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The types of things that you will find under Hr Forms

Authorization Agreement For Automatic Payroll Deposit

Benefit Booklet

Benefit Enrollment Form

Employee Benefit Premiums

Employee Performance Evaluation

Employment Interview

Flexible Spending Account Enrollment

Guidelines for Hiring New Employees

I-9 Employment Eligibility Verification

Incident Report

Leave Request Form

New Employee Checklist

Notice of Disciplinary Action

Notice of Written Warning

Personnel Position Change Notice

Reference Check

Termination and Discharge Checklist

Visitor Check In Sheet

New Hire I.T. Information Sheet

W-4 2004

I.T. Termination Sheet

Employee Hand Book Receipt

Mileage Reimbursement Form

Job Requisition

Employee Evaluation Form Page 1

Employee Evaluation Form Page 2

Employee Evaluation Form Page 3

Employee Evaluation Form Page 4

Employee Status Change FMLA WH380

Employee Privacy and Security Questionnaire FMLA WH381

Expenses Medical Release

2005 Benefit Booklet 2005 Coverage Grid

Unusual Occurrence Front Page Unusual Occurrence Back Page

Etc.

The types of things under Provider Information

Preferred Health Systems Manual

Etc.

The types of things underHR Handbook

Welcome Section 10

Managements Goals and Employees General Obligations Section 11

At-Will Employment Statement Section 12

Equal Employment Opportunity Section 13

Workplace Harassment Section 14

Recruitment Section 15

Policy for Hiring Related People Section 16

Medical and Other Examinations Section 17

Fitness for Duty Section 18

Promotion Section 19

Transfers Section 20

Job Trial Period Section 21

Seniority Section 22

Position Type and Employee Status Section 23

Hours of Work Section 24

Outside Employment Section 25

Employee Orientation Section 26

Smoking Section 27

Personnel File Policy Section 28

Electronic Communication Section 29

Internet Use Policy Section 30

Pay Computation and Procedures Section 31

Pay Adjustments Section 32

Work Premiums Section 33

Employee Benefits Section 34

Vacation Leave Section 35

Sick Leave & Personal Leave Section 36

Holidays Section 37

Family Medical Leave Section 38

Funeral Leave Section 39

Inclement Weather Conditions Section 40

Military Leave Section 41

Court Leave Section 42

Leave of Absence Section 43

Requesting Leave Section 44

Training and development policy Section 45

Performance Evaluation Section 46

Employee Conduct Section 47

Substance Abuse in the Workplace Section 48

AIDS Section 49

Employee Termination Section 50

Discipline Section 51

Grievance/Dispute Resolution Procedures Section 52

Employee Safety and Health Section 53

Security Section 54

Receipt Section 55

Entire Manual

The types of things under HR Policies

Section 10.01 Group practice administrator's letter

Section 11.00 Code of ethics statement

Section 12.00 Human resource responsibilities policy

Section 12.01 Personnel rules amendment policy

Section 14.00 Termination statement for personnel policy manual

Section 15.00 Job classification policy

Section 16.00 Equal employment opportunity and affirmative action policy

Section 17.00 Workplace harassment policy

Section 18.00 Recruitment policy

Section 19.00 Selection policy

Section 19.01 Reference policy

Section 19.02 Policy for hiring related people

Section 20.00 Health examination policy

Section 20.01 Fitness for duty policy

Section 21.00 Promotion policy

Section 22.00 Transfer policy

Section 23.00 Job trial period policy

Section 23.01 Promotional trial period policy

Section 24.00 Seniority policy

Section 25.00 Position type and employee status policy

Section 26.00 Hours-of-work policy

Section 27.00 Outside employment policy

Section 28.00 Employee orientation policy

Section 29.00 Smoking policy

Section 30.00 Employee privacy protection policy

Section 30.05 Electronic communication policy

Section 30.06 Internet use policy

Section 31.00 Record-keeping policy

Section 32.00 Job evaluation policy

Section 33.00 Pay computation policy

Section 34.00 Pay adjustments policy

Section 35.00 Work premiums policy

Section 36.00 Employee benefits policy

Section 37.00 Vacation leave policy

Section 38.00 Requesting Leave

Section 39.00 Holiday policy

Section 39.05 Family medical and leave policy

Section 39.06 Funeral leave policy

Section 40.00 Substance Abuse in the Workplace

Section 41.00 Military leave policy

Section 42.00 Court leave policy

Section 43.00 Disability leave and payments policy

Section 44.00 Leave of absence policy

Section 45.00 Requesting leave policy

Section 46.00 Training and development policy

Section 47.00 Performance evaluation policy

Section 48.00 Employee assistance program policy

Section 49.00 Employee conduct policy

Section 50.00 Substance abuse policy

Section 51.00 AIDS policy

Section 52.00 Employee termination policy

Section 53.00 Disciplinary policy

Section 54.00 Grievance/dispute policy

Section 55.00 Employee organization and representation policy

Section 56.00 Employee safety and health policy

Section 57.00 Security Policy

The types of things under HIPPA Manual

Cover Page

Table of Contents

Introduction 1

Confidential Information 2

Privacy Official 5

Minimum Necessary Standard 6

Treatment of Personal Representatives 8

Disclosure to Individuals 10

Disclosure of PHI to Persons Involved in an Individual’s Care 11

Uses and Disclosures for Treatment, Payment and Health Care Operations Purposes 13

Uses and Disclosures in Facility Directories 16

Uses and Disclosures for Marketing Purposes 18

Uses and Disclosures for Fundraising Purposes 20

Uses and Disclosures Required by Law 21

Disclosures for Public Health Activities 22

Disclosures About Victims of Abuse, Neglect or Domestic Violence 24

Disclosures for Health Oversight Activities 26

Disclosures for Judicial and Administrative Proceedings 27

Disclosures to Law Enforcement Officials for Law Enforcement Purposes 29

Uses and Disclosures About Decedents 32

Uses and Disclosures for Organ Donation Purposes 33

Uses and Disclosures for Research Purposes 34

Uses and Disclosures to Avert Threats 36

Uses and Disclosures for Specialized Government Functions 38

Disclosures for Workers’ Compensation 40

Disclosures to Business Associates 41

Disclosures of De-Identified PHI 43

Authorizations 45

Limited Data Set 48

Verification Requirements 50

Notice of Privacy Policies 52

Right to Request Confidential Communications 54

Right to Request Restrictions 56

Right to Access PHI Maintained in a Designated Record Set 58

Patient’s Right to Amend PHI 62

Record Retention 65

Accounting for Disclosures 66

Complaint Process 68

Sanctions 69

Training 70

Retaliatory Actions 71

E-Mail Usage 72

Facsimile Usage 75

EXHIBIT A MEDICAL RECORDS OFFICERS

EXHIBIT L COMPLAINT OFFICERS

authorization for use and disclosure of protected health information

Data Use Agreement

Notice of Privacy Practices (FMC Version 002)

Request for Confidential Communication

Request for Additional Privacy Protections

Request for Access to Protected Health Information

Response to Request for Access

Request for Amendment of Protected Health Information

Response to Request for Amendment

Request for Accounting of Disclosures

Employee Acknowledgement of Receipt of Policy

Accounting of Uses and Disclosure Log

Change Password

Is used to change your password.

Physicians

Is used to

FMC Website

Is a link to the FMC Homepage

Company Phone list

Has FMC phone number broken down by location

Departments

A/R

BlueShield Report

First Guard Page 1

First Guard Page 2

First Guard Page 3

First Guard Page 4

Diagnostics

Nurses

ASC

KDHE Quarterly Report

South

Southwest

Celldyn Manual

Southeast

Rosehill

Cholestech Manual

Cell-Dyn Manual

Mulvane

Cholestech Manual

Cell-Dyn 1700 Manual

Lab

Corporate Information

RAYPAX PACS System

Outlook Setup

Outlook Help

Setup Printers

Outlook Web access

Phone Guide

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