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Call Details
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Date of Call
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Total Time Spent
• • •
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Reason For Call
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Patient Inquiry / Complaint
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History / Assessment / Decision-Making
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Document: (Symptoms discussed, Clinical findings, Medication changes, Counseling/education, Assessment summary)
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Compliance Checklist
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Patient Is Established
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Patient (or caregiver) initiated call
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Not related to a visit in past 7 days
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Clinical decision-making occurred
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Call was conducted by QHP (MD/NP/PA)
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