OPERATING POLICY AND PROCEDURE
Legacy MSO

Referral Policy:
A “referral” is defined as a recommendation of a medical or paramedical professional. If a patient’s insurance requires written or electronic referrals, it is the responsibility of the patient to obtain the request of the referral in advance of an appointment with Dr. Boppana. Dr. Boppana’s office obtains referrals in two ways:

1. Physician referral – To facilitate an outpatient referral, a referring physician facilitates communication to Dr. Bopanna’s office for consultation. The patient’s name, contact information, medical records and insurance information are needed.
2. Attorney referral – In cases of workers compensation or NF, an attorney may refer his client to Dr. Boppana. The attorney or their office must contact Dr. Boppana and provide information regarding the reason for the visit. They must also provide the patient’s name, contact information, medical records and insurance information.

Scheduling a Visit
A patient may schedule an appointment by telephone or in person with a member of the practice staff. The following information is essential to do so:
1. Patient name
2. Telephone number
3. Address
4. Reason for visit
5. Referral Information
a. Referring doctor’s name and contact information, if applicable
b. Referral letter, if applicable
6. Date of birth
7. Insurance coverage

The practice staff will use the appointment schedule system to enter the information above into the system. Once completed, the patient and staff will decide and assign a date and time for the appointment. The staff member will review the patient details with the patient prior to ending the phone call or patient leaving the office. The staff member will address any items that are needed at the time of the scheduled appointment and advise them of the billing and collection policy. Patients will be contacted X business days prior to the appointment to remind them of their scheduled appointment.

Hours of Operations

Office Visit
Upon the patient’s arrival, the receptionist will check the patient in and retrieve the patient’s folder. While the patient’s records are being obtained, the receptionist will provide the following forms for the patient to fill out:
1. Demographic package
2. Authorization for the release of Medical Information
3. Claimant's authorization to disclose worker's compensation records (for Worker’s Compensation patients only)
4. HIPPA form
5. Assignment of Recovery Proceeds and Authorization for Attorney to Pay (for a LIEN case)
6. New York motor vehicle No-Fault insurance law assignment of benefits form (for a NF case)
7. Authorization, assignment and fee agreement form
Once the forms have been completed and signed by the patient, they will be given back to the receptionist. At this time, the patient will also provide their license or identification card, insurance card and medical records, if applicable. The receptionist will make copies of these forms, enter any missing information into the system and include the documents in the patient’s folder. The patient in-take form, demographic package and C4 form (new worker’s compensation patient) or C4.2 form (existing worker’s compensation patient) will be placed in the chart holder and placed outside of the exam room.
After an exam is given, Dr. Boppana may prescribe medication to the patient. At that time, the doctor’s assistant will make a copy of the prescription and file it into the patient’s chart. Any additional notes made during the appointment should be recorded and entered into the file.
If any additional tests outside the office are necessary, the assistant will call and make a referral appointment. S/he will inform the patient of the new appointment set. Any test results conducted must be obtained and entered into the patient’s file.
Once the exam is completed, a patient will be directed to the check-out desk. The doctor will indicate the services that were provided and the practice staff will enter the charges into the system. The appropriate co-payment or payment will be collected. Payments will be marked in the system and receipt will be provided to the patient. The staff member will then schedule a follow-up visit with the patient. The patient should then be marked as completed in the system.