Defining the Terms for Providing Professional Services
Law, rules and regulations, not Guidelines, specify the requirements for practice and violating them constitutes professional misconduct. Not adhering to this Guideline may be interpreted as professional misconduct only if the conduct also violates pertinent law, rules and regulations, some citations of which are listed at the end of this Guideline.
- At the outset of service:
- You should provide the patient with information on what services you can provide and what is required of the patient receiving these services;
- Involve the patient in the mutual development and implementation of any treatment program or other service plan to the fullest extent of his/her abilities; and
- Provide the patient with a statement, preferably in writing, regarding all fees and relevant business procedures. This includes, but is not limited to, billing and payment procedures, including use of collection agencies, handling of insurance reimbursement, requirements for canceling appointments, charges for missed appointments, and the patient's right to access his/her records within the law.
- Be sure you understand how to bill insurance companies and other third-party payers in accordance with New York State law, rules and regulations.
- If a patient stops using your services against your advice and you believe this places the patient at risk, develop a clear plan, preferably in writing, for re-engaging the patient. The plan should be placed in the patient's record and should note why you believe the termination is inappropriate, any alternative services that are available to the patient, and the mechanisms for re-entry into your care.
- If you close your practice, provide reasonable advance notice in writing and a clear and written plan to patients for the continuation of care. These documents should be placed in the patient's record.
Citations of Pertinent Law, Rules or Regulations:
- Education Law, section 6509(9) - unprofessional conduct
- Education Law, section 6509-a - fee splitting
- Regents Rules, part 29.1(b)(2) - exercising undue influence
- Regents Rules, part 29.1(b)(3) - referral fees
- Regents Rules, part 29.1(b)(4) - fee splitting
- Regents Rules, part 29.1(b)(7) - failing to release requested records
- Regents Rules, part 29.1(b)(11) - patient/patient authorization of services
- Regents Rules, part 29.1(b)(12) - advertising not in the public interest
- Regents Rules, part 29.2(a)(1) - abandoning a patient/patient
- Regents Rules, part 29.2(b) - failing to provide access to records as required by Public Health Law, section 18