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PROCESS FOR PATIENT CONTESTING FEES *

Effective Date: 
Wed, 10/29/2014
Reviewed: 
Wed, 03/28/2018
Revised: 
Wed, 03/28/2018
Policy: 

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: 

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).

SCENARIOS

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".  Billing Supervisor may have Biller send decision securely to student.

Reversals

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) and is noted in the ticket notes.

If situation escalated and actions were 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.

 

OPTOMETRY SERVICES *

Effective Date: 
Tue, 10/28/2014
Reviewed: 
Thu, 03/22/2018
Revised: 
Mon, 02/29/2016
Policy: 

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.

Procedure: 

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 for the diagnosis and management of eye emergencies.

OUTSIDE ORDERS FOR MEDICATION ADMINISTRATION

Effective Date: 
Wed, 10/22/2014
Revised: 
Wed, 01/14/2015
Policy: 

The UCSC Student Health Services may follow through with outside provider orders for medication administration.  These orders must be reviewed, approved, and documented in the electronic medical record and a nursing order entered.

Also see "USE OF PATIENT'S OWN MEDICATIONS" policy.

Procedure: 

Any outside medication order must be reviewed by the Medical Director or designee and approved for administration by the RN.  The medication order should be documented in the electronic medical record (EMR) for Nursing staff to follow.  The original order should be signed by the medical director or designee and scanned into the EMR.

The UCSC Medical Director or designee will decide if the treatment ordered is medically appropriate to be administered by the SHS nursing professionals.  In cases in which the Medical Director judges the medication treatment to not be medically appropriate or administration requires skills and equipment not found at the Student Health Center, the Medical Director will contact the outside ordering clinician and an alternative disposition will be formulated. The student will be notified of the disposition and advised to contact their treating physician for an alternative plan. A referral off campus will be authorized when requested by the patient to facilitate treatment.

PHARMACIST DISPENSING OF EMERGENCY CONTRACEPTION, NICOTINE REPLACEMENT PRODUCTS AND NALOXONE UNDER PRESCRIPTION *

Effective Date: 
Thu, 09/25/2014
Revised: 
Tue, 04/03/2018
Policy: 

Effective January 1, 2014, licensed pharmacists in the state of California have been given provider status under a bill signed by the Governor on October 1, 2013.  This bill, SB 493, allows pharmacists certain authorities in all practice settings, to include the following:

"The bill would authorize pharmacists to perform other functions, including, among other things, to furnish self-administered hormonal contraceptives, nicotine replacement products, and prescription medications not requiring a diagnosis that are recommended for international travelers, as specified."

The pharmacy also prescribes epinephrine to authorized first responders and trained lay rescuers under a UCSC SHS protocol.

Procedure: 

The UCSC Pharmacy follows all applicable pharmacy laws and regulations.

EMERGENCY CONTRACEPTION

The California State Board of Pharmacy has an established protocol in place for Pharmacists Furnishing Emergency Contraception.

Section 4052.3(a)(2) of the California Business and Professions Code authorizes a pharmacist to furnish emergency contraception prusuant to a protocol appproved by the California State Board of Pharmacy and the Medical Board of California.  Use of ths protocol satisfies that requirement: California Code of Regulations Title 16 ~ 1746. Emergency Contraception and is followed by UCSC SHS Pharmacists.  This protocol can be found in the UCSC SHS Pharmacy Compliance Manual for the State Board of Pharmacy.

 

NICOTINE REPLACEMENT PRODUCTS

The authority to furnish prescription nicotine replacement products for smoking cessation is pursuant to a statewide protocol if certain training, certification, recordkeeeping, and notification requirements are met.  Once a statewide protocol is developed by the California Board of Pharmacy and the Medical Board of California, it will automatically apply to all pharmacists and will be incorporatied by the UCSC SHS Pharmacy.  The protocol under review as of June 2014, currently includes the following:

Allows a pharmacist to furnish nicotine replacement products in accordance with a state treatment prococol, provided:

1. Records are retained of drugs and devices furnished for at least 3 years so as to notify health providers or permit monitoring of the patient

2. The pharmacist notifies the patient's primary care provider of drugs and devices furnished or into a patient record

3. The pharmacist must complete 1 hour of CE on smoking cessation therapy

- See additional information below.

 

NALOXONE

The authority to furnish prescription naloxone for opioid reversal is pursuant to a statewide protocol if certain training, certification, recordkeeeping, and notification requirements are met.  Once a statewide protocol is developed by the California Board of Pharmacy and the Medical Board of California, it will automatically apply to all pharmacists and will be incorporatied by the UCSC SHS Pharmacy.  The protocol under review as of February 2016, currently includes the following:

Allows a pharmacist to furnish naloxone in accordance with a state treatment prococol, provided:

1. Records are retained of drugs and devices furnished for at least 3 years so as to notify health providers or permit monitoring of the patient

2. The pharmacist notifies the patient's primary care provider of drugs and devices furnished or into a patient record and/or documents the process in the electronic medical record.

3. The pharmacist must complete 1 hour of CE on naloxone.

Until such time as the California Board of Pharmacy and the Medical Board of California formalize the protocol, the UCSC SHS Pharmacists, acting as delegate for E. Drew Malloy, MD, will act under an internal protocol adapted from the protocol currently under consideration from the California State Board of Pharmacy and the Medical Board of California.  This protocol can be found in the UCSC SHS Pharmacy Compliance Manual for the State Board of Pharmacy.

 

EPINEPHRINE

The California State Board of Pharmacy has approved regulation 4119.3 for pharmacists to furnish, without a prescription, epinephrine to first responders and trained lay rescuers for the purpose of rendering emergency care in accordance with Section 1797.197a of the Health and Safety Code, if both of the following requirements are met.

Under UCSC Protocol, pharmacists will write prescriptions, under the auspices of the UCSC Student Health Center Medical Director, for the official campus community members who can provide a current certificate demonstrating that the person is trained and qualified.  The recipient will be charged full price for the product which can be paid by Recharge Form.

The pharmacy will also include a log for documenting a record that must be kept for 5 years with pertinent information (see below).

 

NICOTINE REPLACEMENT PROTOCOL

Effective January 1, 2014, licensed pharmacists in the state of California have been given provider status under a bill signed by the Governor on October 1, 2013.  This bill, SB 493, allows pharmacists certain authorities in all practice setting, to include the following:

B.2.

An established process for informing the patient of the status of the health care professional and obtaining patient consent for such person's participation in or observation of the patient's care.

Notes: 
P&P

B.1.

A definition close and adequate supervision of students and postgraduate trainees.

Notes: 
P&P

Z.

The organization follows established protocols for instructing patients in self-care after surgery and provides written instructions to patients.

Notes: 
P&P

Y.

The organization has written guidelines for internal transfer of care from one provider to another. These guidelines address:

1. Information to be transferred about a patient’s care, including treatment/ services, current condition, and any recent or anticipated changes.

2. How the information will be communicated among members of the health care team.

Notes: 
n/a

N.13.

Fire risks are identified and minimized, and staff members are prepared to address fire hazards, if necessary.

Notes: 
P&P

B.4.b.

A method of identifying designated locations of paper records throughout the organization in order to deter unauthorized access.

Notes: 
Medical Records
Policy: 
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