Medical practice policies and procedures are important because they serve as guideposts for operational efficiency and consistency. They spell out specific rules and the steps employees must follow to adhere to those rules. But it is not just about having policies in place. Too often, medical practices take the time to create policies and procedures but then do not follow them—and they certainly do not update them with any regularity or audit staff to make sure everyone is compliant.
Following are four policies and procedures that can help medical practices stay on track, simultaneously driving compliance and operational efficiency.
Life science rep management
Ever notice that life science reps tend to show up unannounced at your front desk, interrupting patient flow and distracting staff members and physicians who should be tending to patients? Having a pharmaceutical rep policy—combined with technology to streamline industry rep scheduling—can reduce these disruptions, allowing staff to refocus on revenue-generating tasks and patient care. A medical rep policy should address include why you see medical reps and the value you derive from them. The procedure should include the type of medical reps you will see, specific days/times you will see medical reps, how medical reps can make an appointment, and other specifics such as the code of conduct and consequences of not following the policy.
Electronic health record (EHR) use
The EHR can either boost productivity or completely drain it, depending on staff training and understanding of how to use the system. For example, an EHR policy should address why the EHR is a critical component of your medical practice and how it can improve patient care and care efficiency. The procedure should include steps to perform common tasks (e.g., documenting an encounter, choosing a medical code, entering a consult order, or completing the problem list), shortcuts within the EHR, whether and how your providers are permitted to use copy and paste functionality, a downtime contingency plan, and more.
HIPAA compliance
HIPAA is a complex regulation that requires clear policies and procedures that your staff can follow to ensure compliance and avoid costly breaches. For example, a HIPAA compliance policy should explain why protecting patient information is a priority in your medical practice. The procedure should include steps for breach notification, expectations of business associates, timeframe for record retention, the process for accessing or requesting an amendment to protected health information, the process for requesting an accounting of disclosures, and more. When medical practices have this type of policy and procedure, staff know exactly what to do when patients and others make requests for information. They do not waste time trying to figure out what is required and why.
Patient financial obligations
In an era of high deductible health plans, it is critical for medical practices to create a policy to help patients understand their financial responsibilities. The procedure should include a list of participating insurance companies, the process for collecting up-front copayments and co-insurance amounts, patient responsibilities to obtain referrals when necessary, fees for obtaining copies of medical records, fees for missed appointments, acceptable payment methods, and more. It is also important to remind patients that their insurance company ultimately determines eligibility (and benefits) and that patients are required to pay any portion of the charges not covered by insurance. When patients clearly understand their responsibilities before services are rendered, staff spend less time answering questions about bills and chasing past-due payments.
Each of these policies can help medical practices increase operational efficiency by removing the guesswork for common tasks and workflows. They also help onboard new staff with ease—all with the overarching goal of refocusing efforts on direct patient care.
