·
The
expected out come of a pt’s condition
·
The
prognosis goes in the Assessment section of the soap note.
Definitions:
Medical Necessity- A service
or supply which is appropriate to the diagnosis, widely accepted, based on
scientific criteria and reasonably safe
Fraud- A deliberate activity by a
provider to deceive or misrepresent in order to obtain unfair or unlawful gain.
Malpractice- Negligent performance
and/or dereliction of duty by a practitioner.
Negligence- Careless failure to
exercise common prudence
Spasm- Sustained contraction that
limits motion may indicate a (+) jump sign.
Establishment
of a Doctor patient relationship
·
Can
be done any where and at any time
·
If
pt cancels or fails to show up for an appointment than a follow up must be done
·
Dr.
is advised to tell potential patients to call the office and make an
appointment
·
Verbal
contracts are binding just as a written one is
Abandonment
·
Once
a Dr. has accepted a patient than they are responsible for the care of that pt
and document all missed apts
·
When
discharging a pt the Dr should then send a written letter of discharge and referral.
·
Note
that you are still availible for 10 days
·
List
several other Drs as a referal
Responsibility
for referrals
·
Liability
Communication
(Malpractice Prevention)
·
Dr.
Pt communication is essential to prevent malpractice law suits