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7.8.7 – Procedure – Academic Resale: Physical Therapy Clinic

Part 1: Scope. Students provide physical therapy services as part of their academic program. All services must be integral to the instructional program. Services are provided to the public, Lake Superior College (LSC) students, employees, and the general public by appointment on a first requested, first served basis.

Part 2: Physical Therapy (PT) Clinic

Physical therapist assistant students provide a full range of physical therapy services to patients of all ages within the standard scope of the physical therapy practice. Physical therapy instructors supervise all of the services provided.

The Minnesota Physical Therapy Practice Act allows direct access to physical therapy without a doctor’s referral. Patients are referred to physicians or a professional physical therapy practice if their needs are determined to be beyond the scope of the Clinic or continuity of care is needed over time periods when the PT Clinic is closed.

The PT Clinic is typically open afternoons on Mondays and Wednesdays during the fall and spring academic semesters. Scheduling is done on a first requested, first served basis with no preference given to employees or administrators.

The PT Clinic is advertised on the LSC web site, at Open Houses, LSC Health Fairs, and in brochures available at the College, area doctors’ offices, and community clinics.

Subpart A: Procedures

    1. Patients must complete three (3) forms in order to be served at the clinic.
      1. Patient Health History form – questions regarding the patient’s medical history.
      2. Registration form – includes first, middle, last name, date of birth, address, and phone number. The form includes consent for treatment of services to be received and permissions granted.
      3. Acknowledgment form – confirms copy of the “Health Insurance Portability and Accountability Act (HIPAA) and Patient Bill of Rights” was reviewed or received.
    2. Visits are tracked in a ledger identifying the type of client (LSC student, LSC employee, or member of the public) and the amount paid.

Subpart B: Costs

    1. Charges/fees are easily visible to patients at the PT Clinic office window.
    2. Sliding fee for services: $10 or income-based according to Federal Sliding Fee Scale. LSC employees are charged according to this same fee schedule.
    3. All LSC students receive services at no charge.

Subpart C: Payments and Billing

    1. Payments are made at the PT Clinic office window before services are provided. If patients are unable to pay, it is recorded in the ledger and payment is accepted at their next visit.
    2. Patients may pay for several visits at one time, but there are no refunds.
    3. Payments are only received when the PT Clinic manager or receptionist is available.

Subpart D: Cash Procedures

    1. Ledger and Receipts.
      1. Ledger of patients and charges by day is maintained by PT Clinic manager.
        1. Ledger lists patient name, type (LSC student/LSC employee/public) and amount collected.
        2. A numbered page is created for each day the clinic is open.
      2. Numbered receipt is written for every payment received.
        1. Original is given to the customer.
        2. Duplicate copies are attached to the deposit and submitted to the Business Services Office.
        3. If a receipt has to be voided, it is submitted with the deposit.
      3. Deposit form references the ledger page number and range of receipt numbers.
        1. Copy of deposit form is retained in the PT Clinic.
    2. Cash on hand.
      1. Cash on hand is available to the clinic upon request from the Business Services Office. When it is requested, it is recorded in ISRS. If any change is required, it is exchanged at the Business Services Office. Any cash on hand is secured in a locked drawer within the locked PT Clinic.
      2. Payments are put in a zipped bank bag with copy of written receipt. Payments are secured in a locked drawer within the locked PT Clinic.
      3. PT Clinic manager and student employee receptionist are the only ones with access to the bank bag. The PT Clinic is locked at all times, requires a key to unlock it, and keys are limited.
    3. Deposits.
      1. Must be made within three (3) business days no matter what the total amount. Any time that receipts are over $200, they must be deposited that day. Deposits are typically made the morning of the next business day following a clinic visit.
      2. Clinic manager or student employee receptionist prepares the deposit and it is re-checked for accuracy.
        1. Total in the ledger is balanced to the individual receipts and to the deposit amount.
        2. Deposit form references the receipt numbers and the ledger page numbers.
        3. Cash overages or shortages, if they occur, are recorded on the deposit form.
        4. Deposit date on the deposit form refers to the date received by the Business Services Office (not the clinic date/s).
        5. PT Clinic manager brings deposit to the Business Services Office or may contact Security to deliver it.
      3. Deposit is verified by the Business Services Office staff.
      4. Checks are stamped in the Business Services Office.
      5. Deposits are credited to cost center/object code: 011053/9378.

Subpart E: Accounts Receivable

    1. Patients are expected to pay on the day of service.
    2. If they do not have the funds to make payment, patients are expected to pay at their next visit. If a patient does not pay, the service is considered no charge.
    3. Invoices for past due balances are not sent to patients.
    4. Infrequently customers pay in advance for future services. In these instances:
      1. Funds recorded on the deposit form reflect the day payment is made.
      2. Prepayments are tracked in the ledger.
      3. Refunds are not given to clients if they do not return for services.

Part 3: Internal Mitigating Control

Ideally staff that does not have access to the cash drawer should prepare deposit, but this is not possible due to small staff. Mitigating controls are in place to verify deposits against the ledger and ISRS reports.

Subpart A: Purpose. To conduct an independent review of the ledger to the deposit form and the deposits recorded in ISRS.

Subpart B: Procedure. The internal mitigating control is conducted by the Business Services Office staff. An Account Clerk, Senior from the Business Services Office conducts audit tests of the deposit at least twice each semester (mid-semester and after the last clinic).

Step 1

    1. A random selection of at least 10% of the daily deposits (at least two per month or 8 per semester) will be identified for audit; if time allows, all entries are verified.
    2. Ledger pages are verified to ensure that there is a page for each clinic date.
    3. Deposit forms are verified with numbered pages in the ledger, receipt numbers, and amounts to ensure that all charges paid were deposited.
    4. Receipt numbers are tracked and verified to ensure that all consecutive numbers have been used.
    5. Verify that $200 has not been received per day or in total without a deposit made.
    6. Verify that deposits are made no later than three (3) business days after receipt.
    7. Any discrepancies are to be reported to the Director of Business Services.
    8. An Audit Test Log is used to summarize and match the data.

Step 2

    1. Audit Test Log is completed and includes the following:
      1. Days in the semester that the clinic is open.
      2. Daily receipt totals from the ledger by date.
      3. Deposit totals by date.
      4. Daily receipt totals matched to the deposit totals.
    2. Run ISRS report AC0530CP for 011053/9378.
      1. Deposit amounts and dates entered on the Audit Test Log.
      2. Daily receipts totals compared to the deposit amounts and dates.
    3. Any discrepancies are investigated and reported to the Director of Business Services.
    4. Audit test logs are retained for four years.

Step 3

    1. At least once each semester, the Business Services Office staff conducts an audit of the cash on hand, if any cash has been disbursed to the PT Clinic.
    2. Dates of cash audits and results are entered into the Audit Test Log.

Step 4

    1. Director of Business Services is notified each time the independent reviews/audits are completed.

Date Implemented: June 10, 2015