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PRINTED: DEPARTMENT OF HEALTH AND HUMAN SERVICES01/05/2012FORM APPROVEDCENTERS FOR MEDICARE & MEDICAID SERVICES OMB NO. 09380391STATEMENT OF DEFICIENCIES(X1) PROVIDER/SUPPLIER/LIGAND PLAN OF CORRECTIONIDENTIFICATION
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Start by gathering all relevant clinical records and documents.
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Review the format and structure of the clinical record you are working with.
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Begin filling out the clinical record by entering basic patient information such as name, age, gender, and contact details.
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Follow the instructions or guidelines provided to accurately document the patient's medical history, including any pre-existing conditions or chronic illnesses.
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Record the patient's current symptoms or complaints, along with any relevant observations or physical examination findings.
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Use appropriate medical terminology and abbreviations, ensuring clarity and accuracy in your documentation.
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Double-check the completed clinical record for any errors or missing information before submission.

Who needs based on clinical record?

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Clinical records are needed by healthcare professionals, including doctors, nurses, and specialists, to provide appropriate medical care and treatment to patients.
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Based on clinical record refers to information or documentation that is derived from a patient's medical records and is used as the basis for decision making or reporting.
Healthcare professionals or facilities are typically required to file based on clinical record to maintain accurate and up-to-date patient records.
To fill out based on clinical record, healthcare providers must carefully review the patient's medical records and accurately document any relevant information.
The purpose of based on clinical record is to ensure that healthcare providers have access to accurate and comprehensive information about a patient's medical history and treatment.
Information that must be reported on based on clinical record includes diagnosis, treatment plans, medications prescribed, and any other relevant medical information.
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