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PracticumPortfolio_Eberly

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PracticumPortfolio_Eberly

  1. 1. 10/6/2016 MagnumCare of Hastings Practicum Portfolio HIT 272 Tiffany Eberly DEVRY UNIVERSITY ONLINE
  2. 2. MagnumCare of Hastings LLC. Is a for profit skilled nursing facility that houses 74 residents currently with the ability to house 106. The facility is 1 of 4 in Michigan owned by Beyond Health Care LLC. There are 1 and 2 bed rooms available with the capability to accommodate married couples. The facility itself is X shaped with the nurses station in the center allowing healthcare providers to see down each wing. One of the wings is locked for dementia/Alzheimer’s patients. MagnumCare of Hastings offers healthcare services, social and cultural activities, a full cycle rehabilitation program, nursing and restorative care, case management, and discharge planning. Additional services are also available for residents to take advantage of which include; eye care, dental care, podiatry, beauty shop, transportation, physician services, and a licensed social worker on site. They also provide respite and hospice services to those in need and accept most insurances including Medicare and Medicaid. MagnumCare of Hastings Health and Rehab Center II - Personal Objectives, Curriculum & Career Goals I – Information about the Site Role of the RHIT and Health Care Philosophy Health information technology professionals play a significant part in maintaining, collecting, and analyzing the data that doctors, nurses, and other health care providers rely on to deliver quality healthcare. They are experts in managing patient health information and medical records, determining budgets and implementing policies, administering computer information systems, and coding the diagnoses and procedures for health care services provided to patients. Degree graduates can find employment in a large number of settings throughout the healthcare industry including hospitals, physician offices, clinics, long term care facilities, insurance companies, government agencies, and home care providers. I believe that being passionate about what one does on a day to day basis is the key to happiness in life. I believe that it is of the utmost importance to never stop educating yourself, and as I currently continue to work towards my BS, I am already looking ahead to my Master’s. I believe in the vital role that HIM plays in healthcare. This role is ever changing and expanding. I am dedicated to caring for internal and external customers by providing excellent customer service and ensuring that their records are accurate, complete, protected and secure. I fully embrace an attitude of lifelong learning and I understand there is always something more to learn. The organization and protection of health information, in any form, drives quality patient care.
  3. 3. Hospital structure Medical records o Collection, Storage, and Processing Quantitative & Qualitative Analysis of Medical Records Billing & Reimbursement Administrative Meeting Personal Objective and Career Goals: • Obtain an HIM career at one of the many healthcare settings available • Pursue a bachelor’s degree in Health Administration • Become part of a healthcare organization; specifically involving a leadership or management roll. • Uphold the HIM profession & the AHIMA code of ethics Academic & Career Timeline: • 2016 - Graduate • 2016 - RHIT Certification • 2016 -Work in the HIM field while pursuing my bachelor’s degree in health administration • 2018– Obtain a bachelor’s degree in healthcare administration • 2018 – Earn my RHIA Certification (Registered Health Information Administrator) Practicum Experience Highlights
  4. 4. Attended a 3.5 hour orientation process o Each department manager introduced themselves and explained what their department was responsible for. Learned facility policies and procedures. o In case of Emergency. Learned about building structure. Department Head List Administrator – Gary Fueling Director Nursing – Brenda Miller Marketing/Admissions – Michelle Frizzell Social Services – Julie Cooper Business Office Manager – Mandy Schweizer Activities – Carla Mckelvey Dietary Supervisor – Cheryl Wymer Therapy Manager – Neily Stolicker Maintenance Director – David Cole Housekeeper/Laundry Manager – Tammie Hause Filing paperwork in charts and closed files in back file room Depositing duplicate paperwork in shredder Filling out discharge summary sheet to await proper signatures Assembling re-admit packet for former patient returning to the facility Hospital Structure TCO - 6 Collection, Storage and Processing of Data TCO - 1
  5. 5. Learned the components of the health record o Thinning schedule Breakdown of several deceased patients charts to be filed in the closed cabinets o Ensured required paperwork was included from each chart Reorganized and rechecked current patient files to be sure that everything was properly filed and correct paperwork was in correct file. Reorganized all closed files to check for misfiled paperwork Quantitative & Qualitative Analysis TCO - 2
  6. 6. Billing Office Learned about requirements for Medicare, Medicaid, Managed Medicare/Medicaid, and Private Pay Insurances Observed Resident Fund Management System o Withdrawals from resident accounts when money is requested o Observed deposits being added to the system Looked up Medicare & Medicaid claims to determine if they were paid, going to be paid, or denied. o Resubmitted denied claims for reimbursement Learned how to release claims – how to fill out UB04 electronic claims Added modifiers 59 & KX to claims before submitting them for reimbursement Checking prior authorization numbers etc. All actual coding is done by therapy department Helped Regional Business Office Manager prepare RUG reports for Medicare A, Managed Medicare A, and Medicare B for all 4 buildings. o Calculated ALOS for all 4 buildings on each report Helped Regional Business Office Manager prepare Reconciliation reports for all four Business Office Managers in all four buildings for end of the month reporting. Coding & Reimbursement TCO - 3
  7. 7. Sat in on a QPI meeting with the Director of Nursing, Social Services, Maintenance, Administrator, Dr. Eggleston-onsite doctor, and the Pharmacy rep. Discussed problem areas that need to be addressed and solutions to said problems o Director of Nursing discussed problems with falls and fractures/broken bones. Discussed shortages with nursing staff and a few solutions to fixing shortages such as agencies sending nurses, offering a tuition reimbursement program for attending the nursing program at the local college and paying for CNA certification/schooling. o Maintenance issues were also discussed such as replacing or repairing the roof. Cable installation due to switching provider companies, and moving bird feeders for a resident. o Pharmacy spoke about new prescription drugs and drug disposal of expired drugs. The facility uses several different software programs. Citrix Matrix My Ability-Medicare Medicaid Champs RFMS – Resident Fund Management System Through Citrix an employee can log in on computers in any of the four offices. Matrix Care is used for patient charting and for filing claims. There are touch screen computers mounted in each hall for nurses to chart on plus computers in all business offices and 1 in the nurse’s station. Organization & Management TCO - 9 Technology TCO - 8
  8. 8. My educational experiences with DeVry and MagnumCare of Hastings have provided me with the knowledge and tools I need to get a successful start in the HIM profession. I found the practicum experience to be very interesting and beneficial to my career goals. I very much enjoyed working at MagnumCare with Tabbie, Mandy, and Andy. They were very nice and knowledgeable. They were always available when I needed assistance or had any questions. This experience allowed me to view many sides to the HIM profession. I was able to experience the interworking of the business office and billing practices as well as gaining an understanding of the processes involved with medical records. MagnumCare is a very caring facility dedicated to their patients. The dedicated health professionals offer assistance while respecting the patient’s independence. I truly enjoyed every aspect of my Practicum experience with MagnumCare and I’m very thankful I chose DeVry for my education in this profession. Most ROI request the facility receives are from insurance companies. The requests consist of requests for physician and nursing notes, med lists, physical therapy notes etc. Ethics & Confidentiality TCO - 7 Final Analysis of Practicum Experience
  9. 9. 5 1 1 6 D ARBY RD , S ARAN AC , MI 4 8 8 8 1 5 1 7 - 5 1 5 - 2 0 2 5  TE1 9 8 1 @ ATT.NET T I F FA N Y S . E B E R LY SUMMARY Soon to be graduate with an Associates in Applied Science Health Information Technology. Excellent research, time management and problem solving skills. Highly organized with the ability to manage multiple projects and consistently meet deadlines. WORK OF EXPERIENCE Nov, 2011 to May, 2013 - Backwoods Bar. Sunfield, MI Bartender/Waitress  Cashier  Waited tables  Served food and drinks  Helped with ordering stock.  Handled customer complaints with ease.  Became one of the most requested staff while working behind the bar serving customers. Feb, 2008 to April, 2010- Wolverine Water. Lowell, MI Telemarketer  Filled in for Receptionist  Booked Appointments for sales representatives via cold calling  Filing Feb.14, 2000 to April 1st, 2003- Bishop Distributing, Co. Grand Rapids, MI Customer Service Representative  Worked on the “Order Desk” answering phones and placing orders for customers.  Assisted the claims department with returns and handling customer complaints Resume
  10. 10.  Assisted the billing department  Filing customer paperwork  Mastered the switchboard and filled in for receptionist  Placed fax orders for customers and provided them with confirmation numbers. EDUCATION 5/1999 Lakewood High School Lake Odessa, MI High School Diploma  Graduated with honors 6/2014-Present DeVry University Online  Currently working towards an Associate’s Degree in HIT  Projected graduation October 2016  RHIT exam to be completed upon graduation REFERENCES Dianna Kokx 616-291-7299 Kara Albert 616-813-9673 OTHER There are employment gaps in my history due to having children and raising a family. For the past 3 years I have been concentrating on my education while raising my children and have maintained a high GPA since the start of my college career.
  11. 11. DOMAINS, SUBDOMAINS AND TASKS FOR THE REGISTERED HEALTH INFORMATION TECHNICIAN I. Domain: Healthcare Data Date Completed Data Structure, Content and Use Verify timeliness, completeness, accuracy, and appropriateness of data and data sources (e.g., patient care, management, billing reports and/or databases). 9/6/16 to 9/8/16 9/21/16 9/27/16 9/28/16 Conduct qualitative analysis to assure that documentation in the health record supports the diagnosis and reflects the progress, clinical findings and discharge status. 9/22/16 9/28/16 Assist in the facility’s billing processes. 9/12/16 to 9/14/16 II. Domain: Health Information Analysis Abstract records for department indices/databases/registries. 9/19/16 to 9/22/16 Collect data for quality management, utilization management, risk management, and other patient care related studies. 9/13/16 10/05 and 10/06/16 Calculate and interpret descriptive healthcare statistics. 9/13/16 10/6/16 Present data in verbal and written forms. 9/13/16 10/6/16 III. Domain: Healthcare Environment Healthcare Delivery Systems Interpret and apply laws and accreditation, licensure and certification standards, monitor changes, and communicate information-related changes to other people in the facility. 9/7/16 9/12/16 9/14/16 Understand the role of various providers and disciplines throughout the continuum of healthcare services. 9/6/16 to 10/6/16 Legal Issues Release patient-specific data to authorized users. 9/14/16, 9/26/16, 9/29/16, 10/5/16, 10/6/16
  12. 12. DOMAINS, SUBDOMAINS AND TASKS FOR THE REGISTERED HEALTH INFORMATION TECHNICIAN Request patient-specific information from other sources. 9/14/16, 9/26/16, 9/29/16, 10/5/16, 10/6/16 Summarize patient encounter data for release to authorized users. 9/14/16, 9/26/16, 9/29/16, 10/5/16, 10/6/16 Maintain and enforce patient health record confidentiality requirements. 9/6/16 to 10/6/16 Healthcare Information Requirements and Standards Assist in developing health record documentation guidelines. 9/19/16 to 9/22/16 9/27/16, 9/28/16 Perform quantitative analysis of health records to evaluate compliance with regulations and standards. 9/19/16 to 9/22/16 9/27/16, 9/28/16 Perform qualitative analysis of health records to evaluate compliance. 9/19/16 to 9/22/16 9/27/16, 9/28/16 IV. Domain: Information Technology & Systems Information Technology Use common software packages (e.g., spreadsheets, databases, word processing, graphics, presentation, statistical, e-mail). 9/12/16 9/13/16 10/5/16 Query facility-wide databases to retrieve information. 9/12/16 – 9/14/16 9/26/19 – 10/6/16 Generate reports from various databases. 9/16/16 10/5/16, 10/6/16 Protect data integrity and validity using software or hardware technology. 9/12/16 – 9/14/16 9/26/19 – 10/6/16 Identify common software problems. 9/12/16 – 9/14/16 9/26/19 – 10/6/16
  13. 13. DOMAINS, SUBDOMAINS AND TASKS FOR THE REGISTERED HEALTH INFORMATION TECHNICIAN Health Information Systems Collect and report data on incomplete records and timeliness of record completion. 9/12/16 – 9/14/16 9/26/19 – 10/6/16 Maintain filing and retrieval systems for paper-based patient records. 9/6/16 – 9/8/16 9/19/16 – 9/22/16 9/27/16 – 9/28/16 Maintain integrity of master patient/client index. 9/6/16 to 10/6/16 Maintain integrity of patient numbering and filing systems. 9/6/16 to 10/6/16 Design forms, computer input screens, and other health record documentation tools. 9/12/16 – 9/14/16 9/26/19 – 10/6/16 V. Domain: Organization and Supervision Monitor staffing levels, turnaround time, productivity and workflow for supervisory purposes. 9/12/16 – 9/14/16 9/26/19 – 10/6/16 Determine resources (equipment and supplies) to meet workload needs. 9/6/16 to 10/6/16 Develop strategic plans, goals, and objectives for area of responsibility. 9/13/16 Participate on intra-departmental teams/committees. 9/13/16 Participate on facility-wide teams/committees responsible for health information services issues. 9/13/16 Use quality improvement tools and techniques to improve departmental processes. 9/13/16 Resolve customer complaints. 9/12/16 – 9/14/16 9/26/19 – 10/6/16
  14. 14. DOMAINS, SUBDOMAINS AND TASKS FOR THE REGISTERED HEALTH INFORMATION TECHNICIAN Prioritize department functions and services. 9/12/16 – 9/14/16 9/26/19 – 10/6/16 Implement staff orientation and training programs. 09/06/16 Activity Log by TCO for HIT272 DeVry University Health Information Technology Practicum Dates of Affiliation 9/6/16 thru 9/14/16 Facility MagnumCare of Hastings Practicum Director Andy Adsit Date Activity Details TCO Comment(s) 9/6/16 Filing, 1 Learned filing system 9/7/16 Chart breakdown, components of a file, chart assembly order 1 Learned how to move charts from open to closed status, and how to assemble a new chart 9/8/16 Med/treatment book breakdown, Filing 1 Learned the process of breaking down the Med book-completed monthly to update patient status and medication changes 9/12/16 Observed billing practices, Overview of reimbursement processes for Medicare and Medicaid 3,7 Watched basics of billing process performed 9/13/16 Watched how deposits are put into the system, Created RUG reports for the 4 locations, Sat in on a QPI meeting 2,3,5,9 Learned the deposit process for monies received, Created a RUG analysis report and calculated ALOS, Observed how the quarterly performance information meetings are ran
  15. 15. and the types of things discussed. 9/14/16 UB04 Claims 3,7 Watched how electronic UB04 claims are entered into the system for billing Medicare claims 9/19/16 Reorganizing files 1,2,5 Due to compliance and security issues all of the files have to be gone through to verify correct paperwork is in the files 9/20/16 Reorganizing files 1,2,5 Continued going through files, organizing sections, and pulling incorrectly filed paperwork 9/21/16 Filing 1 Filed current paperwork in open patient files 9/22/16 Reorganizing files 1,2,5 Continued going through files, organizing sections, and pulling incorrectly filed paperwork 9/26/16 Checking Medicaid/Medicare claims, Did deposits 2,3,7 Learned how to log into My ability and Champs to check on status of claims 9/27/16 Reorganizing files 1,2,5 Continued going through files, organizing sections, and pulling incorrectly filed paperwork 9/28/16 Filing, Breakdown, reorganizing Files 1,2,5 Continued going through files, broke down discharged or deceased patient files, filed current paperwork 9/29/16 Posting deposits 3,7 Opened mail, logged and posted deposits 10/3/16 Billing Medicare, Medicaid, and private pay 3,5,7 Beginning of the month billing 10/4/16 Billing Medicare, Medicaid, and private pay 3,5,7 Beginning of the month billing
  16. 16. 10/5/16 Billing and Reconciliation Reports 3,5,7 Finishing up billing, and preparing reconciliation reports for the 4 locations 10/6/16 Checked previous month claims, Reconciliation reports 3,5,7 Checked on claim status, finished reconciliation reports DeVry University HIT272 Health Information Technology Practicum Journal Week 1-4 Dates: 9/6/16 – 10/6/16 Total Hours = _85.5______ Date Activities Performed or Observed Time Spent What was gained from the experience? 9/6/16 Filing Paperwork, Discharge summary sheet 3.5 Learned filing system 9/7/16 Filing, Chart breakdown, Chart assembly order 5 Learned how to move charts from open to closed status, and how to assemble a new chart 9/8/16 Med/treatment book break down, filing 5 Learned the process of breaking down the Med book-completed monthly to update patient status and medication changes 9/12/16 Observed Billing Office duties, Overview of Medicare/Medicaid 4.5 Learned billing office practices 9/13/16 Deposits, RUG Reports, QPI meeting 5 Learned the deposit process for monies received, learned how to create Excel worksheet for RUG report, observed quality performance meeting 9/14/16 Releasing Claims 7 Watched and learned how electronic UB04 claims are entered into the system for billing Medicare claims 9/19/16 Organizing closed current files 5 Learned that you need to pay attention to what you are filing and where you are filing it 9/20/16 Organizing closed current files 5 Learned how to organize files by certain sections and what should be in each section 9/21/16 Filing 5 More practice on what goes where in open files 9/22/16 Organizing closed current files 5 More practice on correct filing
  17. 17. 9/26/16 Deposits, Medicaid/Medicare claims 7 Learned how to scan checks and post deposits in system, learned how to look up Medicare and Medicaid claims 9/27/16 Organizing files 5.5 More practice on correct filing 9/28/16 Filing, Breakdown of D/C files, organizing files 2 More practice on correct filing, More practice on what goes where in open files 9/29/16 Posting deposits 2 More practice on scanning checks and posting deposit 10/3/16 Billing claims 5 Learned the importance of following steps and having correct and complete information to bill claims to Medicare and Medicaid 10/4/16 Billing claims 5 Learned the importance of following steps and having correct and complete information to bill claims to Medicare and Medicaid 10/5/16 Reconciliation Reports, Billing 4.5 Learned how to prepare a reconciliation report for business offices and more practice with billing claims 10/6/16 Reconciliation Reports, Billing 4.5 Learned how to prepare a reconciliation report for business offices and more practice with billing claims Week 1 8/29/16 thru 9/2/19 Monday 8/29 Had my TB test read Wednesday 8/31 Attended a 3.5 hour orientation on polices and policies of the facility. Met with each department for a quick overview of responsibilities. Filled out and signed paperwork. Briefly met with Tabbie in medical records. My whole first week consisted of filling out paperwork, having a drug test, TB test, and fingerprinting done for clearance to work in the building. I attended an orientation to learn about the facility and the procedures/policies that need to be followed during emergency situations. During the meeting each department head introduced themselves and talked about what their department was responsible for. Tuesday Sept. 6th @ 10:00 am will be my first learning day at the facility. Journal
  18. 18. Week 2 9/6-9/8 Tuesday 9/6 Spent the day getting acquainted with the different work areas. Got a brief overview of job duties, helped file, watched a discharge summary sheet be filled out and set aside to await proper signatures. Put together a re-admit pack. Wednesday 9/7 Started the day with filing lab sheets, flow sheets, etc. Did a breakdown of a deceased patient file for the back file cabinet. The Matrix charting system was not working correctly in the C-wing hall and I was able to help get the system reset and working again for the nurses to do their charting. I’m sure it was much appreciated since they all had to do paper charting while the system was down. I also learned that all duplicate paperwork that comes in to be filed goes into the shredder bins that are strategically placed in the nurse’s station. Thursday 9/8 Today I did more filing of lab sheets and flow sheets. We also broke down the med/treatment books for each patient and placed paperwork in files. These books are updated monthly to reflect changes in treatment and medication. I also filed physician orders per patient and learned how their phone system works so that I can help with answering incoming calls. Week 3 9/12 – 9/14 Monday 9/12 Today I got to spend the day in the Business Office. I learned about the requirements for Medicare, Medicaid, Managed Medicare/Medicaid and Private Pay insurances. I observed the Resident Fund Management System and how to do withdrawals from resident accounts when money is requested. We also looked up Medicare claims to determine if they were paid or going to be paid and added modifier 59 & KX to claims before submitting them to make sure the correct codes were there to reflect therapy. I also learned that the main systems that they work with are Citrix, Matrix, My Ability, Champs, and RFMS. Tuesday 9/13 Today I observed deposits being put into the system. I also learned how to create a RUG report for Medicare A, Managed Medicare A, and Medicare B. This is a report created to show how many patients in the buildings have those insurances. I also calculated average length of stay (ALOS) on each report. Today I also sat in on a QPI meeting with department managers. The Director of Nursing, Social Services, Maintenance, Administrator, Dr. Eggleston-onsite doctor, and the Pharmacy rep. were all in attendance. They all discussed problem areas that needed to be addressed and
  19. 19. the solutions. The Director of Nursing discussed problems with falls and fractures/broken bones. Discussed shortages with nursing staff and a few solutions to fixing shortages such as agencies sending nurses, offering a tuition reimbursement program for attending the nursing program at the local college and paying for CNA certification/schooling. Maintenance issues were also discussed such as replacing or repairing the roof. Cable installation due to switching provider companies, and moving bird feeders for a resident. Pharmacy spoke about new prescription drugs and drug disposal of expired drugs. Wednesday 9/14 Today I learned how to release claims and how to fill out the electronic version of the UB04. We also had to check prior authorization numbers for a few patients and I discovered that it is sometimes a long process since you have to chase down people from other departments and also make phone calls to insurance companies to get the information you need. Week 4 9/19 – 9/22 Monday 9/19 This week I am back in the medical records department. Today we are sorting through and organizing the current closed files. Tuesday 9/20 We continued to sort and organize files today. Wednesday 9/21 Today I did some filing in the open files and current closed files. The current closed files are those things that have been thinned from a current patients file but are no longer relevant to have in the open file that is used daily. The State of Michigan also made a surprise visit today so I have also been making copies of paperwork requested and pulling files for them. Thursday 9/22 Due to the surprise visit from SOM there were some in discrepancies found in the filing system that need to be addressed. All files need to be gone through and reorganized. So we are starting with deceased or discharged patients no longer in the facility. Every piece of paper has to be checked to be sure that it belongs in that file. We were looking for misfiled paperwork. Week 5 9/26 – 9/29 Monday 9/26 Today we logged in more deposits. I also learned how to close a deceased patient’s file. From the date of death the facility only has 3 days to close the patients account and
  20. 20. issue a check for any money due back to the family. I also typed a letter for Salon Services and made copies to be added to the billing statements getting ready to be mailed. I also helped check on Medicare and Medicaid claim status to see if the claims have been paid or denied. Tuesday 9/27 Today I was back in medical records reorganizing files. Wednesday 9/28 Today was a short day but I managed to catch up a little filing that needed to be done. I also broke down 3 files of deceased patients and managed to organize one of the closed files. Thursday 9/29 Another short day today. Posted deposits for the billing office. Week 6 10/3 – 10/6 Monday 10/3 Because it is the first of the month all of the billing needs to be done this week. Today we got started on submitting Medicare and Medicaid claims for Part B insurance. Tuesday 10/4 Today was more billing. We double checked some of the Med B claims and worked on Medicare A claims. Wednesday 10/5 Today we checked on the claims that were submitted for Medicare and worked on Medicaid claims. Some of the claims that were submitted earlier in the week were denied so we went back through to find out what the issue was with the claim that caused the denial. Some of the claims needed to be hand keyed into the system which is a longer process that is done right through the websites and other claims were missing the correct modifier or other billing code that was needed. I also helped with preparing a reconciliation report each of the Business Office Managers in each of the 4 locations of MagnumCare. Thursday 10/6 Today is my last day here at MagnumCare. We did some more billing and tied up loose ends so that we could close out the books for September. I worked on finishing up the reconciliation reports for the BOM’s. We discussed the evaluations and said our goodbyes. I made so many good friends and am sad that my time there was finished. I learned so many valuable things while there and feel more confident in my abilities.
  21. 21. Activity Logs
  22. 22. Evaluations
  23. 23. Tiffany Eberly 5116 Darby Rd Saranac, MI 48881 October 6, 2016 Gary & MagnumCare Staff Administrator MagnumCare of Hastings 240 E. North Street Hastings, MI 49058 Dear Gary & MagnumCare Staff: I would like to thank you for allowing me the opportunity to complete my practicum internship at your facility. This was the last big step in completing my education and the knowledge I gained during my time there is invaluable. Thank you for allowing me to work with you all. Special thanks to Tabbie, Mandy, and Andy for sharing their knowledge with me. Sincerely, Tiffany Eberly Thank You
  24. 24. Health Information Technology Salary & Career Guide retrieved from: http://www.healthinformationtechnologysalaryhq.com/ MagnumCare of Hastings, MI Retrieved from: http://nursing- homes.healthgrove.com/l/6525/Magnumcare-Of-Hastings-LLC Pictures provided by Google images Retrieved from: https://www.google.com/search?q=medical+records&source=lnms&tbm=isch&sa =X&ved=0ahUKEwjvkJnnrOfPAhUB5SYKHT72Cg0Q_AUICSgC&biw=1366&bih =659 References

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