1. Managing Medical Records15
Managing Medical Records

2. Learning Outcomes (cont.)
15.1 Identify the common equipment used to file and store paper medical records.
15.2 Outline the security and safety measures that should be employed when working with paper medical records.
15.3 List the common filing supplies used in the medical office.

3. Learning Outcomes (cont.)
15.4 Contrast the methods used for various filing systems and how color-coding can assist with the filing systems.
15.5 Recall the steps in the filing process.
15.6 Compare active, inactive, and closed files and how to set up a records retention program for the office.

4. Introduction Records management system
Vital to patient care and office operation
Must be easily retrievable
An important administrative function is the careful management of the patient medical records.
A well-organized, easy-to-use records management system is essential to providing good patient care.
Records must be organized so they are easily retrievable.
You will learn
Options for handling large volumes of paper medical records.
How to develop an organized approach to maintaining files.

5. Filing Equipment Filing shelves Filing Cabinets Compactable files
Vertical files
Horizontal or lateral files
Compactable files
Learning Outcome: Identify the common equipment used to file and store paper medical records.
Two options are shelves and cabinets. The choice is usually based on space considerations and personal preference.
Filing shelves
Some have doors that can be locked for security.
Advantage – allows several people to retrieve and return files at the same time.
Filing Cabinets
Requires more floor space than shelves
Best used by one person at a time
Only one drawer can be safely opened at a time
Vertical or horizontal
Horizontal, or lateral, filing cabinets require more wall space
Compactible files
Rolling shelves that slide along permanent tracks in the floor.
Conserve space.
When needed, they can be rolled out manually or automatically into an open area.

6. Filing Equipment (cont.)
Rotary Circular files
Plastic or cardboard tubs or boxes
Labeling Filing Equipment
Clearly indicate range of files
Write directly on boxes
Learning Outcome: Identify the common equipment used to file and store paper medical records.
Rotary Circular Files
Files are stored in a circular fashion and are accessed by rotating the files.
They also can be operated either manually or electronically.
Plastic or Cardboard Tubs or Boxes
Inefficient and not advised for larger practices.
Must be locked in a secure storage area to protect patient confidentiality.
Storage boxes are often stacked to save space making it very difficult to locate files.
Boxes cannot be stored on the floor or within 18 inches of the ceiling
Any type of storage box is usually very heavy once filled so take care taken to avoid injury when moving storage container.
Labeling Filing Equipment
Filing cabinets – clearly labeled on the outside of the drawer
Storage boxes – labeled directly on the top and front of the box
List the range of files contained within the drawer, shelf, or box.
Clear labeling enables you to go directly to the appropriate place.
A-D

7. Super! Apply Your Knowledge
What are the disadvantages of vertical filing cabinets?
ANSWER: They take up more room than shelves, only one person can access the files at a time, and if more than one drawer is pulled out at a time they become top heavy and could tip over.
Learning Outcome: Identify the common equipment used to file and store paper medical records.
Super!

8. Security and Safety Measures
HIPAA privacy and security
Medical record security
Lockable cabinets or room
Limit key access
Learning Outcome: Outline the security and safety measures that should be employed when working with paper medical records.
There must be a “reasonable safeguard” to protect health information from any disclosure. Files should be kept in locking, fireproof filing cabinets or secure rooms.
Medical Record Security
Never place patient records in an unsecured filing system .
If files remain open during the day, they must be placed in areas where unauthorized people cannot obtain access to them.
Cabinets that are not in a separate room should be locked every night
Filing shelves should be in a room you can lock.
Limit the number of staff members who have keys.
Security survey teams will ask to see the keys to any locked door or cabinet and ask the staff to demonstrate that they work. .

9. Equipment Safety Purchasing filing equipment Post safety guidelines
Base on space and number of files
Fire proof and secure
Post safety guidelines
Keep drawers closed
Open one drawer at a time
Step-ladder safety
Learning Outcome: Outline the security and safety measures that should be employed when working with paper medical records.
The filing equipment should be fireproof and secure
Safety is an important consideration for all filing systems.
Close filing cabinet drawers when done.
Do not open more than one drawer at a time.
Shelving can be dangerous if staff members need to climb a ladder to retrieve files.
Safety guidelines for each piece of equipment should be posted prominently in the office.

10. Apply Your Knowledge Good Answer!
A busy medical office is currently using filing boxes for patient medical records and wants to change to a different system . What would you recommend to this non-computerized office that will allow more people to retrieve files at the same time?
ANSWER: Filing shelves would enable more than one person to access files if adequate space is available.
Learning Outcome: Outline the security and safety measures that should be employed when working with paper medical records.
Good Answer!

11.   Filing Supplies File folder Tab
Available in letter and legal sizes
Tabs - extensions used to identify the contents
Learning Outcome: List the common filing supplies used in the medical office.
File Folders – basic filing supply
Tabs
Extension at the top or side of the folder.
The most common type of folder for medical charts is the third-cut folder. 
Smith, A.
Adams, G.

12. Filing Supplies (cont.)
Labels
File jackets
Binders
Learning Outcome: List the common filing supplies used in the medical office.
Labels
Use the folder tabs to identify the individual folder’s contents.
Be consistent in preparing file labels.
Printed labels can be created using a label template available with most word processing software programs. .
File jackets
Also called hanging file folders
Hold file folders inside filing cabinet drawers.
Label in a consistent and legible style,
Binders
Binders are labeled on the outside spine.
Stronger than a file folder but require more storage space.

13. Filing Supplies (cont.)
File guides
Out guides
File sorters
Learning Outcome: List the common filing supplies used in the medical office.
File Guides
Heavy cardboard or plastic inserts used to separate the contents
Identify a group of file folders in a file drawer
Out Guides
Markers used as a placeholder when a file is from the filing system.
It will have a way to document whose file is out, who took the file, and date.
Helps to ensure that files are returned to their proper places.
File Sorters
Large accordion-style folders
Stores records temporarily, until the patient records can be returned to their proper placement in the cabinet or shelf.

14. Apply Your Knowledge
Which of the following would you use to mark the place when removing a patient record from the file?
File jacket
File guide
Out guide
File sorter
ANSWER:
Learning Outcome: List the common filing supplies used in the medical office.
GREAT!

15. Filing Systems All use a sequential order
Follow system exactly to avoid losing or misplacing records
Avoid changing system
Learning Outcome: Contrast the methods used for various filing systems and how color-coding can assist with the filing systems.
Filing system is the method by which files are organized and places patient records in some sort of sequential order.
Sequential order – files are placed one after another in a pattern or sequence that can be predicted.
Never make any changes in the filing system without first consulting the physicians and other staff members.

16. Alphabetic Filing System
Most common system
Files are arranged in alphabetical order
Seven indexing rules – keeps alphabetizing simple and consistent
Learning Outcome: Contrast the methods used for various filing systems and how color-coding can assist with the filing systems.
Alphabetic Filing System – most common filing system for maintaining patient files in sequential order
Indexing rules
Specific rules to follow when filing personal names alphabetically
Define a consistent method for the ordering of filed materials.
Refer to Table 15-1 Indexing Rules of Alphabetic Filing of Personal Names and Points on Practice INDEXING RULES
Rule 1 – Individual Names
Rule 2 – Business Names
Rule 3 – Hyphenation and Abbreviations
Rule 4 – Titles and Seniority Terms
Rule 5 – Prefixes
Rule 6 – Names of Married Women
Rule 7 – Identical Names

17. Alphabetic Filing System (cont.)
Indexing rules
Each part of name is a unit
Last name
First name
Middle name / initial
Titles (Jr., Sr. ,Rev., Dr., etc.) ~ the fourth indexing unit
Learning Outcome: Contrast the methods used for various filing systems and how color-coding can assist with the filing systems.
Indexing rules (cont.)
Indexing rules define each part of a person’s name or title as a unit.
Describe the order to display and manage each unit in an alphabetized system.
Updated periodically by the Association of Records, Managers, and Administrators

18. Chronological Filing Based on dates Year, month, day
Used within a patient’s record
Reverse chronologic order
Learning Outcome: Contrast the methods used for various filing systems and how color-coding can assist with the filing systems.

19. Numeric Filing Numeric filing system
Patients ~ assigned sequential numbers
Requires a master list of patient names and associated numbers
Meets requirements of HIPAA law
Learning Outcome: Contrast the methods used for various filing systems and how color-coding can assist with the filing systems.
Organizes files by numbers instead of by names.
Patient names are assigned a number.
Resulting files are sequential by the order in which patients have come to the practice.
Only the numbers are indicated on the files and a master list with associated patient names is kept in a separate, secure place.
More offices are converting to numeric filing systems to meet HIPAA laws concerning PHI.
The numeric system can be expanded to indicate the location of files.

20. Numeric Filing (cont.) Terminal digit filing Middle digit filing 2 - 2
Filing is done based on last group of numbers
Number is read from right to left
Middle digit filing
Uses the middle group as primary index for filing
Number is read using the middle number first
Followed by the left-hand number and right-hand number
2 - 2
5 - 5 6 5
Learning Outcome: Contrast the methods used for various filing systems and how color-coding can assist with the filing systems.
Terminal digit filing
Often the filing system of choice for numeric filing systems
Allows for the storage of many files with only a minimal amount of searching to find the correct files.
Numbers are assigned in small groups of two or three numbers.
Each group of numbers is read from right to left; starting with the last unit as number one.
Filing is done numerically, starting with the lowest number and moving to the highest.
Refer to Table 15-2 MRNs Filed in Terminal Digit Order
Middle digit filing
Uses the middle group of numbers as the primary index
Followed by the left-hand number and then the right-hand one.
Refer to Table 15-3 MRNs Filed in Middle Digit Order*
Numeric, terminal digit, and middle digit filing can all be used in combination with color coding to provide additional information in the filing system.
001 -
25 -
667

21. Color-coding Using classifications
Identify how files are to be classified
Determine method of coding
Determine color for each classification
Post codes
Learning Outcome: Contrast the methods used for various filing systems and how color-coding can assist with the filing systems.
Identify the classifications that are important to your office.
Decide what method of coding will be used (folder, labels, or stickers).
Assign colors to classifications
Post codes on a chart in the file room
Update color-coded files consistently, coding new ones and revising older ones as a patient’s status changes.

22. Color-coding helps identify charts that are out of order.
Color-coding (cont.)
With alphabetic filing
Each letter is assigned a color
Two or three letters of the last name are color-coded J O N E S
Learning Outcome: Contrast the methods used for various filing systems and how color-coding can assist with the filing systems.
Using Color in an Alphabetic Filing System
Each letter of the alphabet is assigned a color.
The first two or three letters of each patient’s last name are color-coded, usually with colored stickers.
Colored tabs are attached to the top of straight-edged or tabbed file folders.
Refer to Procedure 15-1 Creating a Filing System for Paper Medical Records
Color-coding helps identify charts that are out of order.

23. Color-coding (cont.) 5 6 5 2 With numeric filing
Numbers 1 to 9 assigned a distinct color
Use color-coded “key unit” for each chart 5 6
Terminal digit as “key unit” 5 2
Middle digit as “key unit”
Learning Outcome: Contrast the methods used for various filing systems and how color-coding can assist with the filing systems.
Using Color in a Numeric Filing System – most offices color the “key unit” for each chart – terminal digit or middle digit
Refer to Procedure 15-1 Creating a Filing System for Paper Medical Records

24. Supplemental Files Separate files containing additional information
Old patient records
Financial records
Stored in a different location than primary file
Contents should be distinguished from the primary file contents
Learning Outcome: Contrast the methods used for various filing systems and how color-coding can assist with the filing systems.
Supplemental files are usually set up using the same filing system used for primary files.
Require the same security as the primary files.

25. Tickler Files A date-ordered reminder file
Organized by month, week of month, or day of week
Computer systems
Calendar
Reminders to alert prior to event
Learning Outcome: Contrast the methods used for various filing systems and how color-coding can assist with the filing systems.
Any office activity that needs to be scheduled ahead of time can be noted and a reminder placed in the file. When the task has been completed, the note can be crossed off the list or removed from the file and thrown away.
Computerized tickler files are usually in the form of a calendar. Reminders can be set for tasks that must be completed on a regular or one-time basis.
Refer to Procedure 15-2 Setting Up an Office Tickler File

26. Apply Your Knowledge Match the following: ANSWER: E F C B A D
Tickler file
Color-coding
Supplemental file
Numeric filing system
Alphabetic filing system
Chronologic filing
simplest system
used for files within a medical record
financial records
easy to see out of place records
reminder system
helps the medical office comply with HIPAA F C B
Learning Outcome: Contrast the methods used for various filing systems and how color-coding can assist with the filing systems. A D
RIGHT!

27. The Filing Process Medical assistant responsibilities
Follow practice policies for returning records to the files
Place records to be filed in a secure file return area
Learning Outcome: 15.5 Recall the steps in the filing process.
The medical assistant may be required to pull and file patient records and file individual documents.
Records waiting to be filed should be placed temporarily in a secure file return area.
Clear rules should designate who may handle these files and under what conditions.

28. The Filing Process (cont.)
Generally the medical assistant files three types of items:
New
patient
records
Documents
Existing patient
records
Learning Outcome: 15.5 Recall the steps in the filing process.
You will be filing three types of items:
New patient records
Individual documents that belong in existing patient records
Patient records that are being returned to the filing system

29. The Filing Process (cont.)
Storing
Place the files in the appropriate location for easy retrieval when needed
Sorting
Place files in order to save time when storing
Add an identifying mark to ensure that the file is put in the correct place
Coding
Indexing
Name the file using the classification system
Learning Outcome: 15.5 Recall the steps in the filing process.
Inspecting
Remove paper clips rubber bands, and any extraneous material.
Staple loose papers to keep them together.
Affix smaller documents to standard size paper or enclose in clear plastic envelopes before filing.
Indexing
Some files may need to be cross-referenced.
If filed in two or more places, each place should be noted in each file.
Storing
Make sure folders are in good condition; replace when necessary.
If file contains too many documents, divide it into two or more folders and label them Folder 1 of 2, Folder 2 of 2, etc.
Be sure labeling of records consisting of more than one chart is clear.
Replace labels that are no longer legible.
Inspecting
Make sure document is ready for
filing
5 Steps in Filing

30. Filing Guidelines Check each record when pulling it Keep files neat
Remove file from drawer when adding documents
Learning Outcome: 15.5 Recall the steps in the filing process.
Each time you pull or file a patient record, glance at its contents. You should be familiar with the typical contents and the order of a patient record folder to help avoid filing errors.
Keep files neat. Make sure that documents fit neatly into the file folders.
When inserting documents, remove the folders from the drawer To avoid misfiling of, or damage to, documents.

31. Filing Guidelines (cont.)
Do not crowd the file drawer
Use file guides with a different tab position to aid in finding files
It is better to provide too many cross-references than too few
Learning Outcome: 15.5 Recall the steps in the filing process.
Leave extra space to allow for leafing through the files and for retrieving and replacing files easily.
Choose file guides with a different tab position than your folders to help them stand out. Do not place guides so close together that they hide one another.
If you are unsure whether to cross-reference a file, do it. It is better to err on the side of providing too many cross-references than too few.

32. Filing Guidelines (cont.)
File regularly
Do not store anything other than files in the file storage area
Train all staff who will be retrieving files on the system in place
Periodically evaluate your office system
Learning Outcome: 15.5 Recall the steps in the filing process.
File regularly so that you are not overwhelmed with too many records or documents.
Store only files in filing cabinets or on filing shelves.
Do not store office equipment or supplies where files belong.
Train all staff members who will retrieve and replace files to make sure they have a thorough understanding of the system. Update them on any changes.
Periodically evaluate your office’s filing system.
Refer to Points on Practice: EVALUATING THE OFFICE FILING SYSTEM

33. Locating Misplaced Files
Determine where the file was last seen or used
Look for the file while retracing steps from that location
Check filing cabinet where it belongs
Learning Outcome: 15.5 Recall the steps in the filing process.
3. Look in the filing cabinet where the file belongs.
Check neighboring files. Possibly, the file was simply put in the wrong place.
Look inside other thicker files to determine if the missing file was accidentally placed inside another file.

34. Locating Misplaced Files (cont.)
Check underneath files in drawer or on shelf
Check items to be filed
Check cross-reference or similar indexes
Learning Outcome: 15.5 Recall the steps in the filing process.
6. Consider possible cross-references or similar indexes (for example, similar patient names) for the file. Check those headings to see if the file was accidentally placed there.

35. Locating Misplaced Files (cont.)
Check with other staff members
Check other file locations
Stand back and look at the top of the folders
Ask another staff member to double- check your search.
Learning Outcome: 15.5 Recall the steps in the filing process.
8. Check to make sure the missing file was not filed under the patient’s first name instead of the last.
9. Stand back from the file cabinet and view the top of the folders, looking at only the first three letters of the last names. A misfiled file will stand out.
10. If using a color-coded system, look for the color of the misfiled chart.

36. Locating Misplaced Files (cont.)
Straighten the office, carefully checking all piles of information
Check charts that have been pulled for the next day appointments
Check physician’s desk
Learning Outcome: 15.5 Recall the steps in the filing process.
11. Even though files should always be kept in a secure area, occasionally individuals who are not part of the office staff, such as visiting physicians, may be in the area and may inadvertently pick up a file with their own materials. If you think someone could have taken the file, call the person immediately.
12. Ask another staff person to complete steps 1 through 7 to double-check your search.
13. Straighten the office, taking care to check through all piles of information where a file could be lodged.
14. Check those charts that have been pulled for next day’s appointments to see if misplaced charts have been accidentally pulled.
15. Check the physician’s desk.

37. Locating Misplaced Files (cont.)
File may be considered lost if not found within 24 to 48 hours
Recreate a new file
Physicians and staff record recollections of information in the file
Duplicate documents from labs, insurance companies, etc.
Learning Outcome: 15.5 Recall the steps in the filing process.
It may not be possible to duplicate the information within the file, but you can try to recreate it in a new medical record.
Meet with the physician and clinical staff members to review the information needed.
Note on the medical record that it is a duplicate, and that the information is not official.
If the physician considers it appropriate, tell the patient whose file has been misplaced about its status and the steps you have taken to re-create it; including the offices and facilities that have been contacted to obtain information needed to recreate the medical record.

38. Limiting Medical Record Access
Computerized offices
Access code and password
Limits what files you may see
Paper records
Limit who can retrieve and return files
Requisition slip used to obtain a file
Learning Outcome: 15.5 Recall the steps in the filing process.
The information in a patient’s medical record is on a “business need to know.”
In computerized offices, your access ID and password will restrict the information you are allowed to see.
Offices using paper records may restrict the number of people who can retrieve and return files.
Staff members must fill out a requisition slip with their name, the name of the patient, and the reason for the request which is kept either in a notebook or on index cards in a card file.
Under no circumstances should original patient medical records ever leave the practice. Refer to Legal and Ethical Issues chapter.

39. Apply Your Knowledge Terrific!
The medical assistant is training a new employee who will primarily be responsible for the medical records. The new employee asks “Can I first sort the charts, then inspect them?” List the 5 steps to filing in the correct order and provide an explanation to answer her.
ANSWER: The 5 steps to filing are:
1. Inspecting 2. Indexing
3. Coding 4. Sorting
5. Storing
The charts should be inspected first to be sure all necessary documents are in the charts and that they are ready for sorting and storing.
Learning Outcome: 15.5 Recall the steps in the filing process.
Terrific!

40. Active, Inactive, and Closed Files
Active files – used frequently
Inactive files – used infrequently
Closed files
Patient may have died or moved away
No longer come to the office
Learning Outcomes: 15.6 Compare active, inactive, and closed files and how to set up a records retention program for the office.
Definition of what constitutes active and inactive files depends on the individual practice.
Closed files are usually treated in the same manner as inactive files.
Length of storage
Financial records must be kept for 10 years.
Medical records must be kept for 7 years, but the Federal False Claims Act and many legal experts recommend keeping them for 10 years also.
The physician who will determine when a patient file is deemed inactive or closed.

41. Basic Storage Options Paper Storage
Files remain in their original format
Labeled boxes with lids to allow even stacking
Preserve the original documents.
If the paper becomes brittle, transfer documents to another storage medium
Paper Storage
Learning Outcomes: 15.6 Compare active, inactive, and closed files and how to set up a records retention program for the office.
Storage system chosen should enable you to easily find older stored files so that they can be periodically evaluated for retention or elimination.

42. Basic Storage Options (cont.)
Transfer documents to electronic or digital form
Transfer documents from hard drive to storage medium
Computer Storage
Learning Outcomes: 15.6 Compare active, inactive, and closed files and how to set up a records retention program for the office.
Computer storage
Paperless options for storing files, which include computer tapes, recordable CDs or DVDs, jump or flash drives, and external hard drives.
The chosen storage device is then dated and stored in labeled file boxes or other containers.

43. Basic Storage Options (cont.)
Other paperless options
Microfilm
Microfiche
Cartridges
Learning Outcomes: 15.6 Compare active, inactive, and closed files and how to set up a records retention program for the office.
Microfilm, microfiche, and cartridges
Consider using microfilm services, which index and transfer files for a fee.
Always have the service sign a confidentiality agreement.

44. Retaining Files in the Office
Retention schedule
Specifies length of time records are kept in the office once they are inactive or closed
Details when to move files to storage and when they can be destroyed
Post in file room
Learning Outcomes: 15.6 Compare active, inactive, and closed files and how to set up a records retention program for the office.
The retention schedule is generally determined by the physician.

45. Retaining Files in the Office (cont.)
HIPAA law – required retention periods
State and local requirements
Count from year after document produced
Learning Outcomes: 15.6 Compare active, inactive, and closed files and how to set up a records retention program for the office.
The HIPAA advisory website: has the most updated and complete list of required record retention periods according to HIPAA law
There may also be state and local retention requirements. If the office does business in more than one state, follow the schedule that requires the longest retention.
Do not to count the year in which the document was produced but to begin counting with the following year.
Refer to Procedure 15-3 Developing a Records Retention Program

46. Retaining Files in the Office (cont.)
Destruction of records
Maintain Confidentiality
Shred
Retain list of documents destroyed
Learning Outcomes: 15.6 Compare active, inactive, and closed files and how to set up a records retention program for the office.
Be sure a record is ready for destruction.

47. File Storage Facilities
On-site storage
Off-site storage
Commercial records storage centers
Maintain list of files
Learning Outcomes: 15.6 Compare active, inactive, and closed files and how to set up a records retention program for the office.
Onsite storage – check to make sure that the area is secure, accessible, and safe for storing files
Off-site storage
Commercial records centers – check if they retrieve and/or deliver boxes or files and whether there is an on-site work area
General storage facilities – generally not equipped for document management

48. Storage Safety Evaluate storage sites carefully
Place files in fireproof and waterproof containers
The storage site should be safe from
Fire and floods
Vandalism and theft
Extremes of temperature
Learning Outcomes: 15.6 Compare active, inactive, and closed files and how to set up a records retention program for the office.
Additional tips
Choose a site with moderate temperatures year-round and adequate ventilation.
Select waterproof storage containers that can also withstand intense heat. Cardboard boxes are not as strong or durable.
Select a site equipped with a smoke alarm, sprinkler system, and fire extinguisher.
Choose a site that is kept locked, is regularly patrolled, or has an alarm system to prevent theft or vandalism.
Remove old, brittle files as soon as possible, or transfer them to another format.
Ask for references from people at other offices who have stored files at the site.
Inquire about any special precautions for files stored in another form, such as computer disk or microfiche.

49. Excellent! Apply Your Knowledge
A patient who has not been to the office in several years telephones and requests a copy of his medical record. What should you do?
ANSWER: First tell him that you need a signed release to give him a copy of the records. Once you have that you would check to see if his medical record was in the active files. If not you should look on the inactive file list to see if it had been moved to storage.
Learning Outcomes: 15.6 Compare active, inactive, and closed files and how to set up a records retention program for the office.
Excellent!

50. In Summary
15.1 Filing shelves, filing cabinets, compactable files, and rotary files are all commonly used to store paper medical records.
A very small office might opt to use storage bins for its medical records.
15.2 HIPAA requires that filing shelves or cabinets should be fireproof and locked when the office is closed.
Filing systems must be safe for those using them and instructions on their proper use should be posted and understood by all staff members using them.
15.1 Filing shelves, filing cabinets (horizontal and vertical), compactable files, and rotary files are all commonly used to store paper medical records.
A very small office might opt to use storage bins for its medical records, but because of bulk, storage concerns, as well as weight and safety issues when moving the units, this method is ill advised for most practices.
15.2 HIPAA requires that filing shelves or cabinets should be fireproof and locked when the office is closed.
If files are kept in a file room, the room should be locked when not in use with only a minimal number of staff members possessing the key.
Filing systems must be safe for those using them and instructions on their proper use should be posted and understood by all staff members using them.
All staff should be instructed on proper body mechanics regarding all tasks in the medical office to avoid work-related injuries.

51. In Summary (cont.)
15.3 Filing supplies used in the medical office include tabbed file folders, labels, file jackets, binders, tabs with inserts for labeling, file guides, out guides, and file sorters.

52. In Summary (cont.)
15.4 Alphabetic filing is the traditional filing system for medical offices. Color-coding can enhance this process . Numeric systems are used more often because of the confidentiality they provide. These systems use a medical record number, which are then filed by the terminal digit or middle digit format. Color can be used with numeric filing also.
15.4 Alphabetic filing is the traditional filing system for medical offices.
Using the filing rules found in Table 15-1 and the indexing rules in the Points on Practice feature, medical records are filed alphabetically using each patient’s last name, first name, and middle initial as the first 3 filing units.
Color-coding can enhance this process when each letter is assigned a different color and the first 2-3 letters of each patient’s last name are attached to the chart using colored labels so filing errors stand out.
Numeric systems are used more often because of the confidentiality they provide. These systems use a series of numbers assigned to each patient (medical record number), which are then filed by the terminal digit or middle digit format.
As with alphabetic filing, color can be used in a similar way with numeric filing by assigning each number 0-9 a distinct color so that filing mistakes stand out more readily.

53. In Summary (cont.)
15.5 The steps in the filing process include inspecting, indexing (naming), coding, sorting, and storing.
15.6 Active records are those that are used frequently. Infrequently used records are known as inactive records.
Closed files are those of patients who, for whatever reason, no longer come to the office.
15.6 Active records are those that are used frequently. Infrequently used records are known as inactive records.
Closed files are those of patients who, for whatever reason, no longer come to the office. Procedure 15-3, at the end of this chapter, outlines the procedure to be used in creating an office medical records retention program.

54. End of Chapter 15
We must try to continue to hear patient voices above the din of the machinery.
~ Catherine Lopez
From A Daybook for Nurses