Table of Contents

Private Practice Essentials Online Resource

Author(s): Janet E. Brown, Denise Dougherty

Item #: WEB15232

Table of Contents 22
Introduction to Private Practice Essentials Online Resource. 44
- Patient Management Forms 44
- Privacy Forms 44
- Administrative Forms 44
- Document Formats 44
- Permissions 55
Appendices Chapter 1 66
- Checklist for Starting Your Practice 66
- Case Study Starting My Private Practice 77
- Example of Commercial Lease 1111
- Operating Agreement for a Limited Liability Company 1616
Appendices Chapter 2 3232
- Case Study Molly’s Private Practice: The ABCs of Accounting 3232
- School District Related Services Contract 3939
- Consultant Services Contract 4141
- Telephone Intake for Insurance Clients 4343
- Patient Consent 4545
- Receipt for Professional Services 4646
- Patient Financial Responsibility Disclosure Document 4747
- Outstanding Balance Payment Agreement 4848
- Credit Card Authorization 4949
- Appeals of Insurance Denial 5050
- Educational Versus Restorative Services 5252
Appendices Chapter 3 5454
- Policies 101 5454
- Sample Evaluation Cancellation Policy 5454
- Sample Treatment Cancellation Policy 5454
- Sample Make-Up Policy 5555
- Sample Make-Up Session E-Mail 5555
- Sample Overall Attendance Policy 5555
- Sample Dismissal Policy 5555
- Evaluation Reservation Policy 5656
- Preevaluation Welcome Letter 5757
- Pediatric Case History Form 5959
- Adult Case History 6464
- Therapy Cancellation Policy 6767
Appendices Chapter 5 6868
- Model Employment Agreement 6868
- Short-Form Employment Agreement 7272
- Offer Letter 7474
- Employee Agreement 7676
- Noncompetition and Nonsolicitation Agreement 8181
- Nondisclosure Agreement 8484
- Social Media Policy 8585
- Sample Job Description and Competency Assessment 8888
- Sample Performance Appraisal 9191
Appendices Chapter 6 9696
- Ethical Scenarios 9696
- Business Associate Agreement 9999
- Notice of Privacy Practices 102102
Additional Forms 107107
Evaluation and Treatment 107107
- Evaluation Summary 107107
- Treatment Authorization 108108
- Physician Referral for Speech-Language Pathology 109109
- Patient Progress Report 109109
- Patient Treatment Log 112112
Fees 113113
- Fee Schedule Considerations 113113
- Fee Schedule 114114
- Billing and Reimbursement Resources 115115
Payment Policies 118118
- Payment Policy Considerations 118118
- Payment Policy: Insurance Billing 120120
- Payment Policy: Self-Pay 122122
Privacy Forms 123123
- HIPAA Privacy Notice 123123
- HIPAA Privacy Notice Acknowledg ment 128128
- Authorization for Release of Information 128128
- Accounting of Disclosures of Protected Health Information 130130
New Employee Information 131131
- Sample Speech-Language Pathologist Job Description 131131
- Facility Orientation Considerations 133133
- Facility Orientation Checklist 134134
Policies and Procedures Manual 135135
- Sample Table of Contents 135135
- Sample Policies and Procedures 136136
- Policies and Procedures 137137
- Acknowledgment of Receipt of Policies and Procedures Manual 138138

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