Welcome to the Policies and Procedures Manual template for Optum’s Supervisory Protocol compliance. This template will meet the requirements by Optum for Optum’s Supervisory Protocol Compliance audit. This manual is a resource for private practices applying for a Supervisory Protocol audit, with the intention of obtaining a group contract and billing for pre-licensed clinicians under the supervision of an independently licensed clinician.
This manual provides a clear framework for the policy and procedure manual required for the audit. You will find detailed templates of the requested Supervisory Protocol policies. Each practice can adapt the policy to suit their needs and setting.
The following policies are not included in this manual template. They would be found in a private practice intake document or other resources that would be specific to each private practice:
- Description of services and goals of care
- Hours of service availability
- Cost of care
- Cancellation/no-show policy
- Type of care provided
- Quality Improvement Process
- Assessments of staff competency