Note audits

NeatPractice audits every signed note so problems surface before a payer finds them. An audit runs:

• On signing, on the content you sign. The same checks show live in Before signing and the Audit section of the open draft.
• After an addendum, on the note with its addenda, so a correction closes what it fixed.
• Nightly, over visit notes signed in the last two weeks (their charges may have changed) and any signed note that has no audit yet.
• When a reviewer asks, with Run Audit in the note's Audit section.

An audit that finds nothing new on an unchanged note keeps the last result instead of adding another.

What is checked#

Every visit note gets the visit checks, which also run before signing:

• the units billed for each code match the units the note documents
• the codes' minutes fit the session and each code's own times
• the place of service is where the session took place
• the note's template is one the codes are documented on
• at least one plan goal in the note's goal block is marked addressed, or a goal's note says why none was

Notes of every kind also get your clinic's active audit rules that cover them, such as words a note may not use or a minimum length.

AI guideline rules#

When your clinic turns on AI note audits and has AI guideline rules, the AI also judges each covered note against them: met, not met, not applicable or uncertain, with its reasoning and the words of the note it relied on. These rules run a moment after you sign, so signing never waits for the AI, and again after an addendum, nightly and when a reviewer clicks Run Audit. A note that has not changed keeps its earlier AI verdicts and spends no new credits.

AI audits spend your clinic's AI credits, up to the audit budget set in Documentation Rules. When an audit cannot reach the AI (out of credits, past the budget, the AI service is down, the patient opted out of AI or the visit is marked No AI), the audit shows Not run with the reason, keeps the other checks' results and tries again overnight. Your clinic chooses whether such a note is allowed through or sent to QA meanwhile; signing is never blocked.

Checking a draft with the AI#

In the Audit section of a draft, AI guideline check lists how many AI rules cover the note. Click Check Note to have the AI judge the draft now; the button shows about how many credits it costs. The results show under the button with each verdict, its reasoning and the quoted words. A check never blocks signing and opens no findings. If you edit the note afterward, the result is marked The note changed since; check again when ready. A check of the final wording is reused when you sign, so the audit after signing costs nothing more.

What a finding does#

Each failed check or rule opens a finding on the note. What it does depends on the rule:

• Advisory: it only shows.
• Block signing: the note cannot be signed until the rule is met. A user with the Clinical: Audit Override permission can sign anyway and gives a reason, which stays on the finding.
• Hold charges: the visit's charges wait in charge review as Audit findings open until the finding closes.
• Send to QA: the note goes to QA reviews.

A QA rule can also send every note with findings to QA, and a payer can hold their charges while any finding is open.

Working the findings#

Open Documentation > Note audits to see open findings, newest first. Each row names the note, the patient, the rule, its severity, what a failure does and what was found, including the words that matched. Click the note's date to open it. Turn on Show resolved to include closed findings.

A finding closes as Fixed on its own once a later audit passes. A reviewer can also:

• Override it, with a reason, when the note is acceptable as written. Needs Clinical: Audit Override.
• Dispute it, with a reason, when the rule got this note wrong. Needs Clinical: Audit Resolve.
• Reopen an overridden or disputed finding.

To resolve several open findings together, check them in the list and click Override Selected or Dispute Selected, then give one reason for all of them. Each finding is resolved on its own terms; one you cannot resolve says why and stays open.

Overriding or disputing releases the finding's charge hold. Viewing note audits needs the Clinical: Audit Review permission and covers the patients you can see.

Rating the AI#

A finding from an AI guideline rule carries an AI badge. Click Rate AI on it, in the note's Audit section or the QA review, to say whether the AI was right and add a comment for whoever words the rule. Your verdict stays in your clinic and is never sent to the AI service; it changes no resolution or hold. A later rating replaces the earlier one.

A rule the AI found met can be wrong too. On a signed note, click Show passed rules in the Audit section and click Rate AI beside any AI verdict, met or not, to rate it the same way.

The audit section of a note#

Open a note to see its Audit section: the score, each rule that failed with its severity and the matched words, and for a signed note every finding with its resolution. Click Show passed rules to see the rest.

Audit scores#

Each check and rule carries a severity, and each severity a weight: low 1, medium 2, high 5, critical 20. A note's audit score is 100 less the weight of what it failed, as a share of the weight of everything that applied to it. A check that does not apply (a note with no goal block, say) is left out.

Open Documentation > Audit scores to compare authors. Each row shows the signed visit notes of the last 30, 90 or 365 days, how many passed, the pass rate, the average score and the failures by severity, lowest average first. Pick authors on the Providers tab to compare only them. Audit analytics breaks the same audits down by rule, payer and location.

Payer audit packet#

When a payer asks to audit visits, pick that patient in the patient panel on Note audits and click Audit Packet. Choose up to 50 signed visits and click Build Packet. The packet is one PDF with, for each visit, a summary of the services, every signature on its notes, the supervision that overlapped it and its audit score and findings with their resolutions, followed by the signed notes. It builds in the background and lands under My exports in Reports.