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Electronics and Office Fitness Trackers 0. Gadgets Gaming Headsets 1. Headphones Home Security 0. Home Essentials HP Computers 0. HP Laptops 0. HTC Phones 0. Jewelry Kitchen Essentials Laptops Lenovo Computers 0. Each situation is an individual case and he may need to address each one as it comes up rather than making a blanket decision. He also should make prominent signage in the front stating the new policies in a friendly way.
This may take years to resolve… trust me, I know. Possibly Andrew could accept the barter for the first year and outline what would occur after, requesting invoice to invoice follow up to make sure he was getting fair deal?
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Also, would have to change the terms so that the former owner was not reaping the benefits. Right away, a letter to any remaining patients not seen in the office explaining the transfer of ownership and what new policies would be would be appropriate. Andrew may need to set up meetings with some of the patients before seeing them to work out any barters, discounts or new policies going forward.
He should put a sign in the reception area welcoming new patients and introducing his pricing policies. He could put a sentence or two that thanks the previous owner for his long-time relationship with his patients and that he looks forward to making new relationships with these same patients. He should be open to the idea of bartering, but only if it is a fair trade for both parties. Absolutely stop the bartering. Andrew needs to prove to the existing patients what a great doctor he is and the rest will fall into place.
He should support his community outside of work by going to high school sporting events and showing his patients he cares about their families. Support as many fundraisers as he can afford. That will mean a lot and his patients will love him for his generosity. He and his wife have bills to pay! This is now his business, not Dr. Yes, Roland should have highlighted the extent of his side deals. I would have thought He would have followed Roland for a few weeks in the practice and much of this would have come to light.
Andrew should think about the bartering aspect and get some professional advice as there could be tax consequences, as well as Medicare issues, with trading services. He needs to take Roland to lunch and find out how pervasive the bartering thing is. If it is small, I would use what worked for me and explain to those whose barter did not meet my needs we would be able to offer them a cash discount instead on products.
Should it be a large part of the practice, he will need to explain to his patients that he has researched bartering and found that these transactions must be reported as taxable income. The simple truth is that if done legally it is more trouble than it is worth. However, if you purchase an existing practice and the claimed income on the financial statement were the basis of your decision, then you would have also planned your spending around only those funds.
So, the barter services should then become irrelevant to your expected income. Going forward with a new awareness, Andrew could offer those people a payment plan, understanding there will be some period of transition, and those patients should have NEVER gotten so far as the exam room without having payment arrangements in place.
Therefore, to avoid this conversation in the future, the entire front office staff should be trained on the policy for handling past barter patients and that dialogue should be consistently carried from the front desk, to the exam room and on to the dispensary. Be respectful of their offer. You need new sunglasses and I need a tree cut down…Your son needs glasses and I need to rent a tent from your company…. Yes, ethically Roland should have let Andrew know. He should have a discussion with other professionals in the area and see if this is the custom or isolated to Roland.
Change the name of the business so patients know they are dealing with a new entity. Perhaps a letter from Roland to the patients explaining new ownership and how great Andrew is. His coworker had called out an hour before her shift, leaving him to run the optical floor solo. Two patients were already moving through the frame boards when a tech escorted Dr. Tam out of an exam room and over to Colin. Tam was a local general practitioner. Colin was relatively new to the Utah practice but he had already met Dr.
Tam amicably. When he came back Dr. Tam was already seated at an optical station. Do you remember him? He was in last month. Colin sat across from Dr. Tam, reaching into his breast pocket. He pulled out a prescription pad and, in front of Colin, wrote out a prescription for his son. Colin nodded numbly, and awkwardly took the script when Dr.
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Tam handed it to him. Colin priced out the orders, took measurements and escorted Dr. Tam to reception to collect his copays. Later that afternoon Colin found time to enter Dr. However, when he entered the authorization number that the front desk had pulled he found it was actually for Dr. Colin immediately called the number on file for Dr. Tam enthusiastically, studying the near vision card with his new progressives.
Tam chuckled. And seriously who would order anything based on a script a patient wrote out? That being said there is a line to draw when bending the rules becomes fraud or feels wrong. As opticians we feel that any professional that walks into our office will always do the right thing. At this point he would have to understand that something smelled fishy.
When he asked to change the date, I would be frank with him and just say that I would not feel right doing that. If you bend the rules one time the patient expects the same the following year. This case is not uncommon. The simple answer to somebody who asks you to lie to the insurance company is: Not happening!!
Is that even legal?? Tam that the practice can get audited at any given time, and this is considered insurance fraud. I would offer a discount on a second pair. Colin should not have accepted the Rx written by Dr. Tam as it is an unethical action taken by Dr. If the doctor who examined Tam Jr. Ask Dr. Tam to reach out to the insurance to find his options to process the sunglasses order or offer to make the phone call on Dr.
This shows customer service. If Dr. Tam is uncooperative, call the insurance and inform them about Dr.
Tam writing the Rx for Tam Jr. Have the patient discuss this with his insurance as well. Tam follows the right steps. Document everything. Have Dr. Tam sign a liability form, which protects the practice from auditing. Insurance fraud is any act committed to defraud an insurance process. This occurs when a claimant attempts to obtain some benefit or advantage they are not entitled to, or when an insurer knowingly denies some benefit that is due. Graciously, the optician should have advised the patient that the prescribing physician had not provided a script for his son, so unfortunately the sunglasses would not be covered by insurance.
Of course he should not do any of those things. It is considered fraud and he risks at least his participation in the plan if not the license of the practitioner itself. Colin did the right thing by attempting to contact Dr. Speaking with Dr. Tam, as a medical practitioner, is required to acknowledge that he understands insurance fraud and its consequences, and as such he should not be instructing other health care providers to commit fraud on his behalf.
Tam of committing fraud at his own practice, and would absolutely report Dr. Tam and accept a loss on the materials I ordered, knowing that I did the right thing. Changing dates on a receipt or in patient records is fraud. I would also make the practice owner aware of what his patient requested and that he stated that it was done for him in the past at the practice. Let the doctors discuss the issue. Neither Colin nor any other staff members should have to be caught in the middle of this. We would not have filled the Rx, as it was not valid.
However, of course, this is fraud and Colin should not do this. I would advise Dr. Tam he can do what he wishes with the invoices, but that the office cannot and will not change any posting dates as it is fraud. I wonder if Dr. Tam is as loose with insurance policy in his office as he expects Colin to be. While technically he did nothing illegal by writing an Rx for his son, it was an ethically reprehensible thing for a healthcare professional to do. Even worse, he expected Colin to risk his job and the reputation of his company by performing an illegal act. Again, I wonder if it is a standard operating procedure to falsify records in HIS office.
If I remember nothing else from optometry school, one thing will be forever ingrained in my mind: Put a line through the original information, insert the correction, initial and date it.
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However, since Colin notified Dr. Tam indirectly through his wife the order became a private order and was paid accordingly. The receipt date should not be changed to appease Dr. In regard to dispensing the Maui Jim sunglasses, Colin submitted the order with the proper Rx information provided for Dr. Technically it should be said that Richard is sharing the glasses with his father, not the other way around.
This is one of those areas that is stretching the system by Dr. Tam; Colin was following the Rx provided by Dr. Tam for his son. No, we do not change invoice dates; that is fraud plain and simple and no patient is worth the legal problems. As far as notifying the patient of his options of waiting till the first of the month or paying for the glasses, that is our standard policy. As far as making glasses without having a proper written prescription—either our own from records or from another OD or OMD—we would not do it.
We do not feel that a primary MD can give a complete comprehensive eye exam, especially if he is just writing out what is necessary for insurance coverage. I would have discussed all this with management first to see what options they wanted me to proceed with. If those options comprised my morals or ethics, I would then proceed to remind management that we have an obligation to not just the patients but to the practice and employees to make sure we have a secure livelihood by following the rules.
This office wants to show a pre-teen the door — should mitigating circumstances change their minds? Doctors and technicians hustled patients between rooms, and the phone rang incessantly. Technician Carol headed to reception to call in the next patient, year-old Jennie. She began reciting her script of instructions, but Jennie threw her off quickly.
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Carol worked hard to convince Jennie to keep her head still, but only captured one good reading in each eye. Saying she needed something from another room, Carol found a quiet place down the hall and took a minute to collect herself. When she returned, she immediately noticed the 90D and 20D lenses were missing from their regular places.
She wrapped up the exam and found office manager Ed. Ed frowned and followed her into the exam room. Time seemed to stand still. The exchange drew Dr. Cox out of her exam room. As she neared, something hard struck the back of her hand. She yelped in pain as a 90D lens hit the floor then rolled fast along the baseboard. Cox looked up to see Jennie palming the 20D, a look of shock on her face.
Panicking, she dropped the lens and grabbed her coat. Jennie flew around the corner and out the front door. Cox motioned Ed and Carol into the empty room and closed the door. Cox, gingerly massaging her hand, raised her eyes to the ceiling. Hours later, Dr. She begged Dr.
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Cox to let Jennie return the next day to complete her exam, and promised to attend with her daughter. The first problem was allowing an underage child to be seen without a parent or guardian in attendance. The staff may not be pleased, but that should not affect their professional performance. If it does, there is a bigger problem to be addressed. Jennie crossed the line when she refused to participate in the pre-test workup and she should only be allowed to return with a parent or guardian. Why was this patient seen without a legal aged family member?
The patient should have been kept in the waiting room until the adult relation arrived and could be present during testing. This child is a thief. She could have also declared that the staff touched her inappropriately causing a lawsuit and a ruined career. Our office is very specific towards seeing unaccompanied minors. If it is a new patient; definitely not! That usually ends with the parent making the appointment when they are available. There is too much that we as physicians are responsible for and parents need to be… Parents. There is too much at stake to see an unaccompanied minor.
I once had a patient threaten to punch me when I did the NCT on her. She yelled at me loud enough for the doctor to come out. She quickly tried apologizing and said I scared her. If you know your child is having issues then you make arrangements to accompany them to appointments. There is no excuse for theft. The conversation should be had with the person booking the appointment at the time of the appointment and if not, then at the time of the reminder call.
And it should outline the concentration they are expected to have so the exam can proceed. There should be an open door or 3rd party policy to prevent the allegations of sexual abuse also. The first time any child or teen shows up there could be a behavior agreement they have to sign.
Bye, Jennie! The lip I could look past, and would let her come back with a parent at our earliest opening usually about two weeks out. However… the thieving and assault on my staff? That behavior would get you banned from any business, and possibly charged.