Influenza
82. 300.XXX- Vital Signs 2 Attachment
83. 300.XXX- Vital Signs 2
84. 300.XXX- Vital Signs- Pediatric
85. 300.XXX- Vital Signs
400.XXX- Medication
1. 400.XXX- Adverse Reactions Management 1
2. 400.XXX- Adverse Reactions Management 2
3. 400.XXX- Dispensed Medication Log
4. 400.XXX- Dispensing Practitioner- Point of Care Dispensing Indiana
5. 400.XXX- Expired Medication or Hazard Disposal Log
6. 400.XXX- Formulary- Annual Review
7. 400.XXX- Formulary- Approved
8. 400.XXX- Immunization Reporting State- Louisiana
9. 400.XXX- Influenza Control Log
10. 400.XXX- Influenza Immunization Sign in Sheet
11. 400.XXX- Influenza Immunization- CDC Patient Information
12. 400.XXX- Influenza Vaccine Immunization Administration
13. 400.XXX- IV- Adding Medication
14. 400.XXX- IV- Bolus
15. 400.XXX- IV- Discharging
16. 400.XXX- IV- Monitoring the Site
17. 400.XXX- IV- Push
18. 400.XXX- IV- Starting
19. 400.XXX- L.E.T. Application
20. 400.XXX- Medical Recall Log
21. 400.XXX- Medication Refrigerator- Temperature Check Graph
22. 400.XXX- Medication- Administration 2
23. 400.XXX- Medication- Administration Error
24. 400.XXX- Medication- Administration
25. 400.XXX- Medication- Disposal Log
26. 400.XXX- Medication- Expiration Date Audit
27. 400.XXX- Medication- Management Inspection Checklist
28. 400.XXX- Medication- Samples Log 2
29. 400.XXX- Medication- Tracking Form
30. 400.XXX- Medication- Alerts/Warnings
31. 400.XXX- Medication- Disposal Log
32. 400.XXX- Medication- Disposal
33. 400.XXX- Medication- Expired Log
34. 400.XXX- Medication- Injection Log
35. 400.XXX- Medication- Refrigerator Temperature
36. 400.XXX- Medication- Sample Receipt Log
37. 400.XXX- Medication- Samples Management 2
38. 400.XXX- Medication- Samples Management
39. 400.XXX- Medication- Samples Dispensed Log
40. 400.XXX- Medication- Samples Log
41. 400.XXX- Medication- Security Storage Disposal
42. 400.XXX- Medications and Dated Patient Items Review Log
43. 400.XXX- Narcotic Monitoring Daily Log
44. 400.XXX- Narcotic Controlled Substance Inventory Log
45. 400.XXX- Narcotic Controlled Substance Control
46. 400.XXX- Pharma Rep- Confidentiality Form
47. 400.XXX- Recall- Medication, Product, or Equipment
48. 400.XXX- Recall- Medication
49. 400.XXX- Request for New Medication or Service Policy
50. 400.XXX- Td or Tdap Consent
51. 400.XXX- Td or Tdap
52. 400.XXX- Td or Tdap CDC Informational Sheet
53. 400.XXX- Vaccine Encounter
54. 400.XXX- Vaccine Refrigerator/Freezer Temperature Log
55. 400.XXX- Vaccine Reporting Form
500.XXX- Laboratory
1. 500.XXX- Stool Collection Policy
2. 500.XXX- CLIA Waived Testing
3. 500.XXX- Competency- Fecal Occult Blood
4. 500.XXX- Competency- Glucometer
5. 500.XXX- Competency- hCG Urine Cassette Pregnancy Test
6. 500.XXX- Competency- Influenza A & B Test
7. 500.XXX- Competency- Mono Test
8. 500.XXX- Competency- Strep A Test
9. 500.XXX- Competency- Urinalysis
10. 500.XXX- Competency- Critical Test Results- After Hours
11. 500.XXX- Encounter Lab Only
12. 500.XXX- Glucometer
13. 500.XXX- Glucose Level Testing
14. 500.XXX- H. Pylori Testing
15. 500.XXX- Hemoccult
16. 500.XXX- HIV Testing
17. 500.XXX- Influenza Testing
18. 500.XXX- Influenza Molecular Testing
19. 500.XXX- Lab Courier Form
20. 500.XXX- Lab Environment Criteria
21. 500.XXX- Lab Ordering and Tracking Results
22. 500.XXX- Log- Glucometer 2
23. 500.XXX- Log- Glucometer
24. 500.XXX- Log- hCG 2
25. 500.XXX- Log- hCG
26. 500.XXX- Log- Hemoccult 2
27. 500.XXX- Log- Hemoccult
28. 500.XXX- Log- H. Pylori Control
29. 500.XXX- Log- Influenza AB 2
30. 500.XXX- Log- Influenza AB
31. 500.XXX- Log- Bab Daily Quality Controls
32. 500.XXX- Log- Mono Test 2
33. 500.XXX- Log- Mono Test
34. 500.XXX- Log- Room Temperature and Humidity
35. 500.XXX- Log- RSV
36. 500.XXX- Specimen Transport
37. 500.XXX- Log- Strep 2
38. 500.XXX- Log- Strep
39. 500.XXX- Log- Urine Analyzer Daily Maintenance
40. 500.XXX- Log- Urine Dipstick
41. 500.XXX- Manufacturer Package Inserts and Instructions
42. 500.XXX- Mono Test
43. 500.XXX- Non “DOT” Urine Drug Screen Collection
44. 500.XXX- Occ Med Drug Screen, DOT and Non- DOT Collection
45. 500.XXX- Patient Preparation
46. 500.XXX- Point of Care Testing and Results Reporting
47. 500.XXX- Pregnancy hCG
48. 500.XXX- Quality Controls
49. 500.XXX- Reagents- Lab
50. 500.XXX- Records Retention- Lab
51. 500.XXX- Refrigerator- Lab Specimen- Temperature Check Graph
52. 500.XXX- Room Temperature and Humidity
53. 500.XXX- RSV
54. 500.XXX- Safety Overview Lab
55. 500.XXX- Send Out Reference Lab Procedure
56. 500.XXX- Send Out Unable to Complete Test Procedures
57. 500.XXX- Specimen- Blood
58. 500.XXX- Specimen- Fasting
59. 500.XXX- Specimen- Identification
60. 500.XXX- Specimen- Preparation and Transport
61. 500.XXX- Specimen- Urine Clean Catch
62. 500.XXX- Specimen- Wound or Viral
63. 500.XXX- Specimen- Unacceptable
64. 500.XXX- Strep Testing
65. 500.XXX- Training- CLIA Waived Documentation
66. 500.XXX- Urinalysis Results Form
67. 500.XXX- Urinalysis Dipstick 2
68. 500.XXX- Urinalysis Dipstick
69. 500.XXX- Urine Drug Screen Affidavit of Correction (Memorandum for Record)
70. 500.XXX- Waived Testing Overview
600.XXX- Radiology
1. 600.XXX- Outside X-Ray Protocol
2. 600.XXX- Over-reads Process
3. 600.XXX- Over-reads
4. 600.XXX- Patient Log
5. 600.XXX- Pregnancy Consent Form
6. 600.XXX- Radiation Protection
7. 600.XXX- Radiation Discrepancy Policy
8. 600.XXX- Radiation Protection
9. 600.XXX- Radiology Read Discrepancy Log
10. 600.XXX- Radiology Safety
11. 600.XXX- Radiology Summary- Monthly
12. 600.XXX- Radiology Tracking Log
13. 600.XXX- Radiology Tracking
14. 600.XXX- Request for X-Ray
700.XXX- Infection Control
1. 700.XXX- Autoclave- Maintenance Monthly Log
2. 700.XXX- Autoclave- Maintenance
3. 700.XXX- Autoclave- Bio Monitoring Policy 2
4. 700.XXX- Autoclave- Bio Monitoring
5. 700.XXX- Autoclave- Bio Log
6. 700.XXX- Autoclave- Instruments
7. 700.XXX- Autoclave- Log
8. 700.XXX- Autoclave- Procedures
9. 700.XXX- Autoclave- Spore Checks
10. 700.XXX- Cleaning Responsibilities
11. 700.XXX- Communicable Disease Report Form
12. 700.XXX- Communicable Disease Reporting- Louisiana
13. 700.XXX- Communicable Disease Reporting- State Specific
14. 700.XXX- Daily Surface Disinfectant Log
15. 700.XXX- Exposure- Consent Form
16. 700.XXX- Exposure- Control Plan
17. 700.XXX- Exposure- Employee (Biological)
18. 700.XXX- Exposure- Follow Up Protocol
19. 700.XXX- Exposure- Incident Report
20. 700.XXX- Glove Use Audit
21. 700.XXX- Gloving Procedures- WHO Guidelines
22. 700.XXX- Hand Hygiene Policy
23. 700.XXX- Hand Hygiene- CDC
24. 700.XXX- HIV- Healthcare Workers- CDC
25. 700.XXX- Infection Control and Cleanliness Overview
26. 700.XXX- Infection Control- Annual Program Evaluation
27. 700.XXX- Infection Control- Sample Audit
28. 700.XXX- Infection Prevention and Control
29. 700.XXX- Infection Control- Annual- Infection Prevention and Control Surveillance Audit
30. 700.XXX- Infectious Disease- Emergency Response
31. 700.XXX- Infectious Disease Reporting Form
32. 700.XXX- Instruments- Reusable
33. 700.XXX- Personal Protective Equipment- OSHA- Fact Sheet
34. 700.XXX- Personal Protective Equipment- OSHA- Cuts Risk
35. 700.XXX- Reportable Conditions Example- State Specific Policy
36. 700.XXX- Sharps Bloodborne Fact Sheet- OSHA
37. 700.XXX- Sterile Field Preparation
38. 700.XXX- Tuberculosis Annual Screening Questionnaire
39. 700.XXX- Tuberculosis Annual Test Questionnaire
40. 700.XXX- Tuberculosis- Risk Reduction Plan- Louisiana
41. 700.XXX- Universal Precautions- CDC
42. 700.XXX- Universal Precautions Policy
800.XXX- Quality & Safety
1. 800.XXX- Quality and Performance Improvement Plan Form
2. 800.XXX- AED Machine Log
3. 800.XXX- Body Mechanics and Ergonomics
4. 800.XXX- Closure of Center (Unforeseen)
5. 800.XXX- Complaint and Grievance Resolution Policy
6. 800.XXX- Complaint and Grievance- Civil Rights
7. 800.XXX- Complaint- Completing Form and Process
8. 800.XXX- Complaint Form
9. 800.XXX- Complaint Letter- Requesting Emp. Response
10. 800.XXX- Complaint Letter to Complainant
11. 800.XXX- Complaints Tracking Spreadsheet
12. 800.XXX- Crash Cart- Set-Up
13. 800.XXX- Crash Cart- Inventory
14. 800.XXX- Crash Cart-Log (Seals)
15. 800.XXX- Crash Cart- Maintenance
16. 800.XXX- Drill- Behavior Disruption
17. 800.XXX- Drill- EMR Outage
18. 800.XXX- Drill- Internal Event
19. 800.XXX- Drill- Medical Emergency Form
20. 800.XXX- Drill- Missing Person
21. 800.XXX- Drill- Participant Roster
22. 800.XXX- Security Threat
23. 800.XXX- Drill- Severe Weather
24. 800.XXX- Drills- Annual Schedule
25. 800.XXX- Drills- Mock Code
26. 800.XXX- Emergency Preparedness Notification Call Tree
27. 800.XXX- Emergency Evacuation- Fire Explosion
28. 800.XXX- Emergency Evacuation- Sample Center Map
29. 800.XXX- Emergency Management
30. 800.XXX- Emergency Preparedness- Refrigerated Med Test Kits
31. 800.XXX- Emergency Response- Inventory Log
32. 800.XXX- Emergency Response- Inventory Tags
33. 800.XXX- Emergency Response Kit- Inventory
34. 800.XXX- Environment of Care- Annual Assessment
35. 800.XXX- Equipment- AED Daily Log
36. 800.XXX- Equipment- AED Monitoring
37. 800.XXX- Equipment- Annual Evaluation Form
38. 800.XXX- Equipment- Biomedical Inspections
39. 800.XXX- Equipment- Management
40. 800.XXX- Equipment- Management and Maintenance
41. 800.XXX- Equipment- Medical Device Reporting
42. 800.XXX- Equipment- Refrigerator and Freezer Temperature Log
43. 800.XXX-Equipment- Refrigerator Log- Cleaning
44. 800.XXX- Equipment- Refrigerator Log- Temperature with Ranges
45. 800.XXX- Equipment-Refrigerator- Monitoring and Maintenance
46. 800.XXX- Equipment- Refrigerator Temperature Monitoring
47. 800.XXX- Equipment- Refrigerator- Vaccine Storage
48. 800.XXX- Equipment- Safety Evaluation Form
49. 800.XXX- Equipment- Vaccine Refrigerator- Temperature Log
50. 800.XXX- External Events
51. 800.XXX- Fire Drill Record
52. 800.XXX- Fire Safety Inspection Checklist
53. 800.XXX- Fire Safety Version 2
54. 800.XXX- Fire Safety
55. 800.XXX- Fire Audit
56. 800.XXX- Hazardous Materials and Waste Inspection Checklist
57. 800.XXX- Hazardous Mat- Communication
58. 800.XXX- Hazardous Mat- Disposal
59. 800.XXX- Hazardous Mat- List Sample
60. 800.XXX- Hazardous Mat- List
61. 800.XXX- Hazardous Mat- Materials and Waste
62. 800.XXX- Hazardous Mat- Soiled Instrument and Item Transport
63. 800.XXX- Incident and Occurrence- Patient or Visitor Policy
64. 800.XXX- Incident and Occurrences-Corrective Action Documentation
65. 800.XXX- Incident or Occurrence Report- Building
66. 800.XXX- Incident or Occurrence Report- Employee Only
67. 800.XXX- Incident Report- Accident Form
68. 800.XXX- Incident Report- Patient or Visitor Form 2
69. 800.XXX- Incident Report Policy
70. 800.XXX- Incident Corrective Action
71. 800.XXX- Incident- Root Cause Analysis
72. 800.XXX- Incident- Sentinel Event
73. 800.XXX- Incident- Significant Investigative Report Form
74. 800.XXX- Incident- Significant Policy
75. 800.XXX- Medical Equipment Inspection Checklist
76. 800.XXX- Medical Equipment Safety Evaluation Form
77. 800.XXX- Near Miss Report
78. 800.XXX- Patient Satisfaction- Measuring Outcomes
79. 800.XXX- Patient Satisfaction- Phone Survey Spreadsheet
80. 800.XXX- Patient Satisfaction- Survey Policy
81. 800.XXX- Patient Throughput- Time Measuring
82. 800.XXX- Physical Environment- Non-Smoking
83. 800.XXX- PPE- OSHA Facts
84. 800.XXX- Quality and Performance Improvement Plan 2
85. 800.XXX- Quality and Performance Improvement Plan
86. 800.XXX- Quality and Performance Improvement- PDCA Form
87. 800.XXX- Quality Management- Sample Overarching Plan
88. 800.XXX- Safety and Health Overview
89. 800.XXX- Safety Inspection- Environment of Care- Annual Evaluation
90. 800.XXX- Safety- Accessing and Securing the Center
91. 800.XXX- Safety- Annual Assessment Form
92. 800.XXX-Safety- Annual Device Evaluations- OSHA
93. 800.XXX- Safety- Device Evaluation Form
94. 800.XXX- Safety- Electrical and Hazardous Energy
95. 800.XXX- Safety- Electrical Heater and Purifiers Prohibition
96. 800.XXX- Safety- Environmental Annual Assessment
97. 800.XXX- Safety- Environmental
98. 800.XXX- Safety- Facility Hazard Assessment
99. 800.XXX- Safety- Fire Control 2
100. 800.XXX- Safety- Fire Control
101. 800.XXX- Safety- Inspection Checklist
102. 800.XXX- Safety- Monthly Center Evaluation Form
103. 800.XXX- Safety- Monthly Center Evaluation Policy
104. 800.XXX- Safety- Panic Button and Security System
105. 800.XXX- Safety- Panic Button
106. 800.XXX- Safety- Pediatric
107. 800.XXX- Safety- Security Annual Review
108. 800.XXX- Safety- Security
109. 800.XXX- Safety- Weapons Prohibition
110. 800.XXX- Safety Survey- Annual
111. 800.XXX- Security Inspection Checklist
112. 800.XXX- Service Animals Access
113. 800.XXX- Sharps- OSHA Facts Sheet
114. 800.XXX- Utilities- Annual Review 2
115. 800.XXX- Utilities- Annual Review
116. 800.XXX- Utilities- Inspection Checklist
117. 800.XXX- Utilities- Outages
900.XXX- Medical Records
1. 900.XXX- Abbreviations- Do Not Use 2
2. 900.XXX- Abbreviations- Do Not Use List
3. 900.XXX- Abbreviations- Do Not Use
4. 900.XXX- Chart Audit Review- Tool
5. 900.XXX- Chart System
6. 900.XXX- Completion of Forms
7. 900.XXX- Documentation Guidelines 2
8. 900.XXX- Documentations Guidelines
9. 900.XXX- Medical Record Audit
10. 900.XXX- Medical Record Retention
11. 900.XXX- Missing Router
12. 900.XXX- Outages or Disruption
13. 900.XXX- Outages- Disruption in Patient Information Processes
14. 900.XXX- Patient Chart- Computer Down Policy
15. 900.XXX- Patient Chart- Discharge Instructions
16. 900.XXX- Patient Chart- Paper Nurses Note
17. 900.XXX- Patient Chart- Paper Progress Note
18. 900.XXX- Patient Chart- Paper
19. 900.XXX- Patient Medical Record- Processing
20. 900.XXX- Progress Notes
21. 900.XXX- Release of Medical Records Policy
22. 900.XXX- Release of Medical Records Form
23. 900.XXX- Release of Medical Records
24. 900.XXX- Release PHI- Patient Authority
25. 900.XXX- Release- Patient Authorization- PHI to Third Parties
26. 900.XXX- Request for Medical Records Letter Sample
27. 900.XXX- Retention and Management of Medical Records
28. 900.XXX- Router Form
29. 900.XXX- Router
30. 900.XXX- Superbill Sample