DON SELF'S FREE DOCUMENTS PAGE,
LAST UPDATED August 18, 2010
Before you scroll down to the hundreds of free documents, forms, jokes, offers, etc..., we need to talk about what is happening today in our economy and how that is affecting almost every medical office you know.
This has physicians, managers, CFOs and others worrying about the future. By now - you know some physicians that have closed their business or have retired early because they are scared. Some are doing their best to hang on and looking for answers.
Some are looking for hope - but they don't know where to look. Some are trying their best to just survive, while hoping for the best - but perhaps they are looking for the wrong hope?
When, they should be looking in a different direction!
Perhaps it is time that more of us consider that we have been looking to ourselves for answers, but we need to be asking someone else for help.
Ok - I'm not going to go into a 62 second rapping sermon here - unless you really want to click on Tamara Lowe's One Minute Rapping Sermon which is really worth watching.
But - I am going to say that you do not have to draw in like a turtle hoping to ride this out - while laying off staff, cutting hours on staff, and pulling money out of your savings to keep the doors open.
So - don't surrender yet -
You can stand up for what you believe in and let the doomsayers know that it doesn't matter what they say, or how many of them there are - you're going to succeed!
and you are going to do a better job today of taking care of your patients than the doctors who are putting their heads in the sand are. You're going to follow the new guidelines and you're going to benefit by knowing WHERE Medicare and the other carriers have moved their money. You're going to get better medical outcomes and INCREASE your income by following the PQRI instead of doing what 95% of the other doctors are doing and just reporting it. While they are looking for the $6.00 a day bonus money from Medicare, you'll be seeing an extra $600 a day by FOLLOWING the guidelines that the others are missing.
So - cheer up - dance a jig and scroll down and see how Don Self & Associates can help you accomplish what others that believe in us are doing too.
called The Unfiltered Guide to Medical Office Management. Click on this link to see the comments received. Thank you to the hundreds of people that have bought the book and told others about it.
Web Design Note:
I have had problems getting INTERNET EXPLORER to work properly with my webpage. It works great with FIREFOX & SAFARI, but not with Internet Explorer. I had to change the HTML code so that the buttons on the left shows up twice on Firefox & Safari - or it doesn't show up on Internet Explorer if I do not.
WHAT IS OUR MESSAGE?
Physicians & managers MISTAKENLY believe that we are ABOUT to enter a PAY FOR PERFORMANCE (PFP) payments structure & we're about to go through Health Care Insurance Reform. What most do not realize is that we've ALWAYS had PFP (we were paid for performing a service) except for those foolish enough to let capitation agreements take over your practice. Many may not have realized that health care financing reform has been happening since the Balanced Budgement Amendment (BBA) of 1996. In the last 9 years, Medicare (and other payers) have moved money from procedures & visits into Evidenced Based Medicine (EBM) without telling us what they were doing. They reduced the amounts they pay on many procedures & moved that money into diagnostics, clinical lab & some imaging. Therefore - if we have continued to practice over the past few years as we always have, we noticed that we had to see more patients to make the same amount of money - or we've been seeing a decrease in our monthly deposits. The answer is simple. Practice Evidenced Based Medicine & you'll see your income increase (in an average family or internal practice) by $150,000 to $400,000 per year. The best part is that you'll be practicing BETTER medicine & capturing the problems with your patients earlier while you're increasing your practice income. This is what we are teaching thousands of physicians each year at the state & national conventions where we speak
Keith & Don are consultants. We will spend time on the phone with you & your physician, for free, asking questions to see if you're in line with the changes mandated by PQRI, AHRQ, EBM & more. This usually results in an average primary care practice increasing their net income by more than $165,000 per year.... per physician.
Please help yourself to whatever on this page that you want & feel free to donate things to us to share with others, as long as it's not copyrighted.
Do you feel like the penguin on the left & the insurance carriers are the one on the right?
DON'S PAGE HAS BEEN VISITED BY
PEOPLE.
"It is my opinion that you are one of the best assets we coders and billers have in the medical field. It is such a joy to hear someone actual speak the truth! And it shows that you actual care about what you do. You are greatly appreciated :-) - Valerie Dubsky, Goodman Gastroenterology, Chattanooga, TN
CODERS & MANAGERS, MAKE YOUR JOB EASIER & QUIT GIVING YOUR DOCTOR AN ULCER OR HIGH BLOOD PRESSURE.
E&M Coding is very simple, yet so many only know it to be confusing. Your doctor is trying to do a good job - so make it easier on them by
using the E&M Sliderule. I have taught thousands of physicians in the last 9 years using this sliderule & doctors can usually learn all they
need to know about E&M documentation within 20 minutes using this tool - & they LIKE it. Click on the image below to go to a page showing how to order it.
Order them for $12.50 each plus s/h by clicking on the sliderule
JOIN MORE THAN 450 OTHER BILLERS, CODERS, MANAGERS, PHYSICIANS, NON PHYSICIAN PROVIDERS, ETC... ON DON'S LISTSERV (ALSO CALLED A FORUM) FOR FREE. YOU'RE WELCOME TO JOIN, BUT PLEASE TELL ME WHAT SPECIALTY & HOW YOU HEARD OF IT WHEN APPLYING.
HERE ARE THE FORMS, IN ALPHABETICAL ORDER - NOTE THAT 2010 MEDICARE DATA IS LISTED BEFORE THE "A"s..
If the file is in a that your browser will not read, RIGHT-CLICK your mouse on it & click on "SAVE AS" or "SAVE LINK AS" in order to save it to your computer in order to open it in the appropriate program.
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CHART QUOTE: "The baby was delivered, the cord clamped & cut & handed to the pediatrician, who breathed & cried immediately".
I started to skim over Don's book at noon, and could not put this down. It not only is straight-forward, honest, and real life situations, it has such a great sense of humor with it, saying the things we ALL think and want to say but are "filtered" to actually not say. I would recommend this book to physicians, staff, clinicians, coders, billers, administrators, and anyone else in or considering a career in the Medical Field. It was a pleasure to read and I endorse it 100%! I will be encouraging all to buy it once you have it available. - -
Terry Fletcher, BS, CPC, CCS-P, CCS, CMSCS, CCC, CEMC, CMC - - CEO/President Terry Fletcher Consulting, Inc.
Managing a medical practice in the 21st century is perhaps the most complex of all business endeavors. In his new book, “The Unfiltered Guide to Medical Office Management”, Don Self has managed to provide both a tool and a guide for those so inclined to tackle this challenge. Cutting through the maze of confusion, complexity and confounding rules and regulations, Don’s book is a must-read for anyone wanting to assume hero status within their medical practice. -- Frank Cohen, MIT Systems, Inc.
RVU fILEexplanation, showing the description of each column of the RVU file in pdf. added 12/29/09 - 236kb
MEDICARE PQRI - see PQRI below -
CHART QUOTE: "Patient has two teenage children, but no other abnormalities. "
99211 PowerPoint Presentation on when it is appropriate & when it is not appropriate to use 99211, by Lori Hoyt - who did an EXCELLENT job on this & donated it to the site
I think managers and physicians would be hard-pressed to find this amount of information available in one book. The Unfiltered Guide to Medical Office Management is the "bible" of medical office management! What you have successfully developed is a comprehensive guide to just about all aspects of physician billing, coding, collections and compliance in one easy to read (and entertaining) tome! Just implement a few of these tips and you are on your way to a more efficient practice. Don has provided information on increasing revenue and sharpening efficiency...both extremely important in these tough times. -- Charlene Endre-Burgett, MS, CMA (AAMA), CPM, CPC, CMSCS, - Administrator, North Scottsdale Family Medicine
ACRONYMS Used in FEDERAL REGISTER with the 2005 Medicare Fee Schedules
ABN - FOR EVERYONE This is required (since Sept 1, 2008) where Medicare payment is expected to be denied for medical necessity reasons. The revised ABN replaces the 2002 ABN-G (Form CMS-R-131G), ABN-L (Form CMS-R-131L), & NEMB (Form CMS-20007) - in Adobe (PDF)(47KB).
CHART QUOTE: He had a left-toe amputation one month ago. He also had a left-knee amputation last year.
ANCILLARY INCOME chart listing services that most practices can & should be performing in their office, with income potential & costs, donated by Miheer Shah, Director
Strategic Medical Management, Inc./RapidCare
APPEALS BOOK - THE ART OF APPEALS in PDF, written by Steve Verno, CMMB, CMMC, NREMTP & released by the BC aDVANTAGE - ADDED on 11/12/09.
Audit Forms/Instructions Excellent chart auditing form in Word, along with instructions, submitted by ?. This form will help on cpt coding as well as medical documentation.
Audit Worksheet - Emergency Room This is a very useful (48KB) worksheet (WORD) to use, donated by Charlene Burgett, BS,CMA,CMM,CPC,CCP
BC/BS LETTER Letters sent by Georgia State Board of Ins. & BC/BS about the automatic downcoding they did. This is the same one that was being faxed by Anne Robinson. It is in PDF
"The Unfiltered Guide To Medical Office Management" written by Don Self will keep you interested, give you knowledge and make you laugh at the same time. I have read many practice management books over the past 9 years and this book is a keeper. I would advise any practice manager to make this small investment for their career.
-- Desiree R. Baylin, CMOM, CPM-HRS, Executive Director, Physician Office Managers Association of America (POMAA)
Cardiology New patient Form in Excel by Jean Stoner.
CHART QUOTE: On the second day the knee was better & on the third day it had completely disappeared.
Cardiology Est patient Form in Excel, also from Jean Stoner Jean did a great job on these forms! (35KB)
The AMBA also help doctors in the following areas: medical coding information, cpt code usage, claim processing data, tips on electronic medical billing, links to billing services, hipaa compliance & HIPAA compliance, denial by carriers, executive healthcare information & more
used by the physician to record care plan oversight services rendered each month in RTF.
CHART QUOTE: She is numb from her toes down.
CARE PLAN OVERSIGHT FORM used by the physician to record total care plan oversight services rendered each month , which is necessary for medical reimbursement & proper cpt coding.
CHARITY POLICY & APPLICATION used by a Radiology practice in Washington that not only explains what the law is about charity write-offs, but also gives the application & criteria for poverty levels - submitted by Michelle Juette
CLAIM FORM INSTRUCTIONS FOR NEW CMS 1500 - previously called HCFA 1500 claim form in HTML, for the new claim form.
Code Of Conduct and example being used by some offices to show compliance with OSHA, HIPAA, privacy laws, etc. from Joyce Kyle (Indiana)in WORD. Code Of Conduct For Employees in Wordfrom Daryl Ewing in Houston.
YOUR DOCTOR IS CONFUSED ABOUT THE CODING DOCUMENTATION REQUIREMENTS - DOWNLOAD SOME OF THE FOLLOWING E&M CODING ASSISTS & THEN CHECK OUT THE OFFER WE HAVE AT THE TOP OF THE PAGE ON E&M DOCUMENTATION SLIDERULES. YCALL MSI (MEDICAL SOURCE, INC) WHO SPECIALIZES IN ASSISTING IN MEDICAL CODING REVIEW, CPT CODING, CPT CODE USAGE, CLAIM PROCESSING DATA, ELECTRONIC MEDICAL BILLING, HIPAA COMPLIANCE & MORE
called The Unfiltered Guide to Medical Office Management as that helps support the funds he spends for this website he offers to you for free. Click on this link to see the comments received. Thank you to the hundreds of people that have bought the book and told others about it.
“Complete practice management, authoritative and experienced writings are difficult to come by. Don’s book is one that qualifies. All in healthcare management should read it.” Terry McVey, President, McVey Associates, Inc.
Compliance Plan & This 32K text file is a product of Sheila, Susan & Todd. Will it keep the HCFA Gestapo from nailing you in an audit? Who knows - but since they put so much work into it - I added it to the page
CO-PAY, DEDUCTIBLE ∓ WAIVER INSTRUCTIONS & FORM This is an excellent guide, reference & waiver to use on charity cases, submitted by Sherry Straub,(31K). See also - Charity form above for a different guide to waiving co-pay and deductibles
CHART QUOTE: "When she fainted, her eyes rolled around the room."
CHART QUOTE: Whilst in Casualty she was examined, X-rated & sent home.
CO-PAY-LETTER to send to insurance carriers notifying them that the policyholder has not paid the co-pay or co-insurance, donated by Laura Bassett, RMM
.
C.P.O. (CARE PLAN OVERSIGHT) FORM used by the physician to record care plan oversight services rendered each month, in RTF. This form is necessary if bill for G0181 but not for G0179 or G0180
CLICK
HERE TO SEE HOW DON HAS A BETTER THAN 86% SUCCESS RATE, WITH HUNDREDS OF PHYSICIANS IN GETTING RID OF MIGRAINE HEADACHES WHEN PATIENTS HAVE AT LEAST ONE A WEEK
DEATH PRONOUNCEMENT and whether you can bill for it or not (In WORD) thanks to Gregory L. Schnitzer, RN, CPC, CPC-H, CCS-P, RCC.
Great info and in a very easy read format. Along with their diploma, Don's book, the Unfiltered Guide to Medical Office Management, should be given to all medical school graduates. I only wish we had this type of practical information available when my husband started his practice! Marvel J Hammer RN CPC CCS-P PCS ACS-PM CHCO MJH Consulting Denver, CO
DIAGNOSTIC TEST INTERPRETATION rules of Medicare for ERs - telling Medicare to pay for the interp actually used in the treatment & not just an interp used as quality control. Radiologists will not like this rule that most people are not aware of. In PDF- from CMS MCM 15023.
Drug Pricing by NDC in Microsoft Excelin a zipped file. This Excel file is 3.5 megs when unzipped & 957kb when zipped. It was donated to the site by Jacqueline C. Langlois, RN, MSN, CRNI with Mass Med Legal. - - Added 3/24/02
E & M DOCUMENT TABLE This nifty table was submitted by Deb Martinez on 10/7/99 & many will find this easy to use.
CHART QUOTE: "Patient was released to outpatient department without dressing."
E & M HISTORY This form submitted by Stephanie L. Fiedler, CPC, ASC-EM & it is.
E & M WORKSHOP HANDOUT - - - This is the 34 page seminar workbook Don drafted up (garnering info from everyone I could)(135kb) (106KB).
E&M Utilization files - see UTILIZATION PER SPECIALTY for the link to a special page.
Emergency Medicine Documentation Guide for Office 95by Martin Gottlieb called 1998doc.doc. (141kb)
Emergency Room Acuity worksheet in Excel, donated by Mimi Tytko (19kb) Emergency ROOM Acuity worksheet, also donated by Mimi Tytko (63kb)
Emergency ROOM Code Utilization listed by State on ERCODER.COM website run by Todd Thomas, whom I trust more than any other for ER coding answers, added 10/6/06.
EMPLOYEE QUIZ - A quiz (in WORD) to give to prospective employees or to use to test your existing employees donated to the list by Deb Lief in Fort Worth. Be careful though that some lane brane prospective employee with an IQ equal to their shoe size doesn't hire a liberal ACLU certified attorney (looking to save the world for people that refuse to accept personal responsibility) to sue if they fail the test
EMPLOYEE REPRIMAND FORM - This form can be used when warning an employee about improper behavior or when you're not satisfied with their job performance
ENCOUNTER FORM - An EXCELLENT encounter form to use for documentation that prompts the doctor to document all healthcare reimbursement elements needed for the E&M encountercalled encountr.doc by Sandy Turpin.
Encounter Form Maker is one of the easiest programs we have seen for helping offices prepare, update & design superbills & encounter forms. I've created hundreds of different superbills in my earlier career as a Superbill salesman with Controlo-o-fax, & I only wish I had this program back then.
ENCOUNTER FORM 2 - Another EXCELLENT encounter form to use for documentation that prompts the doctor to document all elements needed for the E&M encounterdonated by Deborah Hill in Georgia.
for diagnostic tests - telling Medicare to pay for the interp actually used in the treatment & not just an interp used as quality control. Radiologists will not like this rule that most people are not aware of.- from CMS MCM 15023.
CHART NOTE: "The patient has no past history of suicides."
ERISA - HOW TO APPEAL YOUR CLAIM & MAKE THE CARRIERS PAY YOUR CLAIM IN FULL (NOT JUST ALLOWED OR UCR) USING THE 1974 LAWS IN PLACE THAT THEY HAVE TO OBEY. CLICK ON THE IMAGE BELOW, & BE SURPRISED. YOU'LL PROBABLY WIN ON AT LEAST 80% OF YOUR APPEALS - REGARDLESS OF THE REASON FOR DENIAL OR REASON THEY REDUCED THE PAYMENT.
ERISA WEBINAR , handout in pdf, created by Dr. Jin Zhou in mid January, 2010. Dr. Jin is an expert at ERISA
EVALUATION FORM FOR EMPLOYEES - A tongue-in-cheek employee evaluation formby Don - feel free to add to, modify or alter this form. It's not copyrighted.
This information is fantastic. It's exactly what office managers and physician's need to read and hear in these troubling economic and litigious times. Proper reimbursement has become the most difficult task for every physician's practice. Way to go Don!" John Bishop, P.A.
HCFA Memo re. E&M documentation from Dr. Kanoff submitted by Linda Howrey. If prefered - get it in
TEXT HCFA'S memo format. I have to say - in all of the time I've seen stuff from Linda - I've never seen it incorrect - she's one of the brightest bulbs on the Christmas tree
HIPAA NPP (NOTICE OF PRIVACY PRACTICE 2 PAGE final, donated by Jennifer Humbert - added March 10, 2003, & required if practices intend to be HIPAA COMPLIANT.
7 PAGE, donated by Dr. Herbert Schwarz - He does HIPAA consulting with HIPAA TODAY & his phone is 714-838-4259 (O). This file was added March 11, 2003
CHART QUOTE: "The patient experienced sudden onset of severe shortness of breath with a picture of acute pulmonary oedema at home while having sex which gradually deteriorated in the emergency room. "
This book is the fasttrack to moneytown. You've done what I’ve wanted to write about for years. Steve Verno
HIPAA NPP in SPANISH using WORD, donated by Cindy Weston with The American Medical Billing Associaton (AMBA)- Their site is http://www.ambanet.net.
MEMO PER CMS, donated by Diane Brooks. This letter in pdfis dated in 1991 from CMS
HOSPITAL HCFA'S RULES RE. CLASSIFYING ENTITY AS HOSPITAL OUT-PATIENT OR PHYSICIAN CLINIC
HPI Letters discussion whether it is allowed to count one item notated in the documentation under both, the HPI & the ROS. One of these letters is from Bart McCann, who used to be with HCFA. It is in PDF, so Adobe Acrobat or Acrobat Reader is needed. This is vital to know for proper claims processing & Healthcare Reimbursement
CHART QUOTE: "Many years ago the patient had frostbite of the right shoe. "
If you know someone suffering from IBS - check out LEAP on the top left menu on this page - We have a better than 81% success rate!
LAB ICD9 DIAGNOSIS CHEAT SHEET - THIS IS THE FORM - THAT ADEL MILES HAS BEEN FAXING TO PART B LISTSERV MEMBERS ALL OVER THE COUNTRY. IT IS CALLED LABDX.DOC - - -
that Don Self manages. It's free & it is a great way to network with other offices about Healthcare Reimbursement, medical billing & claim processing as well as executive healthcare issues. We discuss medical coding information, cpt code usage, claim processing data, tips on electronic medical billing, links to billing services, hipaa compliance & HIPAA compliance, denial by carriers, executive healthcare information & more.
One of the ways that Don stays on top of changes is through Internet Listservs. This link will go to a site that not only has a listserv for just about any specialty, & they also deal with medical coding information, cpt code usage, claim processing data, tips on electronic medical billing, links to billing services, hipaa compliance & HIPAA compliance, denial by carriers, executive healthcare information & more
but also they publish some excellent newsletters, publications & consulting.
For the very best in Podiatry coding, medical billing, claim processing & healthcare reimbursement business matters, become a member of the Codingline community, run & managed by one of the very best in the business - Harry Goldsmith, DPM
LOCALITIES - MEDICARE in Excel, listing the different carriers, carrier numbers, localities, states, etc.
MANAGED CARE CONTRACTING TIPS & the top 10 reasons why we should tell Mangled care companies NO,, donated by Patricia Nelson
Multi-Specialty Exam Form in Microsoft Word/Wordpadin a self-extracting file by Bill Cox (21KB) This is not a test to give physicians to see if they can name all the specialties
YOU GOTTA LAUGH
New York, NY During a police lineup, a detective told each man to step forward & repeat the threat delivered at the robbery: "Give me all your money or I'll shoot." One man stepped forward & yelled, "That's not what I said!"
in Microsoft Excelin a zipped file. This Excel file is 3.5 megs when unzipped & 957kb when zipped. It was donated to the site by Jacqueline C. Langlois, RN, MSN, CRNI with Mass Med Legal.
in Kansas/Nebraska/NW Missouri. This document file contains an excerpt from their September 1999 Special Bulletin - submitted to this site by Savannah Seins, CPC in August 2000.
New Patient History Form (41KB) It has the standard questions such as "Were you born? Did you have a mother? Have you made out a will?"
NO-SHOW Information regarding Medicare & CMS, added 4/15/08, thanks to Cyndee Weston with the American Medical Billers Association
NO-SHOW Divorce Letter to patients to explain why you're divorcing them (20KB) Added 4/23/02
NO-SHOW Referral Letter to other physicians that requested your consult, informing them that their patient never showed up for the appointment (20KB) Added 4/23/02
OB/GYN Guide in TEXTby Judy Harris. (8KB) - OK - one bit of advice to the guys .... If you're wife's expecting & you're going to be in the room with her when she gives birth - remove your wedding ring before putting the scrubs on - It will save the husband some pain - BELIEVE ME!!!
PODIATRY LISTSERV - FREE TRIAL OFFER CodingLine has more than a dozen coding experts (most of which are Podiatrists, Seminar Leaders & Consultants). By clicking on this link, you will be taken to a site where you can sign up for a free trial of this Podiatry Listserv. Since it's free - you have nothing to lose by checking it out.
RED FLAG LAW POLICY & PROGRAM Form in PDF. The new 2009 Red Flag - Identify Theft laws went into effect January 1st, to help ensure that patient identify theft is guarded against & it does apply to medical offices - including the 1 doctor practices. The enforcement date changed from May 1st to August 1st - but you need to establish some kind of policy in your office before August 1st & this is an example you're welcome to use & change to suit your needs - for free - from Don - -
Refund Request Response letter Excellent Letter -- -(10kb) - This one really kicks the insurance carriers in the butt! If you like it - you should check out www.appealsolutions.com as they have these specific to each state!
Review Of System form that you have each patient complete on every visit & place into the patient's chart. Not only will you meet every requirement for ROS, but also the PFSH on each visit, as well as serve as a reminder of certain items for the doctor when they are tired & forgot to ask or document by Don Self -- -(34kb) -
SCRIBES CAN BE USED on Medicare patients, per this letter from HCFA in RTF, called scribes.rtf - donated to the site by Deena Wojtkowski, CMA, CCP
WELCOME TO MEDICARE EXAM SYNAPSIS, updated 1/4/05, donated by Charlene Burgett, BS, CMA, CMM, CPC, CCP.
WELCOME TO MEDICARE PATIENT INFORMATION & CONSENT FORM in Word, updated 3/3/05, donated by Charlene Burgett, BS, CMA, CMM, CPC, CCP, who credits it to Steve Cooper at Towncrest Internal Medicine in Iowa City, Iowa. Thank you Steve!
Appeal Solutions has spent
hundreds (if not thousands) of hours researching the legal
issues concerning Healthcare Reimbursement, medical billing, claim processing, insurance claim collections, insurance
appeals & laws to protect the patient & provider. They
offer sample letters on their website, copies of letters &
software to assist you in winning the fight against
carriers
is another company that produces an excellent Healthcare Reimbursement coding product. Some prefer this program over others. They are
definitely worth checking out.
The publication or information on this Website is designed to provide accurate & authoritative information in regard to the subject matter covered. It is presented
and published with the understanding that the author & publisher are not engaged in rendering legal, accounting or other professional service or advice. If legal advice or other expert assistance is
required, the services of a competent professional person should be sought.
We're not employees of, or in affiliation with any governmental or regulatory agencies.
DON SELF &
ASSOCIATES, INC is not a law firm. We do not practice law. We are not actors on a law show. If legal action or advice is required to successfully resolve a claim or a
claim/business decision, we will refer out our client to an outside legal counsel chosen by our client.
We do not teach, advise or participate in illegal, unethical or immoral coding & billing
practices of your health care claims & practice. We advocate proper coding, billing & reimbursement techniques applicable to federal & state laws.
We have assisted the OIG & CMS in
identifying fraudulent billing activities & will continue to assist law enforcement to curtail illegal, immoral & unethical billing practices. Accordingly, we are also aware of the OIG:
Special Advisory Bulletin: Practices of Business Consultants [PDF]