- Documents the results of treatments and patient's progress.
- Basis for decisions regarding the patient's care and treatment.
- Efficient and effective method by which information can be communicated between authorized personnel.
What are four purposes of medical records?
Jan 31, 2020 · The medical record serves as the central repository for planning patient care and documenting communication among patient and health care provider and professionals contributing to the patient's care.
What are the primary uses for the medical record?
Dec 05, 2018 · The Purpose and Meaning of Medical Record Documentation. Keeping a complete medical record of all treatments and conditions to which a resident is subjected is not only good ethical practice and a legal requirement—but can also play a major role in protecting a Skilled Nursing Facility (SNF) from legal trouble.
What is the secondary purpose of health records?
Mar 30, 2016 · The primary purpose of the health record refers to the the purposes for which the information was collected to begin with. Such purposes typically include the provision of adequate and appropriate medical care requested by the patient or deemed necessary for the patient based on the record’s contents.
What is the importance of medical records?
A medical record provides continuity of care between providers and other healthcare professionals by documenting the patient's history, diagnoses, and treatments.
What is the purpose of a medical record?
What is the primary purpose of medical documentation?
What is the purpose of the medical record quizlet?
What are the four purposes of medical records?
- Communicates with other health care personnel. Documentation communicates the what, why, and how of clinical care delivered to patients. ...
- Reduces risk management exposure. ...
- Records CMS Hospital Quality Indicators and PQRS Measures. ...
- Ensures appropriate reimbursement.
Which of the following is an example of a primary purpose of the health record group of answer choices?
Which of the following is one of the three main purposes of a medical record?
Why is a medical record important?
The medical record provides an efficient and effective method by which information can be communicated to authorized personnel in the medical office. The medical record also serves as a legal document. The law requires that a record be maintained to document the care and treatment being received by a patient.
What is a medical record?
A medical record is a written record of the important information regarding a patient, including the care of that individual and the progress of his or her condition. A patient is defined as an individual receiving medical care.
What is a patient in medical terms?
A patient is defined as an individual receiving medical care. The patient’s medical record serves many important functions. The physician uses the information in the medical record as a basis for decisions regarding the patient’s care and treatment.
What is the HIPAA Privacy Rule?
HIPAA is a federal law consisting of several components, one of which contains provisions to protect a patient’s privacy, known as the HIPAA Privacy Rule. The HIPAA Privacy Rule went into effect on April 14, 2003.
What are the components of a medical record?
Each document in the medical record has a specific function or purpose. Most of these documents are preprinted forms or computer templates that contain specific information entered by a physician or other health professionals.
What is medical office administrative?
Medical Office Administrative Documents. Administrative documents contain information necessary for the efficient (record-keeping) management of the medical office. Medical office administrative documents include the patient registration record and patient-related correspondence.
What is administrative document?
Administrative documents contain information necessary for the efficient (record-keeping) management of the medical office. Medical office administrative documents include the patient registration record and patient-related correspondence.
