This tool enables you to define individual events in Practice Management that are evaluated when an encounter is processed as part of the encounter approval process. The events are expressed as criteria which relate the demographic information of the patient to the diagnoses and procedure codes in the encounter to determine whether some modification of the patient’s information is required. If the event criteria matches the information in the patient’s demographic and/or encounter file, a user defined action or group of actions will occur. The actions can include:
Inserting a patient alert note
Inserting a patient profile note
Inserting a patient appointment note
Creating one or more recall records against which future appointments can be scheduled or the patient can be advised by correspondence that a follow-up visit is required
That an error or an advisory should be recorded in the encounter record alerting the user to the need for further review
Examples of events and actions include:
Event – A patient is diagnosed with diabetes (icd9 code of 250). Action – Schedule a recall for a follow-up visit for six months after the date of the visit being evaluated
Event – A patient is seen for a family planning visit. A cpt code for a depo-privera injection is included in the encounter. Action - Schedule 3 recalls, 3 months apart for injections 2, 3 and 4 as part of a year long birth control program. Recall letters can then be sent advising the patient that follow-up appointments should be scheduled for those periods.
Event – A patient is seen for an annual physical. Action - Schedule a recall for one year from date of last physical
All successful events are logged in a table and in the Patient Activity Log in Practice Management. The Clinical Event Tracker log is reviewed each time to avoid duplicates of a previously created entry. For multiple recalls, the system sets the next run date for a date after the last recall is set.
Recall activity generated by the Clinical Event Tracker can be used to project future appointment loads for routine follow-up procedures. As appointments are made, you can determine the rate that patients are responding to a recall notice. Quality of care statistics can also be derived from this information.
The Aristos is part of the Clinical Event Tracker. It also enables you to create relationships between CPT codes and diagnoses which can further review claims information by:
Reallocating money between insurance and patient if services rendered do not have corresponding diagnosis which the insurance carrier will recognize and pay for
Warn you that a the diagnosis used for a particular CPT code should be reviewed but will allow an override to submit to insurance
Fail the approval process, which requires you to change the diagnosis or procedure before continuing the claims process.
