1. Medical Assisting Chapter 10
PowerPoint® to accompany
Medical Assisting Chapter 10
Second Edition
Ramutkowski • Booth • Pugh • Thompson • Whicker
Chapter 10
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

2. Managing the Office Medical Records
Objectives
10-1 Describe the equipment and supplies needed for filing medical records.
10-2 List and describe the various types of filing systems.
10-3 Discuss the benefits of each type of system.
10-4 Discuss the advantages of color coding the files.
10-5 Explain how to set up and use a tickler file.

3. Managing the Office Medical Records
Objectives (cont.)
10-6 Describe each of the five steps in the filing process.
10-7 Explain the steps to take in trying to locate a misplaced file.
10-8 List and describe the basic file storage options and the advantages of each.
10-9 Identify criteria for determining whether files should be retained, stored, or discarded.

4. Importance of Records Management
The medical records are the most valuable information in the medical office.
A records management system refers to the way patient records are:
Created.
Filed.
Maintained.
A well-organized, easy-to-use system saves time and protects vital medical data.

5. Filing Equipment  Filing Shelves Filing Cabinets
Files are stacked upright on shelves in boxes or heavy-duty envelopes
Filing Cabinets
Sturdy pieces of office furniture
Usually made of metal or wood
Both vertical and horizontal (lateral) file cabinets are available

6. Filing Equipment  (cont.) Compactable Files Rotary Circular Files
Kept on rolling shelves that slide along permanent tracks on the floor
Seen often in offices with limited space for files
Rotary Circular Files
Files are stored in a circular fashion resembling a revolving door
Also common when space is limited

7. Filing Equipment  (cont.) Plastic or Cardboard Tubs or Boxes
Organized like filing cabinet drawers
Files can easily be misplaced with this system.
Labeling Filing Equipment
The outside of the file drawer should be labeled
to represent its contents.
A-D

8. Filing Equipment  (cont.) Security Measures Equipment Safety
Many filing cabinets have locks, and the keys should be available to limited staff personnel.
Equipment Safety
Post safety equipment for each type of filing system.
Purchasing Filing Equipment
First determine the amount of space availability
Then determine number of files to be included

9.   Filing Supplies Tab File Folders Labeling File Folders
Referred to as manila folders
Available in 8 ½ by 11 inches and 8 ½ by 14 inches
Tabs are tapered rectangular or rounded extensions
at the top of the folder
Tabs have a variety of cuts
Labeling File Folders 
Smith,A.
Adams, G.
Tabs on the file folder identify the contents

10. Filing Supplies (cont.)
File Jackets
Resemble file folders but have plastic or metal hooks on both sides to anchor it
Files are placed inside these jackets
File Guides
Heavy cardboard or plastic inserts that identify groups of files
Out Guides
A marker made of stiff material that is used as a placeholder for removed files

11. Filing Supplies (cont.)
File Sorters
Large envelope-style folders with tabs that temporarily store files
Binders
Some offices use three ring binders to keep patient records
Tabs are used to separate individual charts
Purchasing Filing Supplies
A common responsibility for medical assistants

12. Apply Your Knowledge
A busy medical office is considering changing their
current filing equipment. Which equipment would
you recommend to this non-computerized office that
will afford more persons to retrieve files at the same
time?

13. Apply Your Knowledge - Answer
A busy medical office is considering changing their
current filing equipment. Which equipment would
you recommend to this non-computerized office that
will afford more persons to retrieve files at the same
time?
Filing shelves would be a great system if adequate space is available.

14. Filing Systems Alphabetic 1 2 3 Numeric
Files are arranged in alphabetical order
Files are labeled with the patient’s last name first, then first
name and middle initial
1 2 3
Numeric
Organizes files by numbers instead of names
Patients are assigned sequential numbers
This system is often used with highly confidential information
A master list of patient names and numbers must be kept

15. Filing Systems (cont.) Color Coding Using Classifications
Used to distinguish files within a filing system
Using Classifications
First identify how files are
to be classified
Select a separate color for
each classification
Color coding can be used with both alphabetic and numeric filing systems.

16. Filing Systems (cont.) Tickler Files A reminder file
Should be placed separately and reviewed often
Computers now offer tickler files
Supplemental Files
Separate files containing additional information
Prevents cluttering of primary files
Contents should be distinguished from the primary file contents

17. Apply Your Knowledge
Today is December 17th , which of the information listed below could be added to a “tickler” file?
Names of patients that missed appointments two-days ago
June medical conference dates just received in the mail
Names of patients seen today for their annual check-up

18. Apply Your Knowledge - Answer
Today is December 17th , which of the information listed below could be added to a “tickler” file?
Names of patients that missed appointments two-days ago
b. June medical conference dates just received in the mail
c. Names of patients seen today for their annual check-up

19. The Filing Process
Generally the medical assistant files three types of items:
New
Patient
Record
Folders
Individual
Documents
For
Existing
Folders
Previously
Filed
Patient
Record
Folders

20. The Filing Process (cont.)
5 Steps to Filing
Place the files in the appropriate location, so they can easily be retrieved when needed.
Storing
Get the accumulated files in order. This will save time when storing the folders.
Sorting
Place an identifying mark to ensure that the file is put in the correct place.
Coding
Name the file using the office classification system.
Make sure document is ready to
be filed.
Indexing
Inspecting

21. Limiting Access to Files
Under no circumstances should original patient records leave the medical office.
Identifying information is often recorded when files are retrieved.
Limited persons in the medical office have access to patient records.

22. Filing Guidelines
Take a close look at the contents of patient records each time you pull them.
Keep files neat.
Do not overstuff file folders.
Take time to properly place documents into the folders to prevent damage.
Do not crowd the file drawer.
If possible use both upper and lower case letters to label the folders.

23. Filing Guidelines (cont.)
Use file guides with a different tab position to aid with finding files.
It is better to provide too many cross-references than too few.
File regularly.
Do not store anything other than files in the file storage area.
Train all staff that will be able to retrieve files on the system in place.
Periodically evaluate your office system to see if it still works.

24. Locating Misplaced Files
Do a complete search of the office to try and locate the file. If the file is not recovered within 24 to 48 hours, it may be considered lost.
Lost files can have potentially devastating consequences.

25. Active vs. Inactive Files
Files that you use frequently
Inactive Files
Files that you use infrequently
Closed Files
Files of patients that no longer consult the office
The physician determines when a file is deemed inactive or closed

26. Apply Your Knowledge
The medical assistant is training a new employee that 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 this question.

27. Apply Your Knowledge- Answer
Step 1
Inspecting
Step 2
Indexing
Step 3
Coding
Step 4
Sorting
Step 5
Storing
The primary reason records should first be inspected is to ensure that all documents are present that belong in the chart.

28. Storing Files Basic Storage Options Paper Storage Microfilm
Computer Storage
Basic
Storage
Options
Files remain in their original format
Good to place in boxes with lids to afford even stacking
If the paper becomes brittle, transfer documents to another storage medium.
Microfilm, microfiche and cartridges offer a paperless way of storing records.
Patient records can be scanned and saved on a disk, tape or computer hard drive.

29. Storage Facilities
Some offices have extra closet or storage space on site.
Smaller offices require the use of off-site storage.
Use a facility that takes precautions against fires and floods.
Maintain a list of all files at each storage location.

30. Storage Safety
Even inactive and closed files must remain safe and secure.
Place files in fireproof and waterproof devices. Cardboard is not an option.
The storage site should be safe from:
Fire & Floods
Vandalism & Theft
Extremes of temperature

31. Retaining Files in the Office
A retention schedule decides how long different types of patient records are to be kept in the office once they become inactive or closed.
Certain records have legal criteria for the length they must be maintained in the office such as:
Immunizations.
Employee health records.
Medical Office Financial Records.
Legal consultants and the AMA also advise physicians on the length of time patient records should be kept. The best rule of thumb is to seek legal advice before destroying any records.

32. Apply Your Knowledge
A former employee from two years ago telephones and requests that copies of her annual physical examination forms that she submitted while employed be mailed to her home address. How would you handle this?

33. Apply Your Knowledge - Answer
A former employee from two years ago telephones and requests that copies of her annual physical examination forms that she submitted while employed be mailed to her home address. How would you handle this?
You should get this request in writing and then proceed to locate the records. The Labor Standards Act specifies that employee health records must be kept for three years, so they should be on hand at the office.

34. Managing the Office Medical Records
End of Chapter