Tom is an audiologist who works at a local teaching hospital that contracts with four skilled nursing facilities. In this contract, residents participate in audiological evaluations and follow-up, usually the first and third Tuesdays of every month. On any of these days, Tom may see up to 20 people from any or all of the four nursing facilities. On one particularly busy day, Tom has a list of residents who are scheduled for appointments, but he loses track of which patients kept their appointments, which residents canceled, and who was added at the last minute. At the end of the day, Tom sits down to write his case notes on the residents. Unfortunately, because the day was so busy, Tom cannot be sure which residents were seen and which had canceled. When he goes to complete billing, he accidentally bills for services for two residents who were not actually seen that day.