NO SHOW OR LATE CANCELLATION (within 24hrs)

Intakes/Feedback

$50 Fee 

Testing 

$350 Fee

Brain mapping/QEEG

$212 Fee

HIPAA Compliance Review 

● Employees discussing or revealing PHI or other condential information to friends or family members. 

● Employees discussing or revealing PHI or other condential information to other employees without a legitimate need to know. 

● The disclosure of a patient’s presence in the oce, hospital, or other medical facility, without the patient’s consent, to an unauthorized party without a legitimate need to know, and that may indicate the nature of the illness and jeopardize condentiality. 

● Approval must be obtained before any disclosure of PHI and/or other condential 

● information not addressed in the guidelines and policies and procedures of INPS is made. I understand that the unauthorized disclosure of patient PHI and/or other condential or proprietary information of INPS is grounds for disciplinary action, up to and including dismissal. 

● Intentional violation or failure to correct a violation may result in immediate termination as well as punitive nes ranging from $100 to $50,000 per incident. 

● Both electronic and physical les are to be accessed only for patient care or business purposes. When not in use, physical les or documents containing patient information are to be kept in a lockable cabinet, and electronic les are to be closed and password protected on computers. 

● Employees should ensure patient names and information are not in sight of other patients and clients, including information visible on desks and computer screens. Work From Home (WFH) Guidelines 

• All employees (either exempt or non-exempt) working from home are required to comply with the following guidelines. 

• Log hours worked using Homebase app ● Summarize tasks and work activities in the NOTES section of Homebase 

● Access work desktops using TeamViewer 

● Remain available by Weave and by phone while clocked in 

● Clock out for lunches and anytime away from work for any length of time. Downtime at home is not billable. If employees are not actively working, clock out. 

● While many of Rockcli Management Services’ procedures can eectively be delivered remotely, patient condentiality is critical. HIPAA has relaxed many requirements, but the following MINIMUM guidelines should be observed by sta conducting patient services via tele-health. 

• Work in an isolated location with minimal distraction/interruption, like a home oce, away from others in your home. This can be in any room in which the door can be closed. 

• Inform others in the home not to interrupt work 

• Equipment provided for the purpose of WFH cannot be used by anyone other than the employee. 

• Equipment provided for the purpose of WFH cannot be used for any reason other than Rockcli Management Services work. 

• Employees using their own equipment must ensure that no other person accesses or can access web-based accounts or logins. 

● DO NOT SAVE PASSWORDS to personal equipment. 

• Employees using their own equipment should not access non-work-related activities (i.e. social media) or 

non-work-related accounts (i.e. Amazon account) while performing Rockcliff Management Services. 

• Employees who use a personal phone to contact clients are to use the Ooma app that routes phone calls to and from the oce line. When using personal phones employees must set the phone to BLOCK their personal phone number if not able to use the Ooma app. ● When leaving messages, instruct clients to contact Fayetteville location at 479-435-6360 

● If, for any reason, an employee must use personal equipment to take a picture or scan of company documents, the images should be immediately deleted and the device’s trash emptied 

● Employees using company equipment at home are responsible for: Ensuring the equipment is maintained and in good working order. Ensuring equipment is only used by the employee for company work purposes. Returning the equipment in the same condition as it was checked out. 

*I hereby acknowledge, by my signature below, that I understand that PHI and other condential records and data to which I have knowledge and access during the course of my employment with Integrated Neuropsychological Services is to be kept condential. I further understand and acknowledge this condentiality is a condition of my employment. This information shall not be disclosed to anyone under any circumstances, except to the extent necessary to fulll my job requirements. I understand that I am legally responsible for maintaining condentiality even after I am no longer employed. 

________________________________ Date ________________________________

Employee Signature