Giving casts to patients RESPONSES (2of 2)
Randy McFarland
Description
Collection
Title:
Giving casts to patients RESPONSES (2of 2)
Creator:
Randy McFarland
Date:
10/15/2005
Text:
(continued- part 2)
When my former employer & I parted ways, my pts were calling and
emailing requesting to follow me to my new facility, but I NEVER advised
them to ask for or get anything from the old place. How uncool. My 2
cents:The test sockets should be looked at as diagnostic tools, and as
tools they are part of YOUR facility. Even if billed for, I would
not take the liability for allowing the pt to have a test socket setup
outside of your facility. Legally, you cannot assume they will utilize
them in another controlled environment such as the other practitioner's
facility. Same with the molds...the materials are all from you
facility and should be considered tools.
Interesting question. If you already billed for the test sockets the
patient
should be entitled to them. I'm sure you generally submit one bill at
the
time of delivery for all services/materials used in the fabrication of
the
device. So if the prosthesis is unfinished at the time the practitioner
and
patient have left your facility, then everything is still your property.
However, if you plan to bill the patient for services and materials
up to
the point of where the job was terminated, then they technically own the
test sockets.
So my questions would be How far did the practitioner get with
fabrication? and What have you billed the patient for thus far? If
the
test sockets have been billed for, I would give them up. However, the
cast
negative and positive molds are not identified with HCPC codes.
Therefore,
they are technically your property.
Of course any temporary adapters, valves, etc. used in the test
socket phase
should not be surrendered as they are not a bill-able item.
BELONGS TO THE FACILITY AND THATS IT
My reaction would be to charge them for the molds and test sockets.
Dream
up a fair amount and charge the patient, not the insurance company or
the
previously employed practitioner.
I'm going off the idea that any patient can request, in writing, a
copy of
their medical records, but you can charge for the service of copying,
collating, and shipping the documents to them. Same with their molds
and
sockets.No non-compete with the practitioner?
That's pretty obvious what's about to happen. I'd probably contact each
one of them personally and assure them their level of care will probably
increase now that they have your personal attention. I'd also say that
you looked at their mold and saw several things that you want to change
to offer more comfort and control-without talking bad about that
practitioner.
Interesting question. If you already billed for the test sockets the
patient
should be entitled to them. I'm sure you generally submit one bill at
the
time of delivery for all services/materials used in the fabrication of
the
device. So if the prosthesis is unfinished at the time the practitioner
and
patient have left your facility, then everything is still your property.
However, if you plan to bill the patient for services and materials
up to
the point of where the job was terminated, then they technically own the
test sockets.
So my questions would be How far did the practitioner get with
fabrication? and What have you billed the patient for thus far? If
the
test sockets have been billed for, I would give them up. However, the
cast
negative and positive molds are not identified with HCPC codes.
Therefore,
they are technically your property.
Of course any temporary adapters, valves, etc. used in the test
socket phase
should not be surrendered as they are not a bill-able item.
I Believe that they are actually the property of the patient and should
be turned over as hard as it may be.
In an actual case, the judge ruled in favor of our company confirming
that a patient's model is considered to be proprietary
work product used for the production of the finished device that was
provided. Further, providing a model could expose you to potential
liability should anything go wrong.
It all depends on how you want to handle it. I sometimes gave the
patients their molds when I ran out of space to store them. If a
competitor were to get a mold to use from that patient there would be
nothing I could do about it. If the practitioner is going to actually
open a business in your direct vicinity, and be a competitor, a lot of
guys would say no to letting the molds go with the practitioner as a
matter of principal. Business is business. . I think most owners want
leaving employees to take off with nothing from the shop..... especially
anything related to patient information...files....as a matter of
privacy. If a patient asks for the cast that is a different story....
I think I would give the patient the mold....but the next time they want
a leg from me I would want to take a new cast and charge for it....as a
matter of principal...unless I gave them the mold to keep because I
didn't have room to store it.
For your protection I would run this through an attorney. There has been
debate on CAD/CAM sockets as to who owns what. The same laws that apply
to photography and video might apply which it is that it is owned by the
producer. In this case it would be the departing practitioner?s. You
might want to look at laws which pertains to inventions of an employee.
However, the departing prosthetist could also claim intellectual
property. It could be a can of worms.
It's a shame to hear of such antics. Presuming the person is ABC
Certified, it is possible this represents a violation of the cannon of
ethics in which case you could file a complaint. I'm not sure if that's
correct, but you could call ABC and they could advise you if you have
any options there. Even an ABC reprimand might be a good lesson.
HIPAA might have ramifications so I suggest you procure a signed
release from the patients before releasing anything of theirs, whether
written or tangible material. My hunch is that, if push comes to shove,
the patient has a legal right to their molds just as they do to their
written records. You could certainly delay things a few weeks while you
check with your corporate attorney to see what his advice is although it
is easy enough for the prac to just take another impression. I would
NOT recommend charging the patients more than a nominal fee and I
wouldn't even do that unless your policy manual states that you charge a
$5 fee for copying records.
You may have some recourse to go after the practitioner for theft of
business information but only your lawyer can advise about the costs and
details of such an effort. You'll have to decide whether it's worth it
or not. If you had a non-compete agreement that would also be a factor.
No obligation but: You can't do anything with them without him.
He wants them because he can use them.
It is paid for, you have to give them.
Keeping or destroying them would do everyone a disservice except you,
but you will not win anything. Patients will find out and then you
loose. You will only win by giving them and be clear that your interest
is in the patient and good services.
END OF RESPONSES
WHAT I DECIDED TO DO:
I decided to release the casts to the patients once they signed a
release of liability form including the following verbiage. NOTE: This
was NOT reviewed by an attorney, so don't use it without checking with
yours.
I acknowledge that there is no guarantee that this model currently fits
me and that by signing this Liability Release Form, I release (owner
name) and (company name). of any and all liability or responsibility of
the released items including any future injury or loss caused to me by
using the released item for future medical care or services in relation
to the model.
I have read and understand the above terms as noted and agree to all
conditions without exception.
Thanks again to all those who responded!
If your reply to me comes back undeliverable, please forward that
error message to our IT guy, Bruce.
His E mail is: <mailto:<Email Address Redacted>> <Email Address Redacted>
When my former employer & I parted ways, my pts were calling and
emailing requesting to follow me to my new facility, but I NEVER advised
them to ask for or get anything from the old place. How uncool. My 2
cents:The test sockets should be looked at as diagnostic tools, and as
tools they are part of YOUR facility. Even if billed for, I would
not take the liability for allowing the pt to have a test socket setup
outside of your facility. Legally, you cannot assume they will utilize
them in another controlled environment such as the other practitioner's
facility. Same with the molds...the materials are all from you
facility and should be considered tools.
Interesting question. If you already billed for the test sockets the
patient
should be entitled to them. I'm sure you generally submit one bill at
the
time of delivery for all services/materials used in the fabrication of
the
device. So if the prosthesis is unfinished at the time the practitioner
and
patient have left your facility, then everything is still your property.
However, if you plan to bill the patient for services and materials
up to
the point of where the job was terminated, then they technically own the
test sockets.
So my questions would be How far did the practitioner get with
fabrication? and What have you billed the patient for thus far? If
the
test sockets have been billed for, I would give them up. However, the
cast
negative and positive molds are not identified with HCPC codes.
Therefore,
they are technically your property.
Of course any temporary adapters, valves, etc. used in the test
socket phase
should not be surrendered as they are not a bill-able item.
BELONGS TO THE FACILITY AND THATS IT
My reaction would be to charge them for the molds and test sockets.
Dream
up a fair amount and charge the patient, not the insurance company or
the
previously employed practitioner.
I'm going off the idea that any patient can request, in writing, a
copy of
their medical records, but you can charge for the service of copying,
collating, and shipping the documents to them. Same with their molds
and
sockets.No non-compete with the practitioner?
That's pretty obvious what's about to happen. I'd probably contact each
one of them personally and assure them their level of care will probably
increase now that they have your personal attention. I'd also say that
you looked at their mold and saw several things that you want to change
to offer more comfort and control-without talking bad about that
practitioner.
Interesting question. If you already billed for the test sockets the
patient
should be entitled to them. I'm sure you generally submit one bill at
the
time of delivery for all services/materials used in the fabrication of
the
device. So if the prosthesis is unfinished at the time the practitioner
and
patient have left your facility, then everything is still your property.
However, if you plan to bill the patient for services and materials
up to
the point of where the job was terminated, then they technically own the
test sockets.
So my questions would be How far did the practitioner get with
fabrication? and What have you billed the patient for thus far? If
the
test sockets have been billed for, I would give them up. However, the
cast
negative and positive molds are not identified with HCPC codes.
Therefore,
they are technically your property.
Of course any temporary adapters, valves, etc. used in the test
socket phase
should not be surrendered as they are not a bill-able item.
I Believe that they are actually the property of the patient and should
be turned over as hard as it may be.
In an actual case, the judge ruled in favor of our company confirming
that a patient's model is considered to be proprietary
work product used for the production of the finished device that was
provided. Further, providing a model could expose you to potential
liability should anything go wrong.
It all depends on how you want to handle it. I sometimes gave the
patients their molds when I ran out of space to store them. If a
competitor were to get a mold to use from that patient there would be
nothing I could do about it. If the practitioner is going to actually
open a business in your direct vicinity, and be a competitor, a lot of
guys would say no to letting the molds go with the practitioner as a
matter of principal. Business is business. . I think most owners want
leaving employees to take off with nothing from the shop..... especially
anything related to patient information...files....as a matter of
privacy. If a patient asks for the cast that is a different story....
I think I would give the patient the mold....but the next time they want
a leg from me I would want to take a new cast and charge for it....as a
matter of principal...unless I gave them the mold to keep because I
didn't have room to store it.
For your protection I would run this through an attorney. There has been
debate on CAD/CAM sockets as to who owns what. The same laws that apply
to photography and video might apply which it is that it is owned by the
producer. In this case it would be the departing practitioner?s. You
might want to look at laws which pertains to inventions of an employee.
However, the departing prosthetist could also claim intellectual
property. It could be a can of worms.
It's a shame to hear of such antics. Presuming the person is ABC
Certified, it is possible this represents a violation of the cannon of
ethics in which case you could file a complaint. I'm not sure if that's
correct, but you could call ABC and they could advise you if you have
any options there. Even an ABC reprimand might be a good lesson.
HIPAA might have ramifications so I suggest you procure a signed
release from the patients before releasing anything of theirs, whether
written or tangible material. My hunch is that, if push comes to shove,
the patient has a legal right to their molds just as they do to their
written records. You could certainly delay things a few weeks while you
check with your corporate attorney to see what his advice is although it
is easy enough for the prac to just take another impression. I would
NOT recommend charging the patients more than a nominal fee and I
wouldn't even do that unless your policy manual states that you charge a
$5 fee for copying records.
You may have some recourse to go after the practitioner for theft of
business information but only your lawyer can advise about the costs and
details of such an effort. You'll have to decide whether it's worth it
or not. If you had a non-compete agreement that would also be a factor.
No obligation but: You can't do anything with them without him.
He wants them because he can use them.
It is paid for, you have to give them.
Keeping or destroying them would do everyone a disservice except you,
but you will not win anything. Patients will find out and then you
loose. You will only win by giving them and be clear that your interest
is in the patient and good services.
END OF RESPONSES
WHAT I DECIDED TO DO:
I decided to release the casts to the patients once they signed a
release of liability form including the following verbiage. NOTE: This
was NOT reviewed by an attorney, so don't use it without checking with
yours.
I acknowledge that there is no guarantee that this model currently fits
me and that by signing this Liability Release Form, I release (owner
name) and (company name). of any and all liability or responsibility of
the released items including any future injury or loss caused to me by
using the released item for future medical care or services in relation
to the model.
I have read and understand the above terms as noted and agree to all
conditions without exception.
Thanks again to all those who responded!
If your reply to me comes back undeliverable, please forward that
error message to our IT guy, Bruce.
His E mail is: <mailto:<Email Address Redacted>> <Email Address Redacted>
Citation
Randy McFarland, “Giving casts to patients RESPONSES (2of 2),” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 5, 2024, https://library.drfop.org/items/show/225560.
