QuickEMR Note Validation
Note Validation
Permission to Complete
To allow a user to complete a note, the user must be given permission in the user settings.
1. Navigate to Lists --> Users
2. Select the user, followed by selecting the Settings tab on the left side of the screen.
3. Check off the box for "Complete Notes" and press Save.
The user must also be designated as a "Signing Provider", which then allows the user to sign the completed note.
1. While in the user settings, navigate to the "Account Info" tab.
2. Check the box off for "Signing Provider" and press Save.
Validations
To complete a note, the note must go through a validation process to ensure that everything that is needed is included.
While not recommended, this can be turned off if needed.
1. You will first need to navigate to Settings --> Validation.
2. Uncheck the box for "Validate required to complete" and press Save.
Please note that Cancellation notes are never validated
For notes to validate, a few other important settings and information need to be correct within the case.
1. A Primary Insurance must be on file for the case.
2. At least one Diagnosis must be set within the case. The Diagnosis must also be valid as of the notes Date of Service.
3. At least one diagnosis pointer must exist on the charge and must match an existing diagnosis
eg 1. If pointer has ABC but only 2 diagnosis are present the "C" will throw an error
eg 2. If the pointers read ABB the second "B" will throw an error.
4. All "Required" custom fields on the General and Details tabs must have something entered within them.
5. Billing Rules are enforced. Certain procedure codes are not allowed with certain diagnosis for a given primary insurance
NOTE: This can be set under the Lists --> Insurance, select the appropriate insurance, then choose the tab labeled Billing Rules.
6. If Settings --> Documentation --> Apply CCI Edits Automatically is turned on, the CCI Edit rules that are labeled "DONOTBILLTOGETHER" will throw an error if both codes are present on the note.
NOTE: The CCI List can be edited under Billing --> CCI Edits.
7. If E-Visit code (G2061, G2062, or G2063) are present no other charges may be on the note.
8. If the insurance within the case has "Require Time on Charge" set within the Insurance Settings, the start and end time must be set on every charge.
9. If Settings --> Validation Rules --> CPT Code Unique is set, the note may only have 1 of each CPT code present.
10. Modifiers KX, GA, UB, U5, 96, 97, GP, GO, GN, 59 are enforced using insurance settings, case settings, and CCI edit list. See individual codes for details on when they are populated and enforced.
NOTE: The modifiers may not be duplicated.
11. If Settings --> Validation --> Note Validation --> "Enforce 8 minute rule" is checked off, the charge units must meet the applied billing rule. See Billing Rule article on how the billing rule is determined and calculated.
12. Minimum and Maximum Bill Units are enforced. Set these values in Settings --> Validation Rules --> Note Validations.
13. Evaluation note types must have at least one validation CPT code.
14. If Settings --> Validation Rules --> Note Validation --> Charges Required is set, at least 1 charge must be present on the note for it to pass validation.
15. If the Note Type Requires the time in/out then time in/out must be populated.
NOTE: This can be set under Documentation --> Customize Note Details. Select the patient type, then note type, and press the Edit button.
16. If Settings --> Validation Rules --> Note Validation --> Require Patient Check-in is set an appointment for the same day, patient, and assigned provider must exist and be set to a checked in status.
17. If Settings => Validation Rules => Note Validation => Goals is set at least one of each of Problems, Short Term Goals, and Long Term Goals must be set.
**Once a discharge note has been completed, the case will automatically be discharged within the system**
API's
Send the note to Foto Outcomes if Enabled.
A QuickEMR article on how to set up Foto within your system can be found here.
A QuickEMR article on how to use your Foto integration can be found here.
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