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EYECARE PRACTICE TOOL KIT
Eyecare Practice Tool Kit
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By
. Mosby

Description
This combination book and CD-ROM contains a wealth of helpful patient education handouts and front office/business documents - in both English and Spanish. It includes office records and tracking forms for routine office procedures; letters to insurance providers, new patients, and specialists; Information on the latest HIPAA guidelines; and many other frequently used materials. Best of all, the CD-ROM allows users to customize many of these documents to meet their own optometric or ophthalmic practice and individual patient needs.

Contents


Part 1: Patient Handouts


1. Accommodative Disorder

2. Amblyopia

3. The Amsler Grid

4. Attention Deficit-Hyperactivity Disorder and Vision

5. Blepharitis

6. Branch Retinal Vein Occlusion

7. Cataract

8. Lenses for Patients with Developing Cataracts

9. Central Retinal Vein Occlusion

10. Central Serous Chorioretinopathy

11. Chalazia and Styes

12. Computer Glasses

13. Computer Vision Syndrome

14. Computer Vision Syndrome: Treatment Sheet

15. Conjunctivitis

16. Allergic Conjunctivitis

17. Convergence Insufficiency

18. Cool Soaks

19. Corneal Abrasion

20. Diabetic Retinopathy

21. Drugs That Cause Problems with the Eyes

22. Drusens

23. Dry Eye

24. Eight Reasons Why You Should Purchase Your Eyewear from Us

25. Epiretinal Membrane

26. Eye Drops and Ointment

27. Eyelid Problems

28. Eyelid Problems: Treatment Sheet

29. Eyelid Massage

30. Eyelid Scrubs

31. Floaters and Flashes

32. Glaucoma

33. Headaches, The Eyes, and Vision

34. Iritis

35. Jump Ductions

36. Keratoconus

37. Keratoconus: Treatment Sheet

38. Lattice Degeneration

39. Macular Degeneration

40. Monovision

41. No Perfect Pair

42. Ocular Hypertension

43. Orthokeratology

44. Refractive Error

45. Reading Glasses Comparison

46. Reading and Writing

47. Retinal Detachment

48. Retinitis Pigmentosa

49. Strabismus and Amblyopia

50. Strabismus

51. Subconjunctival Hemorrhage

52. Systemic Disease and Your Eyes

53. Vision Therapy for Adults

54. Warm Soaks

55. What is Vision Therapy?

56. Family Medical History and Risk



Part 2: Letters and Forms


Appointment Schedule

Authorization for Release of Identifying Health Information

Billing Statement

Pre-Collection Statement

Collection Call Planning Form

Collection Letter

Consent to Payment

Financial Arrangements

Budget Plan Receipt

Binocular Vision

Amblyopia Treatment Flow Sheet

Binocular Vision Evaluation

Binocular Vision Treatment Form

Binocular Vision Treatment Letter

Binocular Vision Treatment Policies

Binocular Vision Therapy Kit

Binocular Vision and Visual Skills Report

Binocular Vision Summary Sheet

Binocular Vision Report

Developmental History Form

Binocular Vision Referral Form

Strabismus Examination Record

Visual Skills Recording Form

Visual Analysis of Reading Strategies and Spelling Skills

Video Display Terminal Assessment

Chronological Record of Patient Care

Computer Vision Syndrome Patient Questionnaire

Consultation Letter

Contact Lens Record

Contact Lens Policies

Contact Lens Selection Questionnaire

Contact Lens Wearing Schedule

Contact Lens Do's and Don'ts

Contact Lens Service Agreement

Six Contact Lens Comfort Lens Plans

Fresh Lens Planned Replacement Program

Contact Lens Maximum Wearing Schedule

Dilation of Your Pupils

Examination Form

Excusal from School (Proof of Appointment Slip)

General Eye Exam: Diabetes Study

Care Instructions for Frames and Lenses

Frame Breakage Release

Patient Prescription Laboratory and Frame Inventory Record

Informed Consent or Refusal for Dilated Fundus Exam

Glaucoma Flowsheet

Health Insurance Portability and Accountability (HIPAA) of 1996

How HIPAA Will Affect your Eye Care Visit

Inactive Notice

Informed Consent for In-Office Procedures

Insurance Information

Vision Insurance Coverage

Vision Insurance: Points to Consider

Determination of Insurance Benefits

Information Request

Preauthorization of Payment

Lifestyle Questionnaire

Low Vision

Patient Information Form

Referral Information Form

Low Vision Billing Form

Low Vision Precertification Request Form

New Resident Letter

No-Show Policy

Ocular Emergency Report Form

Patient History

Confidential Medical History

Patient Information

Questionnaire for Children

Questionnaire for Parent

Recommendations for Additional Care

Patient Registration Form

Notice of Privacy Practices

Reschedule of Missed Appointment

Teen's or Child's Vision Examination Recall

Refractive Surgery

Laser Vision Correction Screening Form

Laser Vision Correction Preoperative Exam form

Laser Vision Correction Postoperative Exam Form

Laser Vision Correction Preoperative Patient Questionnaire

Laser Vision Correction Postoperative Patient Questionnaire

Professional Request for Patient Information

Authorization for Release of Health Information

Reminder of Scheduled Exam

Report to Physician for Routine Eye Examination

Missed Contact Lens Appointment

Confirming Appointment for New Patient

Super Bill

Supplemental Services Record of Visit

Patient Survey

Telephone Inquiry

Thank You to Current Patient

Thank You to New Patient

Thank You for Your Referral

Transfer of Spectacle Information

Triage Sheet

Visual Field Examination

Welcome to Our Office

Patients Who Need to Be Rescheduled

Priority Rescheduling



Part 3: Practice Administration and Sample Contracts


Introduction to Using These Samples (Disclaimer and Recommendation for Legal Consult)

Application for Employment

Telephone Reference Check and Offer of Employment

Employee Evaluation Report

Employee Self-Evaluation

Personnel Performance Evaluation

Employee Performance Review

Progress Evaluation

Employment Agreement

Agreement Between Independent Contractor and Client

Letter of Intent

Agreement of partnership of Eye Center Optometry

1. Exhibit A

Agreement for Purchase and Sale of Assets

2. Exhibit A

3. Exhibit B-Security Agreement

4. Exhibit C-Promissory Note

Optometric Group partnership Agreement



Part 4: Office Manual


Introduction

1. Example #1

2. Example #2

3. Example #3

Mission Statement (Orientation)

4. Example #1

5. Example #2

6. Example #3

Profile of Doctors

Personnel Policies and Guidelines

At-Will Statement

1. Example 1

2. Example 2

Equal Opportunity Employment

Discrimination

Sexual Harassment

3. Example 1

4. Example 2

Resignation/Dismissal

5. Example 1

Exit Interview

Resignations

Reduction to Staff

Termination

Dismissal

Overtime

Calculation of Overtime

Overtime

6. Example 1

7. Example 2

8. Example 3

Performance Review

9. Example 1

10. Example 2

Pay Period

11. Example 1

12. Example 2

Holidays

13. Example 1

14. Example 2

15. Example 3

Disability/Medical leave of Absence

16. Example 1

17. Example 2

Lunch and Rest Periods

Jury Duty/Witness Leave

18. Example 1

19. Example 2

20. Example 3

21. Example 4

Bereavement Leave

22. Example 1

23. Example 2

Personal Leaves of Absence

24. Example 1

25. Example 2

Profit Sharing

26. Example 1

27. Example 2

Leave for Domestic Violence

Military Leave

Expense Reimbursement

Continuing Education

Keys

Profit Sharing

28. Example 1

29. Example 2

30. Example 3

Office Decorum

Discipline

Amendments

31. Example 1

32. Example 2

Staff Meetings

Conditions of Employment

CLASSIFICATION OF EMPLOYEES

33. Example 1

34. Example 2

35. Example 3

Meal and Rest Periods

36. Example 1

37. Example 2

Compensation

Hours of Operation

38. Example 1

39. Example 2

Work Hours and Wages

Timecards/Records

40. Example 1

41. Example 2

REDUCTIONS TO STAFF

Benefits

401(k)

Profit Sharing

Health Insurance

Childcare Benefits

Flexible Spending accounts

Life Insurance

Sick Leave

Vacations

Personal Leaves of Absence

Uniform Allowance

Professional Courtesy for Staff

Credit Union

Costco Membership

Job Descriptions

By Area Worked

42. When Working at the Front Desk

43. When Working in the Style Center

44. When Working in the Data Collection Room

45. When Working in the Contact Lens Area

46. When Working in the Laboratory

By Title

47. Office Manager

48. Ophthalmic Technician

49. Optometric Assistant

Office Procedures

Office Policies

Fires and Emergencies

Injury and Illness

Ergonomics

Safety Committee



Part 5: Office Polices and Procedures for Handling Managed Care Patients


How to Use this Manual

List of Plans Accepted by the Office

List of Plans Not Accepted by the Office

Brief Summary of Accepted Managed Care Plans

Expanded Information Devoted to Each Plan

Telephone Call Summary Form

Patient Price List

Scripts for Use by the Receptionist

Patient Sign-in Sheet

Eligibility Guarantee

Doctor's Plan Coverage Summary

Managed Care Referral Request

Scripts for the Optician

Scripts for Recall

Monitoring Payment

Staff Training Exercise:

Capitation Plans



Part 6: Spanish Translations of Patient Handouts


Part 6 Contenido

Bibliographic details
Paperback, 376 pages, publication date: DEC-2006
ISBN-13: 978-0-323-03941-3
ISBN-10: 0-323-03941-3
Imprint: MOSBY


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Last update: 10 Sep 2009
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