The patient chart — Patient Information

One screen for everything administrative about a patient

Coverage, appointments, paperwork, prescriptions, letters, prior authorizations, money, and outbound messages all live on a single screen called Patient Information. It opens from the patient’s name in the chart header strip, and for a physician or an admin it is a full page in its own workspace tab — not a dialog you have to close before you can do anything else.

1. Hover before you click. The avatar-and-name block is one button, Open patient information workspace. Hovering it pops a Patient Information tooltip with MRN, Age, DOB, Gender, Phone, Secondary, and Address — rows with nothing on file are left out, so a short tooltip means a thin record. For a quick phone number or date of birth that is usually enough.
2. Click to open the workspace. Physicians and admins land on the page /dashboard/patient/{id}/info, which registers its own workspace tab titled Info: Michael Chen. The patient’s chart tab stays open beside it, so you can move between the two without losing either. Staff need a patient-chart permission (patient.view or patient.manage) to load that page; without one the same click opens an overlay dialog carrying identical content. There is no keyboard shortcut for it.
3. Read the header. The kicker PATIENT INFORMATION, the avatar initials, the name, and four chips — MRN, DOB, Age, Sex. A chip is dropped when its field is empty. Save a demographics change and the chips update on the spot, with no reload.
4. Navigate with the sidebar. The page uses a fixed left sidebar under four uppercase headings, in this order: PATIENT, CARE WORKFLOW, FINANCIAL, ADMINISTRATION. A group is hidden when none of its tabs are available to you; the financial and administration tabs depend on your access.
5. Deep-link to a tab with ?section=. The active section is mirrored into the URL, so a link can land on the tab you mean: demographics, more-demographics, implantable-devices, goals-concerns, appointments, chart-sharing, forms-letters, media, prescriptions, prior-auth, questionnaires, custom-billing-rules, insurance, billing-adjustments, health-export, outbound-comms. Anything else falls back to Demographics, which is also where the screen opens the first time with no ?section=, and older links written as ?section=billing rewrite themselves to custom-billing-rules on arrival. Switching sections replaces the URL rather than pushing it, so Back does not walk you through tabs, and a round trip out to a note or the billing workspace returns you to the section you left. Coming back to a patient’s Info tab later in the same browser tab reopens the section you were last on (for example Custom Billing Rules), not Demographics — including a section a link opened, such as Custom Billing Rules opened from Billing.
6. In the overlay dialog it is one tab row. The dialog shows the same items in the same order, flattened into a single row across the top with no group headings, scrolling sideways when it overflows. Close it with Esc, a backdrop click, or Close. With unsaved Custom Billing Rules edits it asks before closing; other open edit forms are not checked, so finish or cancel them before you dismiss it.

Seventeen tabs exist in total. Which you see depends on your role, your permissions, and which optional features your practice has turned on in Admin → Additional Features (four tabs are off until then):

A plain physician — not an admin, not a staff profile — therefore works with ten tabs: Demographics, Appointments, Chart Sharing, Forms & Letters, Media, Prescriptions, Prior Auth, Homework, Questionnaires, and Insurance — plus Goals & health concerns, Implantable devices, More demographics and Export Health Information for each of those features the practice has turned on. Within each group the tabs keep the order shown above. Which permission grants what is set per staff member under Staff & assistants. Other places open this same surface as an overlay: the primary insurance cell in a Patient List (it reads the payer name, or Add insurance, and opens onto Insurance), and every patient name in the Billing workspace, which opens it as the Patient billing dialog — billing tabs only (Demographics, Prior Auth, Custom Billing Rules, Insurance, Invoices & Charges, as permissions allow), with an Open chart button for users who can open charts (see the billing workspace). A claim’s Edit demographics quick-fix opens Demographics already in edit mode.

Open the patient’s documents without leaving Patient Information

Media under Care workflow opens the same document and image workspace as the chart’s Media tab. Staff need document-viewing, triage, or import access to see it; upload, removal, and insurance-card scanning follow their own permissions. It is not included in the billing-only Patient billing dialog. Eligible payment staff also have Take payment entry points from the patient header and billing information; see Payments & card readers.

Demographics: read the cards, edit the record

Demographics is where Patient Information opens: six read-only cards with a single right-aligned Edit button above them. The edit form replaces those cards in place — it is not a dialog.

1. Read the six cards. Identity (Full name, First name, Preferred name, Pronouns when the practice uses them, Middle name, Last name, MRN, DOB, Age, Sex, Gender identity, Marital status, Preferred language, Status, and the SSN row described below), Contact (Email, both phones, and Last portal login), Address, Emergency Contact, Parent / Guardian, and Guarantor. A field with no value is dropped rather than shown blank, and phone numbers are reformatted for reading as (502) 555-0134.
2. Read the empty states carefully. Address and Emergency Contact keep their headings when empty and say so — No address on file. and No emergency contact on file. Parent / Guardian and Guarantor have no such hint, so an entirely empty one disappears from the page. A missing card means nothing has been recorded, not that something failed to load.
3. Know two vocabularies. Status is one of Active, Inactive, Prospective, Discharged, Transferred out, or Deceased. Marital status is one of Single, Married, Divorced, Widowed, Separated, Annulled, Domestic partner, Unmarried, or Unknown.
4. Click Edit to open the form. The button briefly reads Opening… while Hero fetches the latest copy of the record, so you never edit (or save over) an out-of-date one. The heading changes to Edit demographics with Cancel and Save at the top right. Fields run in order: First name, Preferred name, Pronouns (only with the Patient pronouns feature on), Last name, Middle name, Date of birth, Sex, Gender identity, Marital status, Preferred language, Email, Primary phone, Secondary phone, Address line 1, Address line 2, City, State, ZIP, Emergency contact, Emergency relationship, Emergency phone, then a Parent / Guardian block (“For a patient under 18 this is where clinic email, texts and portal access go.”) with Parent first name, Parent last name, Parent email, Parent phone, Parent date of birth and Parent sex. When a minor has no parent or guardian email, an amber note warns that the patient will not receive appointment reminders, forms or portal invitations until one is added. Nothing is required, and the phone fields show the raw stored number rather than the formatted one. The Social Security number is not edited here; it has its own row (below).
5. Two fields are validated. State must be a two-letter US state, territory, or military code; case does not matter (or saves as OR), and anything else is flagged with Use a valid 2-letter US state or territory code. ZIP must total 5 or 9 digits, else ZIP code must be 5 digits (12345) or 9 digits (12345-6789). — a valid nine-digit entry is tidied on save, so 410561234 is stored as 41056-1234. Both may be left empty. Nothing else is checked: email, phone, and date formats are accepted as typed.
6. Save, or back out. Save briefly reads Saving... with both buttons disabled, then closes back to the cards. There is no success toast — the confirmation is that the cards and the header chips now show the new values. A rejected change keeps you in the form with the server’s message in a red banner. Cancel restores the stored values immediately, with no confirmation prompt and no recovery.

The Social Security number row

The Identity card has an SSN row. Some states (Kentucky, for example) need the number for the prescription-monitoring check on controlled-substance prescriptions, and some insurers ask for it to verify coverage. The number is never shown in full by default and never appears in the edit form.

• What it shows. •••-••-1234 (the last four digits) when a number is on file, or Not on file.
• Show / Hide. Show displays the whole number. It hides itself again after 30 seconds, when you switch to another browser tab, or when you leave the tab or patient. Every Show is recorded in the audit log. Viewing many numbers in a short time is paused for a few minutes: “Too many full numbers viewed recently. Try again in a few minutes.”
• Add / Replace. Opens a Social Security number (or New Social Security number) box that formats as you type (###-##-####). Save needs all nine digits (“Enter all nine digits of the Social Security number.”). There is no way to remove a number once saved, only to replace it.

Patients can also type their own number in the portal, during profile setup, when the practice turns on the Social Security Number card in Admin → Patient Portal Configuration → Features (under Orientation intake; off by default). They can skip the step, and once a number is on file a patient cannot change it from the portal; staff replace it here. The staff row above works whether or not that portal card is on.

Coverage, eligibility checks, and how this patient is billed

The Insurance tab holds the patient’s policies, the electronic checks you run against them, and the two settings that decide how their visits are billed. It reads top to bottom: the controls card, a card per policy, then a collapsed Estimated patient cost by visit type panel at the very bottom.

1. Start at the controls card. Bypass insurance (treat as cash pay) is a checkbox, captioned Override the billing classification and use cash pricing for this patient. (when the patient’s billing type is already Cash Pay, the caption says insurance is bypassed by that classification instead). Beside it, Billing type always offers Automatic (based on current coverage) first, then your practice’s own types, and + Custom type creates and assigns a new one in a single step. A failed change shows Unable to update billing type.
2. Add a policy. + Primary and + Secondary open an inline form headed Add primary insurance or Add additional insurance; once the patient has two active policies the second button reads + Tertiary / additional coverage. Set coverage order, next to them, lets you put the active policies in the order you verified (Up / Down, then a required Reason and verification source and Save coverage order); it changes which payer future claims go to, and claims already sent keep their payer. Payer is a typeahead (Payer name or Payer ID from the card) that searches the clearinghouse directory after two characters. Abbreviations and card spellings work (BCBS, BCBSTX, UHC, BlueCross BlueShield of Texas, words in any order), and the Payer ID printed on the card gives an exact match. Each result shows its payer ID, an also known as line when it matched through an alternate name, and Eligibility, Claims, and ERA chips for what that payer supports; a result marked Not available for electronic eligibility or claims comes from an older payer list and will fail every check, so pick the clearinghouse entry instead (Medicare Advantage plans usually file under a separate Medicare Advantage payer). You must pick a result; typing the name and moving on fails with Select a payer. Member ID is required, Group optional (don’t repeat the member ID there; a claim whose member ID is its group number is held), and Relationship defaults to Self. Anything else reveals the policyholder’s name and date of birth plus a Same address as patient checkbox, ticked by default — leave it to put the demographics address on claims. To have the patient photograph their card instead, the Insurance card requests panel’s Request insurance card makes a short-lived link and QR code the patient opens on their phone; cards read from uploaded documents appear in the same panel. Review the scanned details before saving a policy.
3. Read the policy card. The payer name heads the card with a Primary badge and a status chip. Under it, Files to: {payer} with ID {payer ID} and Eligibility / Claims / ERA chips names the clearinghouse payer the policy actually uses; an amber line instead means the policy cannot be used electronically — either {payer} isn’t set up for electronic eligibility or claims or No claims payer selected — and tells you to open Edit policy (a policy linked only to an Office Ally payer is fine at a practice whose claims go through Office Ally SFTP, as long as Hero can match it to one Office Ally claims payer: the line then reads Files to: with that claims payer ID, which can differ from the eligibility ID), whose Claims payer section shows the current payer and a Change payer search; picking a replacement and saving swaps the payer in place and re-checks eligibility (a policy that already has claims or a successful check refuses the swap and asks for a new policy instead). The right column carries Last eligibility {date} or Eligibility never checked, Last COB {date} or COB never checked, and the coverage date range (a missing end date reads present). Below sit the MEMBER ID, GROUP, EFFECTIVE, and TERMINATES tiles.
4. Use the action row. View benefits detail expands the coverage and benefits panel; Policyholder details, on a dependent policy, fills in missing subscriber identity only, since stored fields lock once billing activity exists. Make primary promotes a secondary policy; Invalidate is for one entered in error and Expire for coverage that has ended, both confirmed, with Expire requiring a Coverage end date; Reactivate returns a historical policy to service with no confirmation. There is no delete — retired policies collapse into Inactive and expired insurance (N) so eligibility, claims, and billing history keep their references.
5. Run eligibility — free, and the one to run first. Run eligibility is enabled only on an active policy. The result either lands at once or queues, and the notice under the buttons says which: Eligibility check complete., Eligibility check failed: {reason}, or Eligibility check queued. Results may take a little longer; keep this detail open or retry shortly. A stored failure about the patient’s coverage stays on the card under Latest eligibility failure with the reason in plain words, the recommended action, and a line telling you whether retrying can help. When the insurer only refused the check’s date, there is no red box: a blue notice, The insurer didn't check that date, says it isn’t a problem with the member ID and that Hero re-checks with today’s date (see Eligibility history & payers, which also covers the full list of every check run on a policy). A failure caused by your practice’s setup shows instead as an amber notice — “Eligibility checks aren’t set up · No eligibility clearinghouse is connected for this payer.” (or, for a failure left over from Office Ally, “Office Ally no longer checks eligibility”) — with Open External Providers for admins, or “Ask your practice administrator to set this up in External Providers.” for everyone else; retrying won’t fix it.
6. Run a COB check when you suspect a second plan. Run COB check asks the clearinghouse which plans the patient really has and which one pays first. It costs money — read the callout below before you click. It also needs the COB permission: without it the button is disabled and reads Ask a billing manager or office manager to run a COB check. When the check can’t run, the disabled button says why: “Other-coverage checks aren’t set up for your practice yet. A practice administrator can connect them in Admin → External Providers.”, “Other-coverage checks can’t run while your practice’s clearinghouse connection is in test mode. They work once the connection is live.”, “Other-coverage checks are turned off for your practice. A practice administrator can turn them on in Admin → External Providers.”, “This payer doesn’t accept other-coverage checks.”, or “Other-coverage checks don’t work for traditional Medicare.” After you run one, the card says COB check complete., COB check failed: {reason}, or, after about 30 seconds, “COB check is still running. The result appears here when the clearinghouse answers.”; it keeps refreshing on its own, and one the clearinghouse never answers ends with “The clearinghouse hasn’t answered this COB check. Run it again later.” Once a result lands, View benefits detail shows what came back — either No additional coverage found. or a notice naming the other payers over a card each, carrying the payer ID, the sequence the payer itself reported (Primary Payer, Secondary Payer, Tertiary Payer), and the coordination effective date.
7. Apply the coverage order the check proposes. This is the point of paying for the check. When other coverage turns up, Review coverage order opens a dialog headed Other coverage found. It states the finding in one sentence ({payer} pays second.), lists everything the payer reported under Reported by the payer — each one marked either On file against a policy you already hold or Not on this patient’s chart — and proposes a New coverage order: one row per active policy, ranked Primary, Secondary, Tertiary, each showing where it moved from (↑ was Secondary, ↓ was Primary, or Unchanged) and the reason it landed there. Drag a row, nudge it with the arrows, or take the suggestion back with Reset to COB suggestion. Apply coverage order writes the whole order in one step; Keep current order changes nothing. A reported payer that is not on the chart gets its own amber callout with an Add policy shortcut that opens the add form with the payer name already filled in.
8. Expand the cost estimate last. Estimated patient cost by visit type sits at the bottom and starts collapsed. Clicking it is what fetches the estimate, so the tab itself opens fast; once loaded it stays loaded, and collapsing it again does not throw the numbers away. Inside, a coverage summary names the payer with an Active, Inactive, or Unverified chip and either Eligibility as of {date} or Eligibility not yet verified, over six tiles — Deductible left, OOP left, OOP max, Office copay, Virtual copay, Coinsurance. Beneath them one row per active visit type shows a Price tagged Negotiated, Learned rate, Cash rate, or Not priced, and an Est. patient figure — or the reason there isn’t one, such as Run an eligibility check to estimate. Estimates use the payer’s contract rate, else a rate learned from that payer’s payments (even where claims bill your own list price), else the cash price (see CPT prices & payer rates); a learned-rate estimate is labelled as based on what the payer allowed before, not a contract rate.

When your practice sets a Default Medicare payer in Admin → External Providers → Stedi, a scanned Original Medicare card starts with that Part B payer. Review it before saving; Medicare Advantage still uses its own plan. See Stedi setup.

In Estimate a service by CPT or HCPCS code, select Clinician (optional) when the payer has different clinician rates. The estimate uses the matching contract rate sheet; leaving the clinician blank cannot match a clinician-specific sheet. Payer-rate visibility follows the practice’s rate-access settings.

Every visit for this patient, with paperwork, reminders & outcome

The Appointments tab is the patient-level view of the schedule — as its own sub-line puts it, upcoming visits with paperwork and reminder status, follow-up outreach, and every past visit with its note, billing, and reschedule history. Booking and rescheduling still happen in the scheduler; this tab shows one patient’s whole picture and sends you to the right place. Beside the heading sit Request follow-up, Schedule appointment, and a Refresh appointments icon.

At the top, Prevent this patient from self-scheduling makes the patient contact the practice to book or reschedule while allowing staff to schedule. Physicians, administrators, and staff with scheduling-management permission can change it; the checkbox saves immediately. This is separate from an unpaid-balance scheduling rule and does not cancel existing visits.

1. Scan the six summary chips. Next visit (a date, or None scheduled), Upcoming, Paperwork pending, Reminders queued, Active follow-ups, and Past visits (N) — whose value is a breakdown such as 0 completed · 12 cancelled · 1 no-show · 29 unresolved, turning amber the moment anything is unresolved.
2. Work the upcoming cards. Each card leads with the weekday, date, start time and duration — in your practice’s time zone, never the browser’s — then the visit type, a status chip, a Telehealth pill, a Rescheduled 4× chip when the visit has moved, a From follow-up request chip when it came out of outreach, the provider and location (or Provider not set), and a booking line such as Scheduled by Nicholas Romero (staff EMR) · Aug 26, 2026 at 12:28 PM. Actions on the right: Details, Open note (only with an encounter), Reschedule, Cancel.
3. Read the two readiness badges. Between them they answer “is this visit actually ready?” without opening anything. Paperwork reads No paperwork required, Paperwork complete (2/2), 2 of 2 items outstanding, or — in red — 2 of 2 items outstanding · 2 overdue, with a caption naming what is still open (Waiting on Consent to Treat Copy, Previsit agreement). Reminders reads No reminders, No reminders sent or scheduled, or a count such as 1 sent · 4 scheduled, gaining · patient confirmed in green when the patient replied yes and · delivery problem in red when a message failed or bounced; when another is queued, Next: Aug 27, 2026 at 8:00 AM sits underneath. Inside Details, the Questionnaires & paperwork section lists what the visit type assigned — or Nothing was assigned for this visit. — and, for anyone who can send paperwork (front desk with patient-management permission, physicians, administrators), a Send a form button that opens the same dialog as the Questionnaires tab. The form goes to the patient’s Forms to sign, linked to the visit’s encounter when it has one.
4. Clear the unresolved ones. A visit whose date has passed but which nobody ever marked completed, cancelled, or a no-show is Unresolved: an amber Unresolved chip in place of its status, with the hover note Still “Scheduled” after the visit date — mark it completed, no-show, or cancelled. The history filter has an Unresolved option, and each such row gains a Resolve button. It opens the same dialog as Cancel: pick Initiated by — Provider / clinic or Patient, deliberately unselected until you choose, because provider-initiated waives the fee — then a Reason, optionally a Note for the chart, and confirm with Cancel Appointment or Mark No-Show.
5. Follow the outreach trail. Follow-up requests shows a {n} active pill and a Show {n} closed toggle — a request the patient has already booked counts as closed and hides by default. Request follow-up asks which visit it belongs to, a Visit type (Office visit, Telehealth, Phone call), When (2 weeks through 6 months, or your own number and unit), an optional Preferred time of day, an internal Reason, and Instructions for the patient. The patient is contacted after the practice’s review delay, not instantly. Each row then keeps the whole trail — status (Pending outreach → Patient notified → Awaiting response → Reminder sent, ending at Scheduled, Expired, or Declined), the booking window, attempt counts, whether the patient replied or booked, and every message sent — plus Resend and Cancel, which fires immediately with no confirmation.
6. Mine the history. Appointment history lists past visits under When, Visit, Outcome & billing, and Actions, filtered by Show (All visits, Completed, Cancelled / rescheduled, No-shows, Unresolved). Outcome & billing carries a clickable note chip — Signed note, Note completed, or Unsigned note — plus a billing chip in the same words as the invoices (Paid, Balance due, Partially paid only when the patient paid part, Past due, With insurance, Insurance review, Awaiting secondary while the visit’s secondary claim is pending, Not billed, No charge, Billing cancelled), the payer name, a balance such as $25.00 due, and any no-show or late-cancel fee; rows with neither read No encounter. Cancellations spell themselves out: Late cancellation · by patient — Sick. The filter only searches pages you have loaded, which is why the button reads Load more (17 more visits to search).

The reschedule chain is durable. Reschedule opens no dialog here — it hands you to the scheduler in reschedule mode with the visit preloaded, reusing one Scheduling tab however many times you click it. What this tab keeps is the record: a Rescheduled 4× chip on the card, Rebooked as a new appointment. on a visit that was replaced, and inside Details a Lifecycle section reading Rescheduled 4 times. above a timeline of every move — Booked, Rescheduled, Cancelled, Marked no-show, Checked in — each with its actor, its timestamp, and for a reschedule the old slot and the new one. Open the rebooked appointment and Open the appointment this replaced walk the chain.

Send questionnaires, automate them, read the answers

The Questionnaires tab is the per-patient counterpart to the practice-wide questionnaire rules: send one now, put this patient on their own recurring schedule (or stop a practice rule reaching them), read every result, and find out why a rule did or did not fire. A banner at the top states the precedence plainly — rules on this tab apply only to this patient and always override practice-wide questionnaire rules for the questionnaires they cover. For a patient under 18 a second banner names who actually receives the questionnaire, and warns when no guardian contact is on file to deliver it to.

1. Start with the trends. Score trends is the first section, shown once any instrument has at least two completed, scored results (PHQ-9, GAD-7, AUDIT-C, a youth screener or one of your own all qualify the same way). Each instrument shows Latest {score}/{max} · {interpretation} and the change since the previous result, for example ▼ 4 since Sep 2, with dates on your practice’s calendar. Open one for its chart: the instrument’s severity bands (for example Minimal to Severe on a PHQ-9) are shaded behind the line in neutral tones and named in the right margin, with the scale marks at the cutoffs, then a Date / Score / Interpretation table. Click a point or a row to read exactly how that submission was answered. Results from versions with different score ranges are not compared. With nothing to plot the section is absent rather than empty.
2. Send one now. Send a questionnaire has one button, Send Questionnaire, which expands an inline picker rather than a dialog. Type in Search questionnaires to narrow it; your practice’s own questionnaires sort to the top, then the standard library alphabetically. Clicking a row sends it immediately — no confirmation step, no due-date field, no channel picker. Delivery follows the patient’s notification preferences, and for a minor it routes to the guardian. A green PHQ-9 sent. confirms it; a red banner carries the reason it failed, most often Active assignment already exists when one is still open.
3. Send a consent, intake or other form. The Send a form card sits under Send a questionnaire. Its Send a form button opens a short dialog with this patient already filled in: choose the form in Form — any form your practice has published in Previsit Paperwork, including on-request-only ones such as a controlled substance agreement — and click Send form. The patient signs it in the portal under Forms to sign; no appointment is needed. A green line confirms Sent “Consent to Treat” to {name}, and Send another form keeps the patient selected. This is the front desk’s way to send paperwork: it needs the same patient-management permission as sending a questionnaire, not access to Admin > Previsit Paperwork. If the list is empty, nobody has published a form yet — an administrator does that in the paperwork manager.
4. Put the patient on their own schedule. Automatic questionnaires for {first name} lists this patient’s rules; + Add rule opens New patient rule. Pick a mode — Send automatically or Stop automatic sending (practice-wide rules will never auto-send these to this patient) — choose the questionnaires, and for a sending rule choose When: On a schedule, When a visit is booked, or When a visit starts. A scheduled rule takes a cadence: Monthly, Every 3 months, Every 6 months, Yearly, or your own Every N days up to 1,095. Each saved rule becomes a card with an Active or Paused pill, a plain-English subtitle (Blocked from org-wide sending, Every 3 months), and Pause / Resume, edit, and delete controls.
5. Check what the practice is already doing. Practice-wide rules for this patient is a collapsed panel counting the org rules that reach this patient, plus how many are partly or fully overridden by patient rules. Expand it and each rule shows its triggers and its questionnaires, with any questionnaire a patient-level rule has taken over struck through and labelled Overridden by patient rule.
6. Read the timeline. Previous & upcoming lists everything sent plus what is scheduled next. Filter with All, Upcoming, Completed, Missed; search by name; sort by Newest first, Oldest first, Questionnaire, or Score. Each row carries a badge — Scheduled for a projected future send (drawn with a dashed border, because it does not exist yet), Sent — awaiting completion for a real assignment, then Completed, Skipped, or Expired — a score chip where one exists, the date (Next around…, Due…, or the completion date), and where it came from: Sent manually, Patient rule · PHQ-9 every 3 months, Practice rule · Follow-up Visit questionnaires, or Phone agent. Click a completed row and its answers open inline underneath, question by question, with any safety flag and the item it fired on marked. When the questionnaire scores domains separately, a Subscales breakdown shows each domain’s score and cutoff result — see Score, timing, and every answer. A questionnaire that ended without answers says why: Skipped, Declined, Expired, Withdrawn (visit changed), Withdrawn (visit cancelled), or Replaced (updated version).
7. Cancel one that was sent by mistake. A sent questionnaire the patient has not started has a Cancel link on its row. Cancel questionnaire explains “The patient will no longer see this questionnaire. It stays in the chart marked Skipped.”; confirm with Cancel questionnaire or back out with Keep it. If the patient has just started it, Hero refuses: “Could not cancel this questionnaire. The patient may have just started it. Refresh and try again.”
8. Record a refusal, or fill it in with the patient (optional feature). With Social needs screening turned on in Admin → Additional Features (off by default), an open questionnaire’s row also offers Patient declined (sent or started) and Fill in with patient (not started yet). Patient declined opens Patient declined to answer (“The patient will no longer see this questionnaire. The chart shows it as Declined, and shared records report that the patient declined to answer.”), with an optional Note (optional, stays in the chart); click Record as declined. A declined questionnaire is never scored. Fill in with patient opens the questionnaire so you can enter the answers in the office, then Save answers; every required question must be answered (“… or close and use ‘Patient declined’ if they would rather not answer.”). The same feature adds the social needs and behavior screeners (Hunger Vital Sign, the CMS social needs screening tool, financial strain, education, stress, physical activity, social connection and intimate partner violence) to your questionnaire library.
9. Act on a positive social needs screen. Under a completed social needs screener with a positive answer, Suggested next steps lists each need (for example Food insecurity) with Concern: … · Goal: … and a referral idea (“Refer to a food assistance program (SNAP, WIC, food bank)”). Add to chart adds that concern and goal to Goals, health concerns & health status and then reads Added. It needs Goals, health concerns and health status turned on and permission to edit the problem list; otherwise the button is greyed out and says which is missing.
10. Debug a rule that did not fire. Rule checks answers “why did this patient not get it?” Each rule shows an Applies, Does not apply, Suppresses, or Overridden pill, a Patient rule / Practice rule scope pill, its triggers, and how many upcoming visits matched. Patient criteria lays each condition out in three columns — the criterion, the Patient / visit value, and what the Rule expects — and Upcoming visit checks repeats that per visit for the next few appointments. A row reading visit type Standard Office Visit against an expected Follow-up Visit is the whole answer.
11. See what the rules actually did. Rule checks answers “what would happen now”; the collapsed Why questionnaires were or weren't sent at the bottom answers “what happened, and why”. Its summary reads, for example, 12 times the rules ran · 3 not sent. Each entry is one run — Visit booked, Visit changed (type, provider or time), Visit note opened, Portal registration, Date of birth corrected, or Questionnaires withdrawn — with its time, the visit, and one line per rule marked Sent, Already there, Skipped, Not sent or Withdrawn, the deciding reason first, in your practice’s words: “Not sent: patient is 16, rule is for 18+”, “Not sent: pre-visit forms are off for ‘Follow-up’ visits”, “Not sent: visit type ‘Follow-up’ is not one of the rule’s visit types”, “Not sent: the visit was booked more than 7 days ahead”. Show all N lists older runs; with none it reads No questionnaire rule has run for this patient yet.

The whole prescribing trail for one patient

Prescriptions sits under Care workflow in the sidebar and answers the question the chart’s medication list can’t: did the pharmacy actually get it? The header reads Prescription history over “Everything prescribed for {first name}, newest first. Open a row for the pharmacy trail, the raw Surescripts XML that was sent, and the EPCS signature on controlled substances.” Admins, physicians, and staff holding prescription.view can read it; placing an order from here — New prescription or Reorder — is physician and admin only, and those buttons are simply absent for view-only staff rather than greyed out. Every row you open is recorded as a chart access. For the read-only medication list itself, see the Medications tab.

1. Read the counters first. Five chips: on file, sent to pharmacy, controlled, EPCS signed, and need attention, the last shown only when it is above zero. need attention counts prescriptions in Error, Denied, or Pending signature, plus anything whose Surescripts reply came back as an error, failure, or denial. The controlled chip is also a button: click it to filter the list to controlled substances, click again to release it.
2. Narrow the list. Search drug, sig, or pharmacy matches the drug description, the sig, and the pharmacy name; Filter by status holds one status at a time, starting at All statuses. Include removed is on by default, which is why cancelled and replaced prescriptions appear, faded, with a grey removed chip. There is no sort control — the list is always newest-sent first, and long histories load 50 rows at a time as you scroll.
3. Read a row. Sent is the transmission time. Medication is the drug — with an amber CII-style pill on controlled substances — over a line of quantity · refills · sig. Pharmacy, Delivery (the Surescripts status, a reply count, and an XML link), EPCS, and Status follow.
4. When the Sent cell says Not sent. The prescription has no send time and no transmission date on record — it was printed, faxed, never transmitted, or is still waiting on a signature. A smaller written {date, time} line underneath tells you when it was created, the Overview field Sent to pharmacy reads Not transmitted, and the Surescripts tab says “No Surescripts messages recorded for this prescription (it may have been printed, faxed, or never transmitted).”

Clicking a row opens the detail dialog; clicking its XML link opens the same dialog straight onto the Surescripts trail. The dialog is titled with the drug and subtitled Prescribed by {name} · written {date}, over a strip of pills — the status, Surescripts: {status}, Controlled, the EPCS state, and In medication list or Not in medication list. Four sections sit below it, the last three carrying a count badge:

Reorder appears on every row and again at the top of the detail dialog. It opens the ordinary prescription editor with the medication dialog already showing a new draft titled Reorder · {drug}. Carried over: the drug identity (NDC, RxCUI, DEA schedule), quantity, units, refills, days supply, notes to pharmacy, the sig — rebuilt as structured fields where dose, route, and frequency can be represented, otherwise kept verbatim as free text — and the diagnoses from the original, so the send gate is already satisfied unless you change them. Controlled substances whose schedule forbids free text always open structured, and a route the form can’t represent lands as unknown for you to correct rather than degrading silently. Review the sig, quantity, and refills, confirm the diagnosis, then finish through the normal prescribing flow. If the seed can’t be fetched you get a Could not start the reorder toast and the button is usable again straight away.

Cancel a prescription

A prescription that has already gone to the pharmacy can be recalled from here: Cancel sits beside Reorder on the row, and again in the status strip at the top of the detail dialog. It is offered to exactly the accounts that may place an order — physicians, and admins who hold a prescriber profile — and only where a cancellation can actually reach somewhere. A prescription that was printed, faxed, or never transmitted has nothing at a pharmacy to recall, so its row carries no Cancel at all; nor does one that is already cancelled, one whose cancellation is already on its way, or one that has been replaced by a newer prescription — there it is the replacement that must be cancelled.

1. Say why. Cancel opens Cancel this prescription — “The pharmacy is asked to cancel it. You will see their answer here.” — over a card naming the drug, the pharmacy, and when it was sent. Reason is one of Entered in error, Therapy changed, Patient no longer needs it, Duplicate prescription, or Other; Detail for the pharmacy (optional) takes up to 280 characters of free text, and both travel with the cancellation.
2. Check what is actually being cancelled. If the prescription you clicked was superseded by a renewal or a change response, an amber line says This cancels the replacement prescription sent {date} — the recall follows the chain to the version the pharmacy is holding. On a controlled substance a second amber line reminds you that the pharmacy must acknowledge the cancellation.
3. Send it, or back out. Keep prescription closes without doing anything. Send cancellation queues it and confirms with Cancellation sent to the pharmacy — “The prescription shows ‘Cancel pending’ until the pharmacy answers.” Nothing needs reloading; the row updates itself when the answer arrives.
4. Read the outcome on the row. While it is in flight the status reads Cancellation Pending with an amber Cancel pending pill in place of the button, and Delivery shows CANCEL QUEUED. When the pharmacy answers, the pill becomes Canceled, Cancel denied, or Cancel failed; the detail dialog spells the pending one out as Cancel pending · requested {date, time}.

Prescribe with a clinical note

Prescribing from this tab no longer means leaving the reasoning out of the chart. New prescription and Reorder both open the order workspace with a Clinical note box: once in the prescription dialog, directly under Diagnosis, and once as a Clinical note panel in the body of the modal with an Add a note button. They are two views of the same note — type in either one, and while the prescription dialog is open the panel shows a preview and reads “Editing in the prescription dialog — your changes appear here when you close it.” Dot phrases work exactly as they do in the note editor: type . followed by a few letters (the placeholder suggests .adhdfu) and pick from the list.

Sending a prescription from here with no visit open creates one Orders only encounter for that send, and the note is filed on it as a signed progress note — but only after at least one order has actually gone out. Cancel the modal, or have every order fail, and nothing is filed and no visit is created. When it works the panel gains a green Filed badge; if the orders go but the note does not, the panel says Not filed — your orders were sent, the note was not. with a Retry button beside it. Afterwards the note is an ordinary chart note: it shows on the Notes tab of the visit, it reaches the patient in the portal like any other signed note, and the prescription’s detail dialog records where it went — the Encounter field reads Orders only · {date, time} with a Clinical note filed chip beside it.

Write a letter for a patient without opening the visit

The Forms & Letters item under Care workflow does two things: it lets you produce a letter or an AI-filled form for this patient from any of their visits, and it lists every document that has already gone to their portal, across every encounter. The tab is available to anyone with an active Physician profile on the account — that is every physician, and no purely administrative or billing account, because the underlying document routes need a physician record to sign against. There is no read-only mode: if you can see the tab, you can use all of it.

1. Pick the visit the document belongs to. Associate with encounter carries an amber Required badge for a reason: this is a patient-wide view, so the encounter that supplies the clinical context cannot be inferred and must be stated. The dropdown opens on Select an encounter… (or Loading encounters…) and lists visits newest first as {date} · {visit type} · {physician}; Load older encounters pages further back. If the patient has no saved visit at all you get No encounter is available — “A form or letter needs a saved encounter so its clinical source is auditable.”
2. Write or generate. Once chosen, a Using: {date} · {visit type} · {physician} line confirms the target and the familiar composer appears with Write a letter and Fill a form. This is the same component you use during encounter completion, so the whole authoring walkthrough already applies — starters and the letter editor in Write a letter, the catalog and instructions box in Fill a form with AI, and the sign-off gate in Review & approve. Anything you create here also shows up on the visit itself, and vice versa.
3. Find what has already been sent. The lower card, Sent documents, is described as “Signed letters and approved forms across every encounter. View or reprint the exact filed document.” It includes fax letters to outside providers, which reach the patient’s portal only when you chose to share them. A right-aligned {n} loaded counts what is on screen; the empty state is No sent documents yet over “Signed letters and approved forms will appear here.”
4. Reopen or reprint a filed copy. Columns are Document, Encounter, Sent, and Actions. Under each document name sits one of exactly two labels — Clinician-created or Patient-requested — and the Encounter cell shows the visit date with its chief complaint (or Medical encounter). View opens the filed PDF in the review dialog; Reprint prints the same file. Load older documents pages back through long histories.

Only approved documents reach this list. Drafts, forms still generating, and anything waiting on your review live on the visit, not here — which makes Sent documents a reliable answer to “what does this patient already have?” For the chips a document wears on its way there, and what the patient sees at the other end, see What the patient sees.

Fax a letter to the patient’s doctors, and follow every fax

Faxes under Care workflow appears when your practice has a fax service, for providers and for staff who can view patients. The top card, Fax a letter, lists the patient’s Care team with each doctor’s fax number (marked no fax when one is missing) and the six fax letters: pre-surgical clearance, cardiac clearance, medical records request, lab & test results, care coordination update and consultation report. A provider clicks one and it opens addressed to the right doctor, filled in with their usual choices and filed with the patient’s latest visit; staff see “A provider signs and faxes these letters. You can follow this patient’s faxes below.”

The lower card, Sent faxes, is “Everything faxed from this chart, newest first”: the subject, who it went to and the number, the page count, the time, the reason when a fax failed, and a status chip (Queued, Sending, Delivered, Failed or Cancelled) that updates while a fax is going out. Writing, signing and sending a fax letter are covered in Fax letters.

Track authorizations, approved units, and expiry dates

Prior Auth under Care workflow is where a payer’s approval gets recorded so it can be spent down and watched. The banner states the deal: “Track insurance prior authorizations for {first name}. Approved units are drawn down automatically as linked visits are completed and billed, and staff are alerted before each authorization expires.” Physicians and admins see the tab and may add and edit authorizations without any billing permission; other staff see it only with billing.prior_auth.manage (the Biller and Billing Manager role profiles include it, and they reach it from the Billing workspace’s Patient billing dialog without chart access). Grants are managed under Staff accounts & permissions.

1. Start from a policy. An authorization always belongs to a specific insurance policy, so if the patient has none the card reads “Add an insurance policy on the Insurance tab before recording a prior authorization” and Add authorization is disabled with the tooltip Add an insurance policy first. Add the coverage on Insurance first.
2. Record the approval. Add authorization opens Add prior authorization, subtitled For {first name}. Insurance policy and Authorization number are required; everything else is optional. Save with Add authorization.
3. Read the card. Each authorization is one row: the authorization number, its status pill, an expiry chip when one applies, then a muted line with the policy, {n} units requested, Follow-up {date}, Services: and Diagnoses: when codes are listed, the units, and the effective window. Free-text Notes appear underneath, and Check visits lists which visits will get the number (see Prior auth letters & corrections). The pencil at the end of the row reopens the same dialog as Edit prior authorization, where the primary button becomes Save changes; the ban icon beside it is Entered in error.
4. Let the units look after themselves. In edit mode a read-only Units used box appears, captioned “Tracked automatically as linked visits are completed and billed” — you set what the payer approved, Hero counts what has been spent. Units read Units not tracked when you left the field blank, otherwise {used} of {authorized} used · {remaining} remaining.

Beside the status pill, a card can carry one expiry chip: Expired when the status says so, Past end date when the end date has gone by, Expires today, or Expires in {n}d within a fortnight of the end date. Beyond fourteen days — or with no end date at all — there is no chip. The chips are an at-a-glance advisory; the authoritative expiry sweep, and the staff alert that comes with it, runs on the server overnight.

The form refuses to save with a message in the dialog banner: Select the insurance policy this authorization belongs to., Authorization number is required., Units approved must be a whole number., Units requested must be a non-negative whole number., Enter valid five-character CPT/HCPCS codes and ICD-10 diagnosis codes, separated by commas., or Effective end must be on or after the start date. A rejection from the server shows its own wording, falling back to Could not save the authorization. Try again.

A card shows Partial approval when approved units are fewer than requested. To work all patients’ requests, pending decisions, partial approvals, and upcoming expirations, open Billing → Prior Auths.

Per-patient billing rules, the money already on the account, and superbills

Two sidebar items in the Financial group cover one patient’s money, and they are deliberately different jobs. Custom Billing Rules is settings — how this patient will be charged. Invoices & Charges is the ledger — what they have been charged. Neither appears for a plain physician. Custom Billing Rules needs an account that can see financial amounts plus either organization admin or the staff permission billing.settings.manage; Invoices & Charges needs financial amounts plus admin or one of billing.charges.manage, billing.ar.manage, or billing.sensitive (billing.payments.collect alone, as a medical assistant or nurse has, no longer shows it). Billing staff also open both from any patient name in the Billing workspace, in the Patient billing dialog. If either panel ever fails to render it says so in place — Custom billing rules could not be displayed. or Invoices & charges could not be displayed. — with a Retry button, leaving the rest of the workspace usable.

Custom Billing Rules

The whole tab is one draft: tick boxes and type rates, then press Save changes in the bar at the bottom. The bar reads All changes saved, or Unsaved changes with Discard and Save changes, and confirms “Billing rules saved.” Leaving the tab or closing the dialog with unsaved edits asks first. The Exceptions card holds three checkboxes:

• Bypass insurance (treat as cash pay) — “Visit pricing and collection use the cash fee schedule instead of eligibility/copay rules, and encounter signing will not create insurance claim charges without an explicit override. Mirrors the Insurance tab control.” This is the one exception a staff account cannot touch without billing.settings.manage; without it the box is disabled.
• Bypass card on file — “Card requirements will not block booking for this patient.”
• Bypass booking collection — “Booking-required collection moves to check-in for this patient.” The patient’s portal and billing view then read Deposit due at check-in instead of at booking.

Under Insurance claims, Automatically file secondary claims is on by default: when the primary insurance finishes a claim and leaves a patient balance, the remainder is filed to the patient’s active secondary policy instead of being billed to the patient. Uncheck it to bill this patient directly.

Below them, Cash charge rates is a collapsed accordion — click the button of that name to open the per-visit-type price overrides for this patient. Nothing inside it is loaded until you expand it, which keeps a long provider list from slowing the tab down; once opened it stays available even after you collapse it again. Inside: Search provider or visit type, which matches every word you type across both (a surname plus Standard finds that provider’s Standard visit; rows show the provider’s formal name, so a nickname won’t match), then a row per provider and visit type with Visit type (and its duration, e.g. 45 min / Online), Provider, the read-only Service rate your organization charges, and a Patient cash rate box prefixed with $ and placeheld Default. Type an amount to override; a rate that already has an override also gains a reset button, Use the service rate for {visit type}, which clears it in the draft. In a DPC practice, membership-covered services read Covered by membership as their service rate, with “Not used in DPC: this visit is covered by membership.” Bad input is refused inline with Enter a valid amount. (and the bar reads Fix the highlighted rate before saving.). The fee schedule these overrides sit on top of, and the rest of the patient-exception model, are documented in Patient exceptions.

Invoices & Charges

Four stacked blocks, all for one patient, in this order: Invoices, Patient portal billing view, Issue a charge or credit, and Issued charges & credits. Invoices comes first and is the same record the billing workspace uses: a left rail of invoices — open balances first, then those with insurance or in insurance review, then paid, then cancelled — and the detail opens on the first open invoice. Each carries a status pill (Balance due, Partially paid once the patient has paid part, Paid, With insurance, Insurance review, …), an optional Claim · {status} pill and a date, beside a detail pane carrying the reconciling tiles (Billed, Insurance paid, Paid/credits, Adjustments), the service lines, any Explanation of benefits, and an Insurance claim panel with its journey chips, Filed service lines, and Remittances (EOBs). Open in Claims Pipeline jumps to that claim — see the claims pipeline. An invoice still with the payer shows its invoice number and billed amount, its service lines, and a box that says where it stands instead of a balance: Awaiting {payer} — “The patient owes nothing until the payer decides.”; Claim being prepared — “Not sent to the payer yet — the claim is still being prepared.”; or Insurance review — “The payer’s answer needs billing review before the patient is billed.” An invoice whose patient share is held for a pending secondary claim reads Awaiting {payer} in amber, with “{payer} hasn’t processed this visit yet, so nothing is due until it does.”; it lists after the open balances and the detail doesn’t open on it. While that claim is pending no card can be charged for the share, but a cash or check payment the patient hands you can still be recorded; the hold ends when the secondary claim stops being pending (see Patient balances for the full rule). A patient invoice with a balance carries the payment actions for staff who collect payments: Collect card payment, Record cash/check payment, and Record external card payment — for a card your own terminal or a phone payment already took (“Hero records it and updates the balance; it doesn’t charge the card.”), reviewed on a Confirm external card payment step before Confirm and record payment; every payment dialog has Cancel. The same actions appear on the invoice in Patient AR and in Take payment. The invoice of a cancelled or no-show visit whose refund has completed reads Paid, with an Appointment balance released line for the unpaid balance the cancellation released, so it no longer shows as owed here or in Patient AR. A no-show or late-cancellation fee invoice carries Waive fee for admins and staff with billing.sensitive: the dialog (“Waive the no-show fee of $50.00…”) takes a reason, and anything already paid toward the fee stays paid. For balances and collections as a workflow rather than a record, use Patient balances.

Under the invoices, Patient portal billing view mirrors what the patient sees — “Patient-safe balances, saved-card readiness, and payment actions.” — with tiles for Patient balance, Available credit, and a count of Open charges, then membership, saved cards, and three columns: Portal-visible charges, Payment history, and Statements. Portal-visible charges read the way the patient sees them — Visit charge · Paid $25.00, or Visit charge · With insurance · nothing due yet — with no $0.00 rows and no cancelled or refunded charges, and their status uses the same words as the invoice that holds them: Balance due, Partially paid only when the patient paid part (a charge only the payer paid reads Balance due), With insurance. The rows under Issued charges & credits follow the same rule; credits, write-offs, and voids keep their own labels. A share held for a pending secondary claim reads $10.00 pending other insurance · Awaiting {payer} with “Nothing can be charged to a card until the secondary claim is processed. Cash and check payments can be recorded from the invoice above.”, the Patient balance tile adds + $10.00 pending other insurance, and Charge saved card doesn’t appear on it (nor on any charge with nothing payable).

Financial documents: superbills, Good Faith Estimates, and receipts

Below the invoice list, Superbills, estimates, statements and receipts opens the patient’s document shelf. It is the same panel under a patient’s invoices in Patient AR. Everyone who can see the invoices can download from it; admins and staff with billing.charges.manage can also prepare documents and record delivery. Both documents open already filled in, so most need only a check and two clicks to issue. For a cash-pay, uninsured, or out-of-network visit, the same two documents are also one click from the visit’s Charges section.

1. What fills in by itself. The provider is the visit’s physician, or the practice’s only physician; with more than one, a physician picker shows the choice and switching it changes the billing name and NPI. Support and system accounts are never offered. The provider’s NPI, tax ID, address, and phone come from Billing Identity, folded into one line; Edit details opens them, and they open by themselves when something is missing. Each service is priced at your CPT List Prices price for that code, or, for a code without one, at your practice’s standard multiple of Medicare; a line under the services says which. Typing a new code fills in its name and price. Each line carries the visit’s diagnoses, at most 12 (the most one service line holds).
2. Prepare a superbill. Prepare superbill opens the visit’s superbill with the invoice’s CPT/HCPCS lines. Before the visit has an invoice (opened from Charges), it uses the codes and diagnoses already entered on the visit — “Filled in from the codes in this visit’s charges. If the codes change before signing, update them here too.” If the visit already has a superbill, the dialog shows it, with Make a correction.
3. Prepare a Good Faith Estimate. Prepare Good Faith Estimate fills in the services expected: this visit’s codes, the codes set up for the patient’s next booked visit type, the codes billed most often for that visit type, the patient’s last visit, or your practice’s most billed service, in that order; a line under the services says which. Planned date is the next booked visit’s date (changing it changes every line); Requested on starts at today. “The patient is uninsured or not using insurance for this care.” is already ticked when Hero knows the patient pays out of pocket, with the reason (cash pay, no insurance on file, or out of network with their insurer); for an insured patient you tick it only when they chose not to use their insurance. Other providers or services scheduled separately starts as none; open it to list them.
4. Cash price or list prices. When the visit has a cash price — a fixed price on the visit type in the Service Menu, or this cash-pay visit’s price — the document opens at that price, and Price with shows both choices with their totals: Cash price and List prices (each service at your list price, or your standard multiple of Medicare). One click switches every line. Tick Remember my choice for estimates (or for superbills) and your next one opens on the same choice; untick it to go back to the cash price. The choice is saved for you, not for the whole practice. An invoice’s superbill always shows what was actually charged.
5. Preview, then issue. Preview opens the document on screen — “Draft — nothing is saved until you issue it.” — with Download draft and Back to editing. Anything still needed is listed under Before issuing, and Issue superbill… (Issue estimate…) waits until it is done. It then asks once: “Issue this superbill for $120.00? By issuing it you confirm you checked the provider, services, codes and amounts. It’s saved permanently in the patient’s record; a mistake is fixed by issuing a correction.” — Back or Issue superbill (Issue estimate). To correct an issued document, use Correct next to it in the list (or Make a correction); the earlier version is kept and marked Replaced by a later document.
6. Deliver it, then record delivery. After issuing, Download PDF or Print, give or send it the way the patient asked, and record how with one click (Handed to patient today, Mailed today, or Sent securely today). From the list, Record delivery takes the method (Paper handed to patient, Postal mail, or Secure electronic delivery) and date; the list shows Delivery not yet recorded until you do. Issuing does not send an email or collect money; patients with billing portal access can download issued documents. For a Good Faith Estimate, deliver within 3 business days of a request, or sooner for care scheduled soon.
7. Download receipts and statements. The same panel lists payment receipts (Download receipt), past statements (Download historical statement — older ones without a retained copy download as a labelled summary), and Download current statement.

Manual charges and credits

Issue a charge or credit records an account adjustment. Staff need charge-management permission to issue charges and billing-adjustment permission for credits; administrators can do both. Pick Charge or Credit, enter Amount, choose Encounter, and enter a Reason for the patient’s statement. The default is Account charge (no clinical visit) or Account credit (no visit). The amount must be $0.01–$100,000.00 with no more than two decimal places. Review the confirmation before issuing.

For taxable account items, the practice can enable Charge sales tax; review the displayed rate, tax, and patient total. Visit fees are not taxed. See Sales tax. Eligible invoice charges can also receive self-pay discounts.

The Issued charges & credits history offers Void charge, Reverse credit, or Reverse write-off when the entry and your permissions allow it. Enter a correction reason; the original history is retained. A paid taxable item can instead offer Cancel charge — item returned: this reverses its tax and turns money already paid into account credit unless already refunded. Returning money to a card is a separate refund.

When enabled for the practice, Send add-card link lets authorized staff send the patient a secure portal link to save a card. The result reports delivery or its failure reason; sending the link does not collect payment.

Every reminder, receipt, and message this patient has been sent

Outbound Comms is the only item in the Administration group and the answer to “did we tell them?” The heading reads Outbound communications over “A record of reminders, confirmations, receipts and messages sent to {first name}. This is an audit view — two-way conversations live in the inbox.” It is for organization admins and staff holding admin.outbound_comms.view; a plain physician never sees the item, on the server as well as in the sidebar. Sending from here needs the further admin.outbound_comms.manage grant. Verification and login codes are deliberately excluded from the log. Ongoing conversations belong in patient threads, and bulk outreach to a list of patients in campaign messaging.

1. Check what is still coming. Upcoming scheduled lists the messages already queued for this patient: the message type, an indigo Asks to confirm pill when a reply is expected, a For appointment {date, time} line when one is attached, and the projected send time. Empty it reads No reminders are scheduled to go out. These are real queued sends — cadence-only projections are not shown, so this is a floor, not a forecast. Which reminders exist at all is configured under Patient notifications.
2. Read the history. Sent history carries the total in parentheses. Each row shows the channel (SMS, EMAIL, and so on), the message type, a violet Manual pill when a person sent it by hand, the subject on email, and a two-line preview of the body. The bottom line is the send time — always with its time-zone abbreviation, e.g. Aug 26, 2026, 12:33 PM PDT — plus · {n} segments on SMS.
3. Interpret the pills. On the right of each row: a delivery pill reading delivered, sent, pending, failed, or bounced, and beneath it, on messages that asked for a reply, a response pill reading Confirmed, Declined, Awaiting reply, or No response. A failed row also prints the carrier’s reason in red — Invalid destination number, for instance.
4. Send a one-off message. Send message opens Send a one-off message, subtitled To {first name}. Choose Channel — Email or SMS — add an optional Subject on email, and write the Message, capped at 2,000 characters with a live {n}/2000 counter. The closing note reads “This is a one-way message. If the patient replies, their response lands in the inbox.” Then Send.

Some patient states stop outreach. When they do, a banner sits above both sections quoting the reason — “This patient is discharged from the practice; automated communications are suppressed”, for example — and spells out the consequence: reminders, follow-up prompts, questionnaires, surveys, campaigns, balance reminders, and statements will not be sent, and either “A message you send manually from here (or from the secure inbox) is still delivered” or “Manual messages are also blocked”. A deceased patient falls in the second group and Send message is disabled outright. Setting the patient back to Active resumes everything. Where a suppression is in force, Upcoming scheduled replaces its list with a count of the reminders that will be skipped.

Eligibility history, a separate eligibility payer, and Medicare payers

These parts of the Insurance tab help you see every check Hero ran on a policy, point eligibility checks at the right payer, and pick the right Original Medicare payer.

Every eligibility check of a policy

Open a policy’s View benefits detail. Below the latest result, Eligibility checks (N) opens the full history: “Every check of this policy, newest first, including Billing Hero’s checks of proposed details.” It shows 25 at a time (Show more) and refreshes when a newer result lands.

• Who asked: the staff member’s name (for example {name}, from Pre-visit), an automatic check (Automatic check before the visit, Automatic check when the policy was added, Automatic check after the policy was changed, Urgent care check-in…), or Billing Hero (Billing Hero, approved by {name} when a person approved it).
• The result: Active coverage, Coverage inactive, Member not found, Name or birth date didn't match, Payer didn't confirm, Setup problem, Payer error, Couldn't check, Skipped, or Waiting for the payer.
• The details: when it ran (your practice’s time), which payer was asked, the date of service, the last four digits of the member ID, the clearinghouse, and whether the check was billed.

Billing Hero sometimes asks the payer about details it wants to propose (for example a corrected member ID) before anyone changes the policy. Those rows say so: “Billing Hero asked the payer about proposed details … This check did not change the policy or its eligibility status.” A negative answer there is shown in amber, not red. Billing Hero also adds such a row when it works a claim held or turned back over its member ID or group number: it checks the policy as it is and reads the member ID and group number the payer has for the member (see Member ID and group number). COB checks are not in this list.

Check eligibility with another payer

Some medical groups take the claims while the patient’s health plan answers eligibility. For those patients, keep the medical group as the policy’s payer and tell Hero where to check eligibility:

1. Open the section. In the add-policy form or Edit policy, open Advanced: check eligibility with another payer. It opens by itself when the chosen payer can’t answer eligibility checks, or when one is already set.
2. Pick the health plan. Search Check eligibility with (optional): “Pick the health plan here; claims still go to the payer above.” Pick it from the list; a payer that doesn’t answer electronic eligibility checks is refused.
3. Save. Saving re-checks eligibility. The policy card then shows Eligibility checked with: {payer} ID {id} under its Files to: line.

It changes only who answers this policy’s eligibility checks: claims and COB checks still go to the policy’s payer. To stop, tick Stop using it: check eligibility with the claims payer again in Edit policy. Patients can’t set it from the portal.

Original Medicare payers and Medicare IDs

• Your practice’s Medicare payer comes first. When your practice has set its Default Medicare payer (see Medicare claims), payer searches for Original Medicare list it first, marked Your practice's Medicare payer.
• A warning when you pick another one. Choosing a different Original Medicare payer shows “Your practice bills Original Medicare through {payer}. Claims and eligibility checks for Original Medicare go to the contractor where your practice sees patients, not where the patient lives.” with Use {payer} instead. Keep the other one only if your practice really bills this patient’s care there. Medicare Advantage, supplement and railroad plans are never flagged.
• Medicare ID format. For an Original Medicare payer, the member ID must be the 11-character Medicare ID: “Medicare ID must have 11 letters and numbers in the format 1EG4-TE5-MK73. Check the Medicare card; B, I, L, O, S and Z are not used.” Dashes and spaces are removed for you. Medicare Advantage, supplement and other private Medicare plans keep the member ID printed on their own card.
• Part B decides Original Medicare coverage. When the payer says only Part A is active, the policy shows Inactive coverage: Part A alone doesn’t cover office visits.

When the insurer didn’t check that date

Some insurers only answer checks dated close to today. Instead of a red failure, the card shows a blue notice, The insurer didn’t check that date, explaining that this isn’t a problem with the member ID and that Hero re-checks with today’s date. Hero retries once with today’s date and then re-checks such policies once a day while the patient has an upcoming insured visit. These answers never block a booking or hold a claim.

Card photos

Photos of the insurance card, whether scanned by staff, uploaded by the patient in the portal, or brought in from another system, show on the policy card as Card front and Card back thumbnails; click one to see it full size. Staff without access to insurance billing details don’t see them.

Read authorization letters, take back a mistake, and see which visits get the number

These additions to the Prior Auth tab save typing, keep wrong numbers off claims, and show which visits an authorization will be sent on.

Read the payer’s letter instead of typing it

Letter reading starts off. A practice administrator, or staff with the billing-settings permission, turns on Read authorization letters with AI at the top of Billing → Operations → Prior Auths: “Adds Scan authorization letter to each patient’s Prior Auth tab.” Turning it off later keeps the letters already read in the chart.

1. Click Scan authorization letter. It sits next to Add authorization once the patient has an insurance policy. Read an authorization letter opens: Upload a photo or PDF (a phone photo works, up to 15 MB), or choose a photo or PDF already in the chart under Or choose a document already in the chart. An uploaded letter is also saved to the patient’s documents as Prior authorization letter.
2. Wait a few seconds while Hero reads it. It reads the first pages of the letter (up to six).
3. Check the authorization. Check the authorization shows what Hero filled in: the insurance policy (with how it matched, for example “Matched to {payer} by the member ID on the letter.”), the authorization number, status, effective dates, units requested and approved, the authorized CPT/HCPCS and diagnosis codes, and notes with the approved units per code and the letter’s conditions. Fields marked in yellow (Check this against the letter.) were unclear or missing.
4. Click Save authorization. Nothing is saved until you do. The letter’s pages stay attached to the authorization.

If Hero can’t read the letter, it says so (“Hero could not read this letter. Try again, or close this and type it in.”) and an uploaded letter is still kept in the patient’s documents.

From a fax. Once a fax is filed to a patient’s chart as a Prior Authorization document, its detail pane in the Fax inbox offers Add authorization from this fax under Open chart (letter reading must be on). It reads the fax’s pages straight away and opens the same check-and-save form; afterwards “Authorization saved. It is in the patient’s Prior Auth tab.”

Entered in error

An authorization added by mistake (a placeholder number, the wrong patient’s letter) is taken back with the ban icon next to its pencil, Entered in error. This replaces setting its status to Denied or Expired: an expired authorization can still be sent on claims for visits inside its dates.

1. Click the ban icon. Mark as entered in error? explains: “It stays on {first name}’s list, marked ‘Entered in error’, but its number is never sent on a claim, its visits aren’t counted, and no expiry alert is raised for it. Its open alerts are closed. This can’t be undone; add a new authorization if you need one.”
2. Say What was wrong? (required), then click Mark entered in error.

The row moves to the bottom, struck through, with Marked entered in error on {date}: {reason}. Never sent on a claim. It can’t be edited, and it drops out of every bucket and count in the Prior Auths queue. Once any visit has used one of its units, the button is disabled (“… its number may be on a claim. Edit it instead.”): correct that authorization with the pencil.

Numbers Hero refuses

The authorization number is sent on claims, so Hero refuses words in its place: “Enter the authorization number the payer gave you. Words like ‘error’, ‘N/A’, ‘pending’ or ‘TBD’ are not authorization numbers, and the number is sent on claims.” Also refused: all zeros or X’s, punctuation only, and answers such as none, see letter or no auth required. Real numbers that only start with such a word (for example PEND-0042) are fine. Numbers are at most 50 characters. If the payer hasn’t given you a number yet, add the authorization when it does.

Which visits get the authorization number

Hero matches an authorization to a visit when the claim is built: the same policy, an Approved status (or Expired, when the visit falls inside its dates), the visit inside the effective dates, and, when the authorization lists Authorized CPT / HCPCS codes, a billed code on that list. “Only visits that bill one of these codes get this authorization number and use an approved unit.” Diagnoses never decide: Authorized diagnosis codes are for reference, and a visit coded with a different diagnosis still gets the number, with a warning on its claim, The authorization lists a different diagnosis. The warning never stops the claim.

Check visits on an authorization lists the patient’s recent and upcoming visits and says, for each, whether the number will be sent and why not, for example “Will be sent on the Oct 14 visit.”, “Will be sent on the {day} visit only if it bills {codes}.”, or “Won’t be sent on the {day} visit: the visit is after the end date.” It also warns when the approved visits are used up.

A replaced authorization expires quietly

When a newer approved or pending authorization on the same policy picks up where an ending one stops (and covers its codes), Hero sends no “expiring soon” or “expired” alert for the old one. At its end date it turns Expired with a note, Replaced by authorization {number}; this one ended {date}., and leaves the queue’s Expiring and Expired lists. An authorization that ends with no replacement still alerts as before.

More demographics: race, ethnicity, language, sexual orientation, gender identity and more

More demographics records the details that the standard Demographics card keeps to one plain answer: several races and ethnicities with detailed choices, a preferred language from the full list, sexual orientation and gender identity, a sex for clinical use, name prefix and suffix, previous names and addresses, tribal affiliation, occupation, phone types and date of death. Each answer is saved with a standard code, so it travels correctly when the record is shared with another practice or exported.

1. Turn it on. A practice administrator opens Admin → Additional Features, switches on More demographics, and clicks Save Changes. It is off by default. The pronoun choices also need Patient pronouns turned on.
2. Open it. In Patient Information, choose More demographics under PATIENT (or link to it with ?section=more-demographics). It shows four cards: Identity, Background, Life, work and contact, and Previous names and addresses. A question nobody has answered reads Not recorded.
3. Click Edit. The form Edit more demographics replaces the cards, with Cancel and Save at the top. Pick answers from the chips and search boxes (see the table), then Save.
4. Add previous names and addresses. These save on their own, without Edit. Add previous name asks for a first and last name and the Kind of name (Previous name, Name at birth / maiden name, or Nickname), then Add name. Add previous address asks for the street, city, state and ZIP, then Add address. The bin icon on a row removes it.

Prefer not to say means the patient was asked and declined to answer. It replaces any other choice for that question, and picking a choice replaces it.

Keep a list of the patient’s implanted devices

Pacemakers, joint replacements, stents, cochlear implants: Implantable devices lists what the patient has implanted. You scan or paste the device’s UDI (the barcode on the device label or implant card), Hero reads the device ID, lot, serial number and dates from it, and fills in the brand, model, maker, MRI safety and latex information from the FDA device database.

1. Turn it on. In Admin → Additional Features, switch on Implantable devices and click Save Changes. It is off by default.
2. Open the list. In Patient Information, choose Implantable devices under PATIENT. In the vertical chart layout the same list is an Implantable devices section in the patient panel, with a count of active devices. Each row shows the device name, the maker and model, and chips such as MRI: MR Conditional or Contains latex; click a row for every detail.
3. Add a device. Click Add device. In Scan or paste the device's UDI, scan the barcode (a scanner fills it in and looks it up) or paste the whole UDI and click Look up (or press Enter).
4. Check what Hero read. The preview is headed with the device name and lists Device ID (DI), Lot, Serial, Expires, Made, Issuer, the description, MRI safety and Natural rubber latex. Add an Implant date (optional), then click Add device.
5. Mark a device inactive when it is removed. Mark inactive on a row keeps it on record but takes it off the active list; Mark active undoes it. Show all devices includes inactive ones; Show active devices only goes back.

Physicians and administrators can add devices and change their status. Staff need patient.view to see the list and problem_list.manage to add or change devices. Turning the feature off hides the list; nothing is deleted.

Record the patient’s goals, health concerns and health status

Goals & health concerns keeps three short lists the care team updates over time: what worries the patient or the team (health concerns), what the patient is working toward (goals), and coded answers about functional, disability, cognitive and pregnancy status (health status). Positive answers on a social needs screener can add concerns and goals here in one click (see Questionnaires).

1. Turn it on. In Admin → Additional Features, switch on Goals, health concerns and health status and click Save Changes. It is off by default.
2. Open it. In Patient Information, choose Goals & health concerns under PATIENT. In the vertical chart layout it is also a section in the patient panel; its count is the open concerns and goals.
3. Add a health concern. Add concern opens Health concern (for example Worried about falls at home); click Add concern to save. Resolve closes one and Reopen brings it back; resolved concerns hide behind Show resolved concerns (N).
4. Add a goal. Add goal asks for the Goal (for example Walk 30 minutes, 5 days a week), Whose goal? (Patient's own goal or Set with the clinician), an optional Target date, and, when there are active concerns, For which concern? (optional). Each goal’s status menu offers Proposed, Active, On hold, Completed and Cancelled; completed and cancelled goals hide behind Show finished goals (N).
5. Record health status. Record health status asks for the Area, then a question and its answer, and saves with Save. The newest answer to each question shows; Show earlier answers (N) lists the history with dates.

• Chips. Social need marks a concern or goal that came from a social needs screener; Patient's goal marks a goal the patient set.
• Entered by mistake? The × on a row, Remove (entered in error), takes it off the list.
• Who can do what. Physicians and administrators can add and change entries. Staff need patient.view to see the section and problem_list.manage to add or change entries; without it the add links are greyed out with “Adding needs permission to edit the problem list.”
• What it does not do. Adding a concern or goal does not add a diagnosis to the problem list; record diagnoses there as usual (see Problems & allergies).