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PUPROSE 

SCOPE

REQUIREMENTS 

Patient Visit Encounter Closure

1. All patient encounters must be completed, documented, and closed within 24 hours of the visit.
   
2. Incomplete or delayed encounter closures can result in disruptions in patient care, billing inefficiencies, and compliance risks.
   
3. Complete documentation includes a detailed assessment and plan. 
   

Lab Sign-Off

1. Providers must review, sign off, and take necessary actions on all lab results within seven (7) days from the date it is sent to the provider.
   
2. Any abnormal or critical lab findings must be addressed promptly and documented appropriately.
   
3. Phone call communication must be documented in the patient’s chart.
   

Patient Case Response

1. Providers must respond to open patient cases within 24 to 48 hours of initiation, ensuring that patients receive timely follow-up and appropriate care.
   
2. Delays in addressing patient concerns can result in adverse health outcomes and impact patient satisfaction.
   
3. Documentation of all communications and actions taken must be included in the patient’s chart.
   

Monitoring and Reporting 

1. A weekly compliance report is generated and distributed to all providers at the beginning of the week.
   
2. Providers are responsible for reviewing their compliance status and taking immediate corrective actions, as needed.
   

Escalation and Accountability

1. Initial Notification
   
1. If a provider has more than 10 open encounters, an initial compliance notification will be sent to the provider, via an email to the provider’s work email sent from the Regional Director (“RD”), with a copy to the Practice Manager (“PM”) and Practice Medical Director (“PMD”).
   
2. The provider must address outstanding items within one week of receiving the notification.
   
2. Compliance Deadline and Escalation
   
1. If the provider takes no action to resolve all open encounters identified in the initial compliance notification within one week from receiving the notification, unless an extenuating circumstance is identified (as defined in the “Exceptions and Provider Responsibility” section below), the issue will be escalated to the Chief Medical Officer (“CMO”) and RD for further review.
   
3. Performance Plan and Consequences. Failure to comply with the requirements outlined in this policy may result in progressive disciplinary actions. The specific consequences will be determined on a case-by-case basis, taking into account the frequency and severity of the non-compliance, as well as any extenuating circumstances. Possible consequences include but are not limited to:
   
1. Placement on a remediation plan in collaboration with the CMO, RD, and practice leadership.
   
2. Formal written warnings regarding non-compliance.
   
3. Other measures as defined in the provider’s employment agreement.
   
4. Further administrative actions as deemed necessary by senior leadership and in accordance with the provider’s employment agreement.
   

Exceptions and Provider Responsibility

1. Providers experiencing extenuating circumstances (e.g. approved leave, system outages, extraordinary clinical workload) must proactively communicate with their PM or PMD to request an extension or assistance by other providers in practice.
   
2. The above should be documented by PM or PMD and cc’d to RD.
   

Acknowledgement

All providers must review this protocol. Compliance with these expectations is a condition of continued employment and critical to maintaining a high standard of patient care and practice efficiency.