Amending the Medical Record Despite best efforts and good intentions for perfect documentation at the time of service, errors and omissions occur. When that happens, the situation has its own documentation requirements. Failure to properly amend the medical record may give the appearance of falsifying documentation, which is considered fraudulent. CMS has direct guidance for…
Amending the Patient Record
Sometimes in our busy day-to-day life, patients don’t remember the details of their health record. This is one reason for the portability of health records…to be able to glean information from provider to provider in an effort to have the most complete health record. What if the patient failed to mention something? What now? Don’t…
Amendments-Corrections-Delayed Entries
Download Reference Documents Medicare understands, Chiropractors can be wonderfully effective providers, yet they often make unforced errors in the documentation like other doctors do. Also, it’s clear that providers may become aware of pertinent patient information needed to add to a completed note. This Reference Document is Medicare’s own Change Request document that outlines exactly…
Amending the Patient’s Record
Sometimes, “Adjustments” are Necessary Despite best efforts and good intentions for perfect documentation at the time of service, errors and omissions occur. When that happens, the situation has its own documentation requirements. Failure to properly amend the medical record may give the appearance of falsifying documentation, which may be considered fraudulent. CMS has direct guidance…