What Forms do I need to Start Up?

If you’re considering forms, congratulations!  I assume that means you’re taking the leap and now just trying to get your ducks in a row to start on-boarding new patients.  The “convincing yourself and everyone around you that you’re doing the right thing phase” is over.  Now you know you ARE doing the right thing to unburden YOURSELF from the system and to care better for YOUR patients. 

You want to be set up with the right forms to make the on-boarding process as simple as possible for you AND patients.  Many DPC practices share their forms online.  Here are a few examples to look through to get your own together.  I suggest reading through a few and copying and pasting the parts that make sense to you.  When you have that model, go through and make sure it says what YOU want to agree with your patient about.  If you feel comfortable, ask a lawyer with familiarity in the direct care world to help you review your final product.

Patient Agreement
This is between you and your patient so it needs to be tailored to what you’d like to offer in terms of services, time commitments, etc.  Be careful going through it to make sure it is what you want it to be.  Here are some examples: Kansas City DPC, Direct Doctors, AtlasMD.  The amazingly helpful guys (aka doctors) at AtlasMD offer free services to those setting up or participating in direct care practices - one of these is legal counsel, so check them out if you have questions! 

HIPAA Statement
You possibly/probably need a HIPAA statement (depending on which view you accept on whether Direct Care practices qualify for HIPAA).  

• For our practice we’ve combined HIPAA and patent electronic consent into one form.  This statement allows patients to review and sign stating they are OK (or not!) with electronic communication and our privacy practices. 
• Some practices choose a HIPAA compliant program (which is an added cost) for text/email with patients.  
• Our EMR includes a HIPAA-secure private patient portal, which is a third option for security.  
• Examples: Direct Doctors, Atlas MD Starter Pack Forms, AAFP
• Philip Eskew, DO, JD, MBA talks about all the aspects to consider from a HIPAA point of view on his DPC Frontier HIPAA discussion

Medical Record Release
A couple of examples exist online of DPC records releases - i.e. AtlasMD, Direct Doctors.  Copy one of these styles but remember the key in staying burden free is how do you want records to arrive? We only want faxes - why? - it keeps us burden free and paper free.  We review, we send to the EMR, we are done. Paper requires scanning and shredding, both time consuming and not without costs. 

Medicare Opt Out Form
If you opt out of Medicare and you see Medicare patients (remember some are disabled and younger, so ask everyone who joins!), you will need them to sign an Opt Out Agreement.  The gist is, this lets them know that neither you nor they will bill medicare for your services.  They can still use Medicare for everything else.  Here’s a sample from AAPS.

Other Forms
Other forms will come up with patients as you proceed (i.e. controlled substance agreement, one-time visit agreement, and letterhead) but you will likely have time to make those as you go along.  DPC Frontier has lots of form information.  If you’re starting from scratch, i.e. out of residency or in a new geographic location, you will have lots of time during start up to work out these kinks.  If you’re transitioning an existing practice, you may need this stuff up and running asap.