Applies to: Dr. Darlington and McManus Techs, Assistants, Clinic Supervisors, Front Office Receptionists, Surgical Counselors, Front Office Leads
 
With the intention of ensuring that our post-operative cataract surgery patients enjoy the best possible comfort with the least possibility of post-operative inflammation, a change has been made to the post-operative steroid regimen.  Going forward, and beginning this week, the new steroid eye drop regimen will be as follows:
 
If Durezol: 1 drop 3 times for 21 days and then 1 drop once per day for 7 days, then D/C
If Pred Forte: 1 drop 3 times a day for 21 days, then 1 drop once per day for 7 days, then  D/C
 
Note:  IT will be updating the PO Patient instruction sheets to reflect this change.  The previous steroid regimen was:
 
If Durezol: 1 drop 3 times for 7 days and then I drop 2 times a day for 14 days, then D/C
If Pred Forte: 1 drop 3 times a day for 21 days, then D/C
 
There are no changes in terms of the antibiotic eye drops or the NSAID eye drops.

Applies to:  All hourly employees
 
Hourly employees are required to record their work time each day of work.  You need to clock in every day in the ADP system upon starting your work time (not necessarily when you arrive but at the beginning of your shift), in and out for lunch and at the end of day.  Clocking in before 10 minutes prior to your shift starting is not allowed.  All employees should take a minimum of a 30 minute break for lunch unless otherwise directed by your supervisor. 
 
If you miss a punch, please contact your immediate supervisor or the Human Resources Manager to correct your timesheet. 
 
You should check on a daily basis the ADP timekeeping system to ensure that you have clocked in and out as appropriate for the day. At the end of the pay period, please review your time to make sure it is accurate and punches have been missed.
 
If the system goes down, please keep track of your time by paper and notify Human Resources so that your times may be entered when the system is once again available.

Applies to:  All Employees
 
It is essential that each computer device is used, maintained and stored in a manner that will ensure the Practice obtains the maximum life from it.
 
All staff members are responsible for knowing and following the rules set forth in this policy.  They are:
 
Effective immediately, no drinks or food are to be brought into the examination rooms or other areas where there are computers.  This is to help ensure that no damage is caused by spillage of any sort.  Alternatively, you may keep drinks or drink cups in the technician areas (on the same counter as the sink).
 
Computers are to be used as per the guidelines established during your training.  There is to be no use of computers for activities unrelated to work.  You may not introduce software of any type or download materials or programs from the internet.
 
Should your computer not be working properly for any reason, DO NOT MOVE or TRADE your monitor or keyboard from another room.  You are to immediately contact IT and explain the difficulty you are having.  

Applies to: Clinical, Clinic Leads, Front Office Leads, CEO, HR

Prior to leaving any office both technicians and assistants should be cleaning up their own rooms and their work areas.  Make sure that all machines are off, lights off, any papers cleaned up especially patient papers, etc.  We need to be considerate of the next team coming in the next day.  This is not the sole responsibility of the late tech. 

Applies to: Surgical Counselors, Front Office Leads, Clinic Leads, Jason K. Darlington, M.D.; Eric Straut, O.D.

There are a significant number of one week PO cataract surgery exams on his schedule that should be scheduled with Dr. Straut. 
 
Dr. Straut can see all patients for their one week PO cataract surgery appointment, except: 

• Those patients that Dr. Darlington specifically requests to examine personally;
• Patients referred by outside Optometrists;
• Patients referred by Dr. Michael Mandese – they should see Dr. Mandese for their one week PO visit, unless he is out of the office for the week;
• Patients who have had a multifocal or accommodate lens implant (ReStor, Tecnis Multifocal, Crystalens, or Trulign).

 
Patients who have had toric IOLs can be placed on Dr. Straut’s schedule, unless they were Optometric referrals.
 
(One week exams on patients referred by outside Doctors’ of Optometry typically see that doctor, but this refers to cases in which Dr. Darlington wants the patient seen here one additional time prior to the return to their family eye doctor).
 
If a patient refuses to see Dr. Straut for their one week PO appointment for any reason, email the particulars to the CEO, cc’ing Dr. Darlington, Scheduling Supervisor, Clinic Leads.
 
For clarification:
Cat, Cat/istent, YLC can be seen postop by our OD or referring OD.
Glaucoma, Cornea, Lid will need to see Dr. Darlington postop.

Applies to: Surgical Counselors, Front Office Lead, Clinic Leads, Billing Lead
 
On all elective cases, we need to get payment up front.  There are simply too many scenarios in which, when this does not happen, one of two things result:
 

1. We spend an inordinate amount of time pursuing the payment;
2. We do not get paid.

 
Therefore  do not make payment plans on the day of surgery because monies may not collected. It is a key responsibility of the each of the Counselors to explain that their (estimated) copayments, co-insurance, deductibles, and other amounts due for surgery (FEC and ASC) must be paid in advance of surgery.  The Counselors also need to explain that if the payments due in advance of surgery are not made, unfortunately, their procedure will be cancelled. This is especially important with regard to patients having DSEK and Transplants (PKs).
 
We should not be ordering corneal tissue – which costs ~ $4600 – until the Counselor confirms that any copayments, co-insurance, deductibles, and other amounts due for surgery (FEC and ASC) have been paid in advance of surgery.
 
All such scenarios – concerns/issues related to payment must be brought to the attention of the CEO, Billing Supervisor, ASC DON and Scheduling Supervisor.
 
Patients are not to pay for premium IOLs, LRIs, copayments, deductible, co-insurance and other patient financial responsibilities on the day of surgery,  these monies are to be collected in advance of the day of surgery.  Some people may not be prepared to make payment at the time of pretesting/Counseling, but they could do so at any time in advance of surgery.
 
Some patients who may not feel comfortable providing you with credit card information over the phone.  They can drop a check off in advance of surgery or pay by credit or debit card in person if this makes them more comfortable.  They can also pay via our patient portal.  (If you have questions regarding this, ask the Billing Supervisor).
 
This should be explained to patients at the time of pretesting to ensure that the payments we need to receive are, in fact received prior to surgery.

From: Louise Anastasio
Sent: Thursday, August 06, 2015 12:14 PM
To: FrontDesk&ClericalUsers

Scheduling in time order is the protocol to be followed for ALL of our physicians.  Not following this protocol creates a need to have to move the patient to another time. 

Applies to: Clinic Leads, Front Office Leads, Anterior Segment Assistants
 
Paracentesis is occasionally performed in the clinic.  It is not ever performed for diagnostic purposes but rather only for therapeutic purposes, to the best of the CEO’s knowledge.

Applies to: Clinical; Billing; Clinic Supervisors, Front Office Leads
 
Clinical Assistants and Billing Staff – Please note that the “Impressions”(Diagnosis) listed in the chart notes must correspond with the Diagnosis’ listed in the Operative Report for all procedures, including injections, of course.
 
If you are the Assistant for a procedure and you see that this is not the case, please immediately bring this to the attention of the physician so that he can correct it; if you are a member of the billing department and see this in the course of your duties, please request a review or an addendum of the note by the rendering physician and copy the Billing Lead, Clinic Leads, Scheduling Lead and CEO.