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Kaiser Foundation Health Plan of the mid-Atlantic States, Inc.
REQUEST FOR AMENDMENT OF PROTECTED HEALTH INFORMATION
Patient Name:
Health Record Number:
Patient Address:
Phone #: (H)
(W)
DOB:
After
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How to fill out health record number
How to fill out a health record number?
01
Locate the section for the health record number on the form or document.
02
Enter the assigned health record number in the designated space accurately.
03
Double-check the number to ensure it is correctly written and there are no errors.
04
Make sure to follow any specific formatting instructions, such as including hyphens or spaces between digits if required.
05
If you are unsure about your health record number, contact your healthcare provider or institution for assistance.
Who needs a health record number?
01
Patients: A health record number is necessary for individuals seeking medical care or treatment. It serves as a unique identifier for their medical history, allowing healthcare professionals to access and manage their records efficiently.
02
Healthcare Providers: Health record numbers are crucial for healthcare providers as it helps them accurately identify and maintain records for their patients. This number is used to ensure that the correct medical history and information correspond to the right person.
03
Health Institutions: Hospitals, clinics, and other healthcare institutions require health record numbers to manage their patients' records effectively. These numbers enable the storage and retrieval of medical data efficiently, ensuring seamless healthcare operations.
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What is health record number?
Health record number is a unique identification number assigned to an individual's medical record.
Who is required to file health record number?
Healthcare providers are required to file health record numbers for their patients.
How to fill out health record number?
Health record numbers are typically filled out by healthcare providers during a patient's visit or when creating a new patient record.
What is the purpose of health record number?
The purpose of health record number is to accurately identify and track an individual's medical history and treatment records.
What information must be reported on health record number?
Health record numbers typically include the patient's name, date of birth, medical history, and treatment information.
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