Are you struggling to create an enrollment packet for your geriatric care management practice? In today’s article, I want to discuss how to create an enrollment packet that not only meets the legal requirements for your business but also helps you start to build a foundation of trust.
All businesses need to establish trust with their customers and this is especially true in the business of geriatric care management.
For older adults and their families, working with a geriatric care manager takes a huge leap of faith and trust. They are entrusting us to guide them through a very difficult time in their lives and we owe it to them to fine tune every aspect of our practice so they feel cared for right out of the gate.
We provide peace out of chaos, empowerment out of fear and confidence out of confusion.
None of this happens without a foundation of trust and this trust starts from the very beginning of the enrollment process. By enrollment process, naturally, I’m referring to your paperwork. This is health care after all!
Give serious consideration to creating your client focused enrollment packet before you open your doors. If you think you can pull this together over night, you’re going to be in for a big surprise, a lot of frustration and possible liability risks.
You’ll need to have an attorney review your forms and provide the ultimate sign off on their legality. I’m sharing this information with you as someone who’s owned a geriatric care management practice for many years and has helped others.
I am not an attorney nor do I play one on TV!
Here are some basics everyone needs in their enrollment packet to start building trust with their clients.
Service Agreement – The service Agreement is your contract that establishes parameters around the work you’re doing for a client. This agreement will look different depending on your license, certifications, state laws and type of service you’re providing.
This is your opportunity to practice transparency in your practice, set boundaries and establish trust in your client relationship.
I prefer to have some portions of the service agreement in separate documents. The fee schedule, electronic communication and transportation waiver can be part of your service agreement. I just find that it makes the document too long and clients “zone out’ by page three. This is simply a matter of personal preference and client feedback.
The important thing is that you somehow cover and have purchasers sign off on these components either in a service agreement or separate documents.
- Name of your business
- Primary client name (older adult)
- Purchaser (person responsible for hiring you and paying your bill)
- Date of agreement
- Outline services you’ll be providing and/or the scope of your practice (it’s especially important for nurses to clarify types of bedside tasks you’ll be providing such as vital signs, medication management etc.)
- Billing practices including policies related to past due accounts, how often you bill and preferred method of payment
- Software that you utilize either for clinical documentation or billing
- Fee schedule that outlines very specific tasks you bill for. I prefer to have this as a separate document and acknowledge in the service agreement that client has received this document. You’ll find more about the fee schedule below.
- Consent to treat (this will vary depending on type of care and service provided. You can also make this a separate document depending on the scope of your practice)
- Disclosure statement that outlines any contractual relationships you have with other companies
- Clause describing the termination of the contract and services (this includes your right to terminate services)
- How you handle client’s needs after business hours and emergencies
- Service area covered and travel policy including cost for travel time
- Transportation waiver statement can either go in to your service agreement or be a separate document
This list is in no way exhaustive and you’ll need to provide additional components depending on your state, licensing and personal preference. Check with your local small business administration or SCORE, professional organizations and business attorney for additional guidance. Over time, you’ll receive feedback from clients that will help you organize your service agreement in a way that makes sense for them. This brings me to a fee schedule.
Billing Fee Schedule – I started using a billing fee schedule a few years ago as a way to provide clarity around the specific tasks I bill for. I use to have it as part of the service agreement but found the information was often overlooked and I also needed a way to share this information with family members that may not be privy to the service agreement.
For example, eldest daughter hires me and is paying for my services. Other family members start calling me to share concerns and obtain support. I use my fee schedule as a way to educate and clarify with every member of that family how I bill for my time.
The components of the fee schedule should include very specifically every task that you bill for. For care managers that provide services at different costs, the fee schedule provides you with a way to document those different costs. For example, some care managers have assistants that perform certain tasks at a lower cost. Nurses may charge more to assist with medication management.
Notice of Privacy Practices – this is your HIPAA (Health Insurance Portability and Accountability Act) compliance forms. There will be one form that outlines your privacy practices (the fine print) and another form that your client signs to acknowledge they have received these policies. If your primary client (older adult) is capable of understanding and signing this document, that is your best practice. If not, the power-of-attorney, guardian or health care proxy can sign. When in doubt, I have both sign.
We’re not going in to detail about HIPAA compliance because, as I said earlier, I am not an attorney nor am I a HIPPA compliance officer or expert. The information provided here is simply a guideline. It is your responsibility to remain compliant and understand HIPAA updates as they occur.
Electronic Communication – the health care system is a dinosaur in terms of technology. Even though great strides have been made in terms of medical records, the hard copy and fax machine are still uncommon and some health care professionals refuse to email documents. However, my clients are accustomed and often prefer to communicate via text messages and e-mails.
To lower your risk of HIPAA violation it helps to establish policies and procedures about electronic communications. I use an electronic communication form to facilitate conversation around how we’re going to communicate, the steps I take to protect privacy and ask for permission to text and use email.
Consent to Share Information – at the core of what a geriatric care manager does is intense coordination of services and communication between health care providers. I prefer to have both my primary client and purchaser sign off and authorize me to share information with other providers. This form also outlines guidelines regarding how I share information.
I’ve gone back and forth between having this embedded in my service agreement and having it as a separate document. I like the ability too share this signed separate documented with other health care providers so they know I have this consent. It also speaks to my role in my clients life and credibility.
Medical release form – to obtain medial records from other health care professionals, you’ll need a medical release form. Some care managers prefer to get this signed upon enrollment some have them signed as they need them. I get it signed as I need it. I have this form in my toolkit but I rarely use it. Typically when I need medical records, I have my client sign the release form from the health care provider I need the records from.
Transportation waiver – I do not have this in my service agreement nor do I have clients sign it during the enrollment process but some care managers do. I have this form in my toolkit but I prefer not to transport clients so I only use it on an as need basis. Basically, this is to lower your risk of liability if you transport clients in your personal car. You absolutely need to do your research specific to your state and the best place to start with this is to ask your insurance agent and your attorney for guidance.
Your enrollment packet is your number one priority in getting your practice up and running. Your enrollment packet needs to ensure you are compliant with county, state and federal regulations. However, I caution you to not make it so full of legal jargon, policies and procedures that it becomes meaningless to your clients.
The enrollment process is a necessary and critical part to you doing business so make the best of it by keeping it client focused while meeting your legal obligation to your care management practice.
What are your thoughts? Do you have questions about the enrollment packet? If so, leave your comment with your burning question. Better yet, share your thoughts on this topic.
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