(A) Chiropractic physicians who function as
owners, operators, members, partners, shareholders, officers, directors, and/or
managers of a chiropractic clinic shall be responsible for the policies,
procedures and billings generated by the clinic.
(B) Chiropractic physicians who function only
as clinical staff without any management or financial responsibilities are
required to familiarize themselves with the clinic's billing practices to
ensure that the services rendered are accurately reflected in the billings
generated.
(C) Chiropractic
physicians have a right to review and correct all billings submitted under
their name and/or identifying number(s). Signature stamps and/or automatically
generated signatures shall be utilized only with the authorization of the
chiropractic physician whose name or signature is designated. Such
authorization may be revoked at any time in writing by that
individual.
(D) Chiropractic
physicians shall accurately report the services rendered to a patient on all
billing documents.
(E) Chiropractic
physicians shall release copies of billing records upon a written request from
a patient or a patient's authorized representative within thirty days of said
request.
(F) Chiropractic
physicians shall not knowingly:
(1) Increase
charges when a patient utilizes a third-party payment program;
(2) Report incorrect dates or types of
service on any billing documents;
(3) Report charges for services not
rendered;
(4) Bill for services
rendered which are not documented in a patient's file.
(G) No chiropractic physician shall waive the
payment of all or any part of a deductible or copayment that a patient,
pursuant to a health insurance or health care policy, contract, or plan that
covers the chiropractor's services, otherwise would be required to pay if the
waiver is used as an enticement to a patient or group of patients to receive
health care services from that chiropractor, unless the waiver is made:
(1) In compliance with the health benefit
plan that expressly allows a practice of that nature. Waiver of the deductibles
or copayments shall be made only with the full knowledge and consent of the
plan purchaser, payer, and third-party administrator. Documentation of the
consent shall be made available to the board upon request, or;
(2) For professional services rendered to any
other person licensed pursuant to this chapter, to the extent allowed by this
chapter and the rules of the board.
(H) No chiropractic physician shall offer
cash, gift cards, gift certificates or cash equivalents to patients or
potential patients as a referral fee or an inducement to enter into or to
continue care.
(I) Promotional
items shall not be more than
ten
seventy-five dollars in retail value
and not total more than twenty dollars per
year per patient. Professional services, product samples, literature, or
refreshments served at events such as health fairs, open houses, educational
lectures or health care orientations are not considered promotional items.
Promotional items shall not be claimed directly or indirectly or otherwise
shifted to any third party for reimbursement.
(J) A chiropractic physician may
provide complimentary transportation directly to and from his or her office for
the purpose of rendering care to a patient or potential patient who is unable
to provide his or her own transportation. The cost of the transportation shall
be paid by the chiropractic physician directly to the transportation provider
and shall not be claimed directly or indirectly or otherwise shifted to any
third party for reimbursement. Transportation shall not be via luxury
transportation.
(K)
(J)
Nothing in this rule shall prevent a
chiropractic physician from providing a reasonable time of service
discount.
Notes
Ohio Admin. Code 4734-9-07
Five Year Review (FYR) Dates:
4/30/2019 and
04/30/2024
Promulgated
Under: 119.03
Statutory
Authority: 4734.10
Rule
Amplifies: 4734.31
Prior
Effective Dates: 05/02/2003, 08/01/2007, 04/05/2009,
05/25/2014
Effective:
5/25/2014
R.C. 119.032 review dates:
03/10/2014 and
05/25/2019
Promulgated
Under: 119.03
Statutory Authority: 4734.10
Rule
Amplifies: 4734.31
Prior Effective Dates: 5/2/03, 8/1/07,
4/5/09