Overview:
In an ideal world, the documentation of an encounter is accurate when it is first entered by the pharmacy team, however at times errors are made. Our ‘encounter editing’ function allows pharmacy teams to make necessary edits to historic encounters. All changes will need to be attested to for accuracy.
For encounters which resulted in a medical claim, modifications to the encounter will have a downstream impact on the claim, which will also be modified and therefore must be resubmitted and readjudicated. This means that the claim status is important to understand prior to making modifications to the encounter, as claims that have been submitted cannot be adjusted unless they are reversed.
Before modifying an encounter for the first time, we recommend reaching out to support@imagemovermd.com to schedule a screenshare so we can support your first edit and ensure you understand all the necessary steps and impacts. Following that initial use case, the instructions below provide the guidance needed to modify encounters (and potentially claims).
How To:
All PHI shown below is fake data from our testing environment. No PHI is being exposed in this guide.
Encounters that cannot be modified:
Submitted Claims - You’ll see in the example below that encounters associated with claims that have been submitted cannot be adjusted. While you will be able to modify things like adverse reactions or other clinical details within the encounter, you will not be able to modify anything associated with the claim itself. This is why the ‘Resubmit claim…’ option in the screenshot below is greyed out. In order to modify the claim elements of an encounter in this status, you will need to reach out to support@imagemovermd.com to discuss, as we will need to reverse the claim.
Completed Claims - You can also review the claims dashboard to confirm the claim status. In the example below, the claim is in a ‘completed’ status which means payment has already been made, either by the patient or their payor, so the claim cannot be adjusted. If the encounter you need to modify is in this status and the elements you need to modify are associated with claim creation, you will need to reach out to support@imagemovermd.com to discuss, as we will need to reverse the claim.
How to modify an encounter:
- Find Patient - In the web portal, search for the patient, hover over their name and click ‘Edit’ (the pencil icon) on the far right to open their patient record.
- Find the Encounter - Scroll to the bottom of the patient record and look for the encounter you’d like to modify in the ‘Test Results & Encounters’ section. Click ‘Edit’. This will launch our desktop workflows, which houses the encounter editor.
- The system will log your email as the person editing the encounter as well as the date and time at which you’re making the modification.
- Editing the encounter - Before making your encounter edits, select which downstream actions you would like the system to take.
- Resubmit claim and/or manage patient payment info will allow us to resubmit the claim on your behalf and/or charge the patient for their responsibility. If you do not select this item, you will not be able to modify the ‘Billing’ or ‘Counseling’ portions of the encounter.
- Resend patient notification will resend the AVS to the patient based on their preferences.
- Resend CCD (Continuity of Care Documents) to HIE (Health Information Exchange) will update the data we provide to the HIE on your behalf.
- Resend report to PMS will refax the AVS to your PMS (if you have that feature configured).
- Next, use the navigation menu on the far left, to find the field(s) that need to be modified. Modify any responses that need to be changed by either directly updating them or clicking the ‘Edit’ icon as needed..
- One edit that may need to be made after the fact for a vaccine encounter is adverse reactions. If you learn that your patient suffered an adverse reaction from a vaccine you provided, you can update that information easily via the editor.
- Once all edits have been made, navigate to the Summary or Finalize page (depending on the type of encounter and edits you’re making) and click ‘Save and Exit Session’.
- If at any point you determine a change should not be made, simply ‘Cancel without saving’ and the encounter will revert back to its original state.
Once you’ve finalized your changes, please notify support@imagemovermd.com as to the change(s) you made so we can ensure the claim/payment steps are managed appropriately.