Military Treatment Record Management

Question 1

NAVMED P-117

Answer 1

Manual of the Medical Department (MANMED)

Question 2

What is the purpose of the military treatment record?

Answer 2

A chronological record of medical treatment afforded members of the naval service

Question 3

The military treatment record has current and long-term medico-legal value to who?

Answer 3

The individual concerned, Their survivors, U.S. Government.

Question 4

Health records are used to what?

Answer 4

• Patient care and evaluation
• Documentary evidence
• Communication between providers
• Legal
• Data collection
• Justify costs

Question 5

A new health record is opened when?

Answer 5

Initial entry (at MEPS)

Question 6

When is a dental record created?

Answer 6

First dental visit

Question 7

How do you request records for individuals who have had prior service and have been discharged?

Answer 7

From the National Personnel Records Center using DD 877, Request for Medical/Dental Records.

Question 8

In accordance with Article 23 of the MANMED, a military health treatment record
(HREC) shall be closed when?

Answer 8

Will no longer show up to work. (Dies, discharged, resigns, released from active duty, etc.)

Question 9

Where do you record the closing entries for a record?

Answer 9

On NAVMED 6150/4, Abstract of Service and Medical

History

Question 10

When closing a HREC what should be included along with it?

Answer 10

Dental record

Question 11

The medical record is the property of who?

Answer 11

The US Government

Question 12

Health record procedures when patient is hospitalized at MTF?

Answer 12

Include the HREC or OREC and copy of IREC with the patient

Question 13

Health record procedures when patient is at a Federal Facility?

Answer 13

HREC will accompany patient, or send as soon as possible.

Question 14

Health record procedure when patient is at a VA medical center?

Answer 14

Forward a copy of the HREC, all medical boards, and IREC of a patient. Transfer the original HREC to the cognizant MTF.

Question 15

Disposition procedures of a UA service member?

Answer 15

UA in excess of 10 days, send the record to PSD

Question 16

NAVMED 6150/7

Answer 16

Charge out Receipt Card (Pink Card) (Maintained for 1 year after transfer)

Question 17

In the even a record is lost or unaccounted where would you document this?

Answer 17

Administrative remarks (NAVPERS 1070/613 page 13) entry

Question 18

When a record is lost and replaced what it the jacket labeled with?

Answer 18

REPLACEMENT and written on all forms replaced

Question 19

When a health record approaches a state of illegibility or deterioration what is the jacket labeled with?

Answer 19

DUPLICATE RECORD

Question 20

What system is used to file records?

Answer 20

Terminal digit filing system (TDFS), according to a terminal

digit, color-coded, and blocked filing system.

Question 21

Health record verification should be done when?

Answer 21

Upon receipt (check-in), At the time of physical exam/PHA, Before transfer

Question 22

DD 2766

Answer 22

Adult Preventive and Chronic Care Flow sheet.

Question 23

NAVMED 6230/4

Answer 23

Immunization Record.

Question 24

NAVMED 6000/2

Answer 24

Chronological Record of HIV Testing.

Question 25

DD 771

Answer 25

Eye Wear Prescription

Question 26

NAVMED 6470/10

Answer 26

Record of Occupational Exposure to Ionizing Radiation.

Question 27

NAVMED 6470/11

Answer 27

Record of Exposure to Ionizing Radiation from Internally | Deposited Radionuclides.

Question 28

DD 2215

Answer 28

Reference Audiogram.

Question 29

DD 2216

Answer 29

Hearing Conservation Data, Annual audiogram

Question 30

NAVMED 6224/1

Answer 30

TB Contact/Reactor.

Question 31

NAVMED 6260/5

Answer 31

Asbestos Medical Surveillance Program.

Question 32

DD 2493-1

Answer 32

Asbestos Exposure-Part I, Initial Medical Questionnaire.

Question 33

DD 2493-2

Answer 33

Asbestos Exposure-Part II, Periodic Medical Questionnaire.

Question 34

OPNAV 5100/15

Answer 34

Medical Surveillance Questionnaire.

Question 35

NAVPERS 5510/1

Answer 35

Record Identifier for Personnel Reliability Program (PRP)

Question 36

SF 600

Answer 36

Chronological Record of Medical Care.

Question 37

SF 513

Answer 37

Consultation Sheet.

Question 38

DD 2005

Answer 38

Privacy Act Statement (PREPRINTED)

Question 39

DD 2808

Answer 39

Report of Medical Examination (Replaced SF 88)

Question 40

DD 2807-1

Answer 40

Report of Medical History (Replaced SF 93)

Question 41

NAVMED 6150/2

Answer 41

Special Duty Medical Abstract.

Question 42

NAVMED 6150/5

Answer 42

Abstract of Service and Medical History.

Question 43

DD 877

Answer 43

Request for Medical/Dental Records.

Question 44

OPNAV 5211/9

Answer 44

PREPRINTED: Record of Disclosure

Question 45

NAVMED 1300/1

Answer 45

Medical, Dental, and Educational Suitability Screening for | Service and Family Members.

Question 46

EZ 603

Answer 46

Dental

Question 47

Hypersensitivity to a drug or chemical is recorded on what?

Answer 47

NAVMED 6230/4, Immunization Record under Remarks and Recommendations. DD 2766, block 1. Placing an “X” on the front leaf of the health/dental record in the alert box. SF 600, Chronological Record of Medical Care.

Question 48

What is the purpose of a medical warning tag?

Answer 48

To recognize special health problems when: Medical records are not available. Patient is unable to give medical history.

Question 49

Dental Class I

Answer 49

Having no pathological oral conditions and requiring no treatment.

Question 50

Dental Class II

Answer 50

Having minor pathological oral conditions for which early clinical treatment is indicated.

Question 51

Dental Class III

Answer 51

Have pathological oral conditions for which early clinical treatment is indicated.

Question 52

Dental Class IV (4)

Answer 52

Dental classification is unknown because they have not received an oral examination by a Dental Officer within the past 12 months or for whom no dental record exists.