Add New Treatment Episode to an Existing Patient

A Treatment Episode represents the patient’s stay, starting with the day they were admitted to the Practice and ending with their discharge date. When a patient returns to treatment, you can create a new prospective or admitted treatment episode for their latest episode of care.

Treatment Episodes tab

Treatment episodes are summarized under the Treatment Episodes tab. This is where new treatment episodes are added. 

Add an Admitted Treatment Episode to an Existing Patient

You can add a new admitted treatment episode to an existing patient directly from their Treatment Episodes tab.

1. Open the Patient profile and click Create Treatment Episode.
2. The Add Episode section allows you to choose whether you want to create a Prospective Episode or an Admitted Episode. Choose Admitted Episode. 
   

   At minimum: Select a Practice to admit the patient into. If the correct practice is not listed, click Back and use the checkboxes to select the correct practice.    Select an A/R Classification. Is the patient paying through insurance, private pay, or a combination? Enter the Admit Date. This is the date when the patient entered treatment. Enter the Patient's Street Address, City State, and Zip Code. While this field isn't required, you will need to add it at some point to resolve the To do: Treatment Episode must have a completed Patient Profile alert. Add at least one Diagnosis Code. You can use the + button to add additional diagnosis codes. While this isn't required, you must add a diagnosis at some point to resolve the To do alert that appears on the treatment episode.  When adding a new treatment episode to an existing patient, you will see an option to Import Patient Data from Last Treatment Episode. Toggling On will move previous treatment episode information including intake, diagnoses, and insurance over to the new episode. Claims and UR plans will not be moved to the new treatment episode. Other fields [Optional]: Standalone Services Only: Enabling the Standalone Services Only toggle only allows patients to be billed for individual services and excludes the patient from level of care/per diem billing.  Admit Time: The time when the patient entered treatment. Admit Type: Elective, Emergency, Information not Available, Trauma, or Urgent. If the information is not known, please use Information not Available. Admit Source: Clinic Referral, Court/Law Enforcement, Emergency Room, HMO Referral, Information not Available. Physician Referral, Transfer from another Health Care Facility, Transfer from Hospital, Transfer from SNF. If the information is not known, use Information Not Available. Occurrence Code: Occurrence codes are typically required when billing workers comp. This only applies to institutional claims and requires a claim form rule to be created.  Occurrence Code Date Referral Source: Use this to track where a referral originated. Anticipated Discharge Date: If there is an estimated length of stay, enter the potential end date of treatment. Click here for more information on managing treatment episodes. Next, you have two options: Choose Add Patient and Episode Only to finish creating the patient's treatment episode without insurance details. Choose Next: Add Insurance to move to the next step in the wizard and add the insurance details.

3. From the Add Insurance window, you can include the patient's primary Medical, Home, and Behavioral payer.
   

   All fields on this page are optional.  Enter the policy's Effective Date.  Use the Payer field to select an insurance. By default, the first payer added is the patient's Medical payer.  If you would like to add the Home Plan or Behavioral Payer, please use the related links.  If needed use the radio button for New Payer or New Paper Payer to add a missing payer to the practice. Click here for instructions on adding secondary and tertiary payers. Next, you have two options: Choose Add Patient, Episode, and Payer Only to finish creating the prospect without Policy information. Choose Next: Add Policy Info to move to the next step in the wizard and add the prospect's insurance details.

    
4. The last section allows you to add the patient's insurance policy details:
   

   At minimum: Add the Insurance ID.  Select the Patient Relationship to Insured.  If the relationship is not Self, please complete the First Name and Last Name fields for the subscriber.  Click Finish to create the admitted patient treatment episode.

Complete Required Information

If you didn't complete all the fields within the newly admitted treatment episode, you may encounter some To Do alerts on the patient's treatment episode. These alerts indicate that some patient information needs to be completed prior to billing.

Check out the below instructions for resolving the most common To Do alerts. 

1. Complete the Patient Profile on the Intake tab.
2. Add the Diagnosis codes on the Intake tab.
3. Complete Insurance Information or add Secondary/Tertiary payers on the Intake tab.

Add a Prospective Treatment Episode to an Existing Patient

You can add a new prospective treatment episode to an existing patient directly from their patient profile.

1. Open the Patient profile and click Create Treatment Episode.
2. The Add Episode section allows you to choose whether to create a Prospective Episode or an Admitted Episode. Choose Prospective Episode. 
   

   At minimum: Select a Practice.  Enter the Anticipated Admit Date.  Next, you have two options: Choose Add Patient and Episode Only to finish creating the prospect without insurance details. Choose Next: Add Insurance to move to the next step in the wizard and add the prospect's insurance details.

3. You can include the patient's Medical, Home, and Behavioral payer from the Add Insurance window. 
   

   All fields on this page are optional.  Enter the policy's Effective Date.  Use the Payer field to select an insurance. By default, the first payer added is the patient's Medical payer.  If you would like to add the Home Plan or Behavioral Payer, please use the related links.  Next, you have two options: Choose Add Patient, Episode, and Payer Only to finish creating the prospect without policy details. Choose Next: Add Policy to move to the next step in the wizard and add the prospect's policy details which are required to run an eligibility check.

4. The last section allows you to add the patient's insurance policy details:
   

   At minimum: Add the Insurance ID.  Select the Patient Relationship to Insured.  If the relationship is not Self, please complete the First Name and Last Name fields for the subscriber.  To run an eligibility check, toggle on Verify Eligibility on Save. Click Finish to create the prospective treatment episode and run the eligibility check, if enabled.

Patient Billing

For clients who have purchased Patient Billing, as soon as the prospective treatment episode is created for the patient, you have access to the Patient Billing tab. The only tab that won't be available is Services. From here, you can collect payments prior to admission.