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. Items are alphabetical within each group, and a group whose every item is hidden from you is not rendered at all — a plain physician never sees the FINANCIAL or ADMINISTRATION headings.
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, appointments, forms-letters, prescriptions, prior-auth, questionnaires, custom-billing-rules, insurance, billing-adjustments, outbound-comms. Anything else falls back to Demographics, which is also where the screen opens with no ?section= at all, 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.
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. Nothing warns you first, so finish or cancel an open edit form before you dismiss it.

Ten tabs exist in total, and which you see depends on your role and your practice permissions:

A plain physician — not an admin, not a staff profile — therefore works with seven: Demographics, Appointments, Forms & Letters, Prescriptions, Prior Auth, Questionnaires, and Insurance. Which permission grants what is set per staff member under Staff & assistants. Two 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 the billing workspace’s claim quick-fix, which opens Demographics already in edit mode.

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 (names, MRN, DOB, Age, Sex, Gender identity, Marital status, Preferred language, Status), Contact (Email and both phones), 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 heading changes to Edit demographics with Cancel and Save at the top right. Fields run in order: First name, 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. Nothing is required, and the phone fields show the raw stored number rather than the formatted one.
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.

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 Visit collection uses the cash fee schedule instead of eligibility copay. Beside it, Billing type always offers Automatic ({label}) first — literally Automatic (Not assigned) when the practice has not classified the patient — 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 secondary insurance. Payer is a typeahead (Search payer name or ID) that searches after two characters — you must pick a result; typing the name and moving on fails with Select a payer. Member ID is required, Group optional, 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.
3. Read the policy card. The payer name heads the card with a Primary badge and a status chip; a Files to: line appears when claims actually route to a differently-named payer. 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 stays on the card under Latest eligibility failure with the payer’s reason code, the recommended action, and a line telling you whether retrying can help.
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 Requires the COB check permission (billing.cob.run)., and a payer the clearinghouse cannot run the transaction against disables it with COB checks are not available for this payer. 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, 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.

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 on the calendar; 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.

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.
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 (Paid, Balance open, Past due, Pending insurance, Not billed and the rest), 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 scheduling workspace 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. 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.
2. 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.
3. 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.
4. 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.
5. Watch the trend. Score trends appears once an instrument has at least two completed, scored results — it is not a fixed list, so PHQ-9, GAD-7, AUDIT-C, or one of your own instruments all qualify the same way. Each group shows Latest {score}/{max} · {interpretation}, a count and date range, a chart on an honest zero-to-maximum scale, and a Date / Score / Interpretation table beneath it. Click a point or a row to read exactly how that submission was answered. With nothing to plot the section is absent rather than empty.
6. 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.

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 letter and Fill form (AI). 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 “Filed portal copies across every encounter. View or reprint the exact document the patient received.” 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.

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.” The tab is visible to everyone who can open Patient Information, and physicians and admins may add and edit authorizations without any billing permission — other staff need billing.prior_auth.manage, which is checked on the server, so a staff account without it will see the buttons but be refused on save. 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, the units, and the effective window. Free-text Notes appear underneath. The pencil at the end of the row reopens the same dialog as Edit prior authorization, where the primary button becomes Save changes.
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., or Units authorized must be a whole number. A payer-side rejection shows the server’s own wording, falling back to Could not save the authorization. Try again.

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

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.payments.collect, billing.ar.manage, or billing.sensitive. 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 Exceptions card holds three checkboxes, and each one saves the moment you click it — there is no Save button and no confirmation.

• 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.”

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, 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 and the save (disk) icon lights up; a rate that already has an override also gains a reset icon that clears it back to the organization default. Bad input is refused inline with Enter a valid amount., a failed save with Unable to update billing preferences. 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. Patient portal billing view mirrors what the patient sees — “Read-only preview from the same patient-safe billing contract used by the portal” — 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. Invoices below is the same record the billing workspace uses: a left rail of invoices, each with a status pill, 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 reads the literal word Pending in place of a number and a balance, because there is no patient responsibility to state yet. For balances and collections as a workflow rather than a record, use Patient balances.

Issue a charge or credit is the only write on this tab. Pick Charge or Credit, enter an Amount, choose an Encounter — the first option is always Create a new encounter — and give a Reason, which is captioned Shown to the patient on their billing statement. The button reads Issue charge or Issue credit and stays greyed out until the amount is above zero and the reason is at least a few characters; there is no inline error text, so a stubbornly disabled button means one of those two. Success reports Charge of $19.50 issued. or Credit of $25.00 applied., and the row lands in Issued charges & credits at the bottom with a Charge or Credit pill, the reason, who issued it, and the amount — credits shown negative.

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.