What is placed in the chart to show who has authorization to make changes to patient information?
a. A signature card
b. An authorization form
c. An authorization to document form
d. An authorized user form
Answer: a
Health Professions
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Which of the following documents is usually found only in the problem-oriented medical record?
Progress notes Problem list Diagnostic reports Medical history
Health Professions
Which is a legal consideration that applies to the retention of health care records?
A) Available storage and methods of destruction. B) Decision made by the health information committee. C) Length of time required by statute and regulation. D) Policy established by the health care institution.
Health Professions