Effective Date: 
Fri, 04/24/2015

The Optometry Department performs daily cleaning.  See the procedure.


Certol ProSpray wipes (yellow top canister):

  • Exam chair
  • Stool

**Remove filmy build-up by wiping surfaces with plain water and paper towel as needed**

Sani-Cloth wipes (black top canister):

**Use a minimum of 2 cloths to properly wipe down all the following items**

  • Counter top and area around sink
  • Faucet handles
  • Cupboard and drawer handles
  • Keyboard and mouse
  • Inner and outer door handles
  • Retinoscope handle
  • Lamp arm


70% isopropyl alcohol wipes:

**To be performed in front of patient at start of every exam**

  • Phoropter forehead and nose rest
  • Slit lamp chin and forehead rest
  • Cover paddle
  • FDT forehead and nose rest


Effective Date: 
Thu, 04/23/2015
Mon, 02/29/2016

See the Opening Procedures for Optometry below.

  • Turn on main desk computer and exam lane computers. Log in to Windows and open and log in to Point and Click (PnC) EMR.
  • Open Google Chrome with the following tab: Eyemed. Log in to site so that insurance authorizations can be checked at each patient visit.
  • Check phone messages.
  • Open Updated Format Master Excel log (found under Desktop, Optometry).
  • Open CL Log and Frame Log (found in Desktop, pub.optometry, My Documents).
  • Organize any glasses or contact lens orders from Optometry Technician that have been left on the desk. Bill appropriately if not yet billed. Add to Updated Format Master Excel log spreadsheet. Add to Frame Log the frame that was sold, and to CL Log the CL order that was made, with the date and number of boxes.
  • In PnC, make a brief chart note for each Optometry Technician order that was left on the desk, indicating that the patient came in with the Optometry Technician and ordered glasses or CL, etc on which date. The Optometry Technician is not able to make entries in PnC as they are not licensed.
  • Respond to Instant Messages in PnC.
  • Pick up CL or frame shipments in the Pharmacy.
  • Leave CL boxes in Pharmacy under pt’s name.
  • Place all glasses in appropriate cases with lens cloths and leave in Pharmacy under pt’s name.
  • Send secure messages to pts using PnC indicating their glasses and/or CL are ready for pickup in the pharmacy.
  • Uncover and turn on exam lane equipment.
  • Retrieve/unlock ophthalmic meds from locked cabinet and prepare for exam use.
  • Unpack any frame shipments and label with prices and stock the displays (see top desk drawer folder labeled Glasses Inventory, has inventory and price list).
  • Restock contact lens solution starter kits in upper cabinets (back exam room).


Effective Date: 
Thu, 04/23/2015

Optometry appointments need special consideration and are performed by Insurance staff.

Documentation of vision insurance is required.

Attached File: 


Form Type: 
Form Number: 


Effective Date: 
Tue, 03/10/2015
Wed, 11/08/2017

All dispensed prescription medications must be acknowledged and signed out on the signature pad at the pharmacy in the Propharm POS (Point of Sale System) with a valid signature.

If the patient is not the person signing out, then the pharmacy staff member will document the name and/or other identifying information at the Pickup Signature Capture in the Propharm POS prior to having the person sign the signature pad.


AC - insurance rebill

RN sign out - when picking up prescriptions to administer or for patients too ill to pick up the prescription on their own

DL - Rx reconciliation - when verifying after the fact that the prescription was picked up

LG for pt - when signing out on behalf of the patient



Effective Date: 
Wed, 03/04/2015
Thu, 02/08/2018

The Student Health Center has adopted the practices of a Patient Centered Medical Home.  A Patient Centered Medical Home primary care office provides comprehensive and coordinated primary care in active partnership with the patient.  A Patient Centered Medical Home provides care:   across the life span, across the spectrum of health care needs; preventive, acute and chronic and by coordinating care across the health care delivery system.   A Patient Centered Medical Home provides evidence based quality care and has a quality management program which continuously monitors and improves the care delivered by assessing:  the patient/primary care relationship, accessbility, comprehensiveness, continuity and quality of care.

The Student Health Center demonstrates its practice as a Patient Centered Medical Home when it meets the standards established by the AAAHC in chapter 25, sections A through E.


Effective Date: 
Mon, 01/26/2015
Mon, 01/26/2015
Tue, 11/29/2016

In order to facilitate timely and effective communication between CAPS and primary care providers, all referrals will have a complete CAPS referral encounter note signed prior to the primary care appointment.  There are two types of CAPs referrals to Primary Care:  Same Day Urgent and Non-Same Day.




For Same Day Urgent referrals:

The CAPS provider will complete a draft of the Same Day CAPS referral to primary care, providing primary care the pertinent information.

The CAPS provider will contact the Charge Nurse to request a same day appointment and provide the appointment information to the student.

The Charge Nurse will attempt to schedule a 40 minute appointment with a primary care clinician if the schedule permits. Alternatively a 20 minute slot will be used if there are no other options.

The Charge Nurse will enter the reason code as "CAPS URGENT SAME DAY REFERRAL".

The primary care provider will review the CAPS referral prior to evaluating the patient for critical safety and follow up information. In the event there are any additional questions or the CAPs professional  (or bakc-up) has additional information to share, the CAPS provider and primary care provider will communicate directly. 

 The primary care provider will instant message the CAPS provider their signed note upon completion.


For Non-Same Day Referrals:

The CAPs provider completes the Non-Same Day Referral chart note, indicating the relevant note for the primary care provider to review.  This note is visible to all primary care staff. 

The CAPs provider instructs the student to present to Primary Care Reception to schedule the appointment. 

If a student presents to Primary Care Reception stating they were referred by CAPs, reception staff will review Visits/Notes in the EMR to review the Non-Same Day Referral from CAPs to SHS for instructions on visit type and priority.

It is the student's responsibility to present to Primary Care Reception to schedule the appointment


Effective Date: 
Fri, 01/09/2015
Sat, 03/04/2017

UCSC students must all have health insurance.  The SHS Health Insurance Office tracks the health insurance option that the student maintains, in order to ensure that the students have health insurance.

Students are automatically assigned UC SHIP, University of California Student Health Insurance Plan and may waive it with proof of suitable insurance, based on UC-wide waiver criteria.  This includes students "in absentia".

Addressing inconsistencies may be required for withdrawals, leave of absences, late waivers, late enrollments etc.  For the process to address these, see the Procedure.


WITHDRAWALS - also see policy on Medical Withdrawals

IN ABSENTIA - These students are required to have health insurance however they will be part of a different insurance group.  Insurance staff will document this status in the EMR and the database.  They may be seen at the UCSC Student Health Center.



Note: A leave of absence is a type of withdrawal - with the intent and option to return.  If the leave of absence begins after the quarter starts, the student is on UC SHIP unless the students requests to rescind the insurance and it has not been used. 

Only students on UC SHIP the previous quarter may voluntarily enroll in UC SHIP after the current quarter, by "voluntary" enrollment through Wells Fargo Insurance Services (WFIS).  This is allowed for up to two ensuing quarters, once in their academic career, (Spring is combined with Summer). 

Documentation of voluntary enrollment:

- Receipt of email notification of voluntary insurance enrollment by WFIS sent to Insurance staff

- insurance database updated by Insurance staff

- electronic medical record updated by Insurance staff as on "voluntary UC SHIP", and eligible to use SHS

If the student does not have UC SHIP or is early enough in the quarter and chooses not to keep UC SHIP

Documentation of the LOA:

- insurance database updated by Insurance staff

- electronic medical record updated by Insurance staff "not eligible" (make sure the student has been credited in AIS)

This change will automatically be updated for WFIS.


Make sure that the insurance database is correct and add the information to the electronic medical record.  Ensure that the student is charged the UC SHIP premium in AIS (if they do not have other health insurance or appropriately waived) if not in the next update, then manually.  The other updates should be done automatically.

For Late CruzCare enrollment, notify Billing.

Documentation for late enrollment in UC SHIP:

- Insurance Database updated by Insurance staff

- EMR updated by Insurance staff

- Checking for charge in AIS - check date; student may have a reg form from Registrar's Office that Insurance staff documents their initials and documents whether to keep UC SHIP or waive.  If student wants to waive, Insurance staff provides late waiver opportunity.

LATE WAIVER (as of closure of waiver site)

Document the waiver results in the database and update the electronic medical record.  The credit will appear in the Academic Information System (AIS) with the weekly updates.

Documentation of late waiver:

- Insurance Database by Insurance staff

- EMR by Insurance staff

- Charge the late waiver fee


When a student shows that they are not enrolled, but the rosters for UC SHIP Insurance show that the insurance is active, when the student shows up at the Student Health Center, determine that the student did not voluntarily purchase the insurance via Wells Fargo Insurance Services.  If the student did not enroll in the UC SHIP plan voluntarily, and did not pay for insurance, insurance staff would check AIS to see if billed and paid, and if did not purchase UC SHIP, edit/document in the electronic medical record that the student is not enrolled and is not eligible for services.  If services were rendered and the insurance plan was billed, contact the insurance plan to rescind those claims.  Inform billing via IM.  If there are outstanding bills, the remittance of payment is the responsibility of the patient and the patient should be notified via secure message. 

Documentation for Not Enrolled Student:

- Insurance Database by Insurance staff in the PnC Admin Notes (further updates done automatically)

- EMR by Insurance staff

- Insurance Carrier if claims need to be rescinded (by Billing staff)

- AIS if charges need to be added


Our policy follows the guidelines set forth by the UCSC Registrar's Office regarding refunds.

For Withdrawals - If the student withdrew prior to the start of the quarter, then they get a full refund of the insurance premium.  If the student withdraws in the first week within the quarter, then the student will show as having UC SHIP and can petition to get off the insurance and get a refund.  If a student withdrew from Day 8 onward, they will remain on the insurance for that quarter.

For LOA's - if a student files an LOA in advance of the quarter with the absence, then they will be refunded UC SHIP premium for that quarter, independent of the timing of the beginning of the LOA.


Effective Date: 
Wed, 10/29/2014

The UCSC Student Health Services (SHS) will address requests to reconsider fees that were incurred in the provision of health services.

Fees for  "outside paid services" like reference lab testing, and for consumables like prescriptions or medical supplies, in general, will not be considered.

The Billing staff member cannot reverse fees without manager authorization, notably when the fees have been posted to the Academic Information System (AIS).

UCSC SHS staff cannot reverse late fees.  The student can contact Student Business Services with that request.  Occassionally, the UCSC staff, Billing or managers, may request reversal of late fees from SBS if appropriate and due to SHS actions.


Procedure for handling requests.

Note: Any communication from Billing or other staff will not guarantee nor infer that fees will be reversed, including late fees which can only be addressed by Student Business Services (SBS).


1. Patient comes to the SHS to contest fees. 

The Billing staff member sends a linked secure instant message (IM) to the Billing Supervisor with the request. 

Billing Supervisor Action - The chart is reviewed and potentially referred to another manager for input.  The outcome is communicated to the Billing staff member and action is taken by the Billing staff member if required.  If no billing action is required, a secure message with the appropriate response is sent to the student by a manager.

2. Patient telephones / leaves a message with Billing.

The Billing staff member recommends putting the request in writing and sending it to the Billing Supervisor.  If the telephone message was clear, the Billing staff member may IM the Billing Supervisor, who will take the above "Billing Supervisor Action".

3. Patient emails the request to Billing.

The Billing staff member de-identifies the patient and any PHI and forwards the email to the Billing Supervisor.  The Billing Supervisor will follow the above "Billing Supervisor Action".


If a reversal of fees is authorized, the manager will securely contact the Billing staff member and document the authorization to reverse fees with the amount, date and manager signature (or document via IM).

If actions was taken, the Billing staff will add an administrative note in "Registration" with the date, the situation and action, the manager approver and the Billing staff initials.



Effective Date: 
Tue, 10/28/2014
Mon, 02/29/2016

The UCSC Student Health Services (SHS) provides Optometry Services through a collaboration with the UC Berkeley School of Optometry (UCBSO).
Services are provided by a licensed faculty optometrists in accordance with all laws, regulations and ethics pertaining to optometry.

The UCSC SHS Optometry Department also serves as a training site for 4th year UCBSO student optometrists, who provide exams and eye care services under the supervision of the faculty optometrist.


Optometry Services from the UC Berkeley School of Optometry includes the following and will be provided by faculty optometrists and/or 4th year UCB student optometrists, under the supervision of the faculty optometrists, who document those services in the UCSC SHS electronic medical record:

  • Optometric exams for eye health screenings and vision care
  • Evaluation of ocular health, and referral to specialist as needed
  • Optometry Technician services
  • Prescriptions for glasses and contact lenses
  • Acquisition of glasses and contact lenses pursuant to prescriptions (from in-house or outside)
    - frames available on-site
  • Fittings for glasses and contact lenses
  • Submission of optometric claims to Vision Insurance providers

Additionally, the optometrist may see patients from the UCSC SHS Same Day Clinic, who present with urgent eye illnesses or injuries in the diagnosis and management of eye emergencies.

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