Visits

A visit is the billable encounter: one patient seen by one provider on one date of service. Each visit belongs to an episode of care, which supplies the discipline and the diagnoses. NeatPractice keeps every visit; a visit created in error is voided, never deleted.

Start a visit from an appointment#

Once the patient has checked in, click Start Visit:

• at the bottom of the Edit Appointment window
• on the appointment's summary on the calendar

NeatPractice creates one visit for each patient who came and each provider who renders: a group gives each patient their own visit, and a co-treatment gives each provider their own visit under the patient's episode in that provider's discipline. The patient's status changes to In session and the visit screen opens on your own visit.

Click Start Visit again to reopen the visits already started; NeatPractice never adds a second visit for the same patient and provider on an appointment.

The visit starts with what the appointment already knows:

• the patient, the episode and its diagnoses in claim order
• the rendering provider and, from Setup supervision, the supervising provider
• the date of service, start and end, location or service address, and the place of service
• the visit type's default procedure codes; a single timed code takes the whole session as its minutes
• the patient's coverage and authorization on that date

For a telehealth appointment, starting the visit counts the patient as arrived without a check-in (a group still checks each patient in), and the place of service and telehealth modifier come from the patient's payer rules (see Telehealth).

Visits across your patients#

Click Visits in the main menu to see visits for every patient you can see, newest first, at the location you are working in. Each row shows the date and time first, then the patient and chart number, the visit's markers, provider, discipline, codes and units. Click the date to open the visit, or the patient's name to open their chart's Visits tab.

• Pick providers on the panel's Providers tab to see only their visits.
• Pick patients in the patient panel to see only their visits, and move from one patient to the next without opening each chart.
• Click Filter to narrow the list by status, provider or discipline, and click a column header to sort.
• Type in the search box to find visits by a patient's name or chart number, a provider's name or a date of service.
• With exactly one patient picked, click New Visit to start a visit for that patient without an appointment.

Start a visit without an appointment#

For a service delivered outside the schedule, open the patient's chart, go to the Visits tab and click New Visit (or pick the patient on the Visits page and click New Visit there). Choose the episode, the rendering provider, the location, the date and times and, if you like, a visit type for its default codes. Each episode shows its discipline, status and start date, so two open episodes in the same discipline are easy to tell apart. A visit created this way does not add an appointment to the schedule.

The visit screen#

The chart's Visits section lists the patient's visits, newest first, with their status, provider, codes and units. When your clinic offers applied behavior analysis (ABA), a Data sessions tab beside the visits lists the learner's data sessions. Click Filter to narrow it by date, status, provider, discipline or a marker (provider signed, patient signed, co-signed, billed, paid, payroll), click a column header (all but Codes) to sort, and click the date to open the visit. An icon in each marker column shows where the visit stands (hover it for its name):

For a telehealth visit booked with a meeting link, Join Meeting at the top of the visit screen opens the meeting in a new browser tab while the visit is a draft (see Telehealth).

The visit screen shows the patient's active alerts and allergies, the provider, discipline, payer and eligibility, and two lists. Each allergy shows its severity and reaction; a critical alert or a severe allergy turns the banner red and says so in words. If the alerts or allergies cannot be loaded, the banner says they are unavailable and offers Retry: check the chart before treating. If the visit itself cannot be loaded, click Try again.

• Before signing: what still needs filling in, such as minutes for a timed code or a diagnosis pointer.
• Good to know: warnings that do not block, such as overridden units, a payer that does not cover telehealth, a code retired on the date of service with the codes that replace it, Medicare co-treatment minutes to split between the providers, or no active plan of care on the date of service.

While the visit is a draft you can change the date and times, location, service address, place of service and supervising provider, reorder the visit's diagnoses, and edit the treatment lines. The Place of service follows where the visit happened: choosing a service address fills in that address's code, and choosing the location fills in the location's code. Claims report the address with its code, so a visit cannot be saved with a place of service that differs from them; change the address or location instead. Telehealth visits use the payer's telehealth code, which you can pick from the code list. Click Save Visit to keep your changes. New diagnoses are added on the episode, then picked here; each diagnosis can be listed once.

The date and times are the clock at the visit's location. When you move a visit to a location in another time zone, the times you see stay the same and are read on the new location's clock.

Scheduled, actual and billed times#

A visit from an appointment keeps three pairs of times, shown in its Details:

• Scheduled: the appointment's start and end.
• Clocked: the provider's EVV clock in and clock out.
• Billed: the visit's own start and end, which claims and units use.

A visit started after the provider clocked in and out bills the clocked times; otherwise it starts with the scheduled times. Changing the billed times so they no longer match the clocked times (or the scheduled times when nobody clocked) asks for a Reason for billed times, kept on the visit and in the audit log. Setting them back clears the reason.

If you click a link, reload or close the page with unsaved changes, NeatPractice asks before discarding them. If someone else saves the visit while you have unsaved changes, the screen says so: click Reload Visit to see their version, which discards your changes, or Keep My Changes to save over it.

Under Attachments, click Attach File to add a file to the visit, such as a home program or a school form. Choose its category and click Upload. The file joins the patient's chart documents, where it is checked for malware before anyone can open it. A void visit takes no new files.

Under People present, click Edit People to record who was at the session: caregivers from the patient's contacts, staff from your providers, or anyone else by name. When a caregiver guidance code is on the visit, the section shows Caregiver needed, and the visit is not ready to sign until a caregiver is listed or you enter why no caregiver was present.

When the provider clocked in or out from the NeatPractice app on their device, an EVV Clock section lists each clock: the device time, when it reached NeatPractice, the location with its accuracy (or why it is missing), its distance from the scheduled place, who recorded it, the provider's reason or comment, and a flag when the device clock was more than two minutes off. A clock out the office recorded to close the visit shows as Closed by the office or Closed at end of day, and the clocks a split added as Split at the note cap (see Long sessions). This works for every discipline; see Clocking in and out and the EVV page.

For a visit at a patient's home or school, click Mileage to enter the miles driven, to one decimal. Mileage stays editable after the note is signed, and payroll pays it at the clinic's mileage rate (see Payroll settings).

Click Write Note to start the visit's note (a daily note, evaluation or other visit document) on a template you pick, or Open Note once it exists. Signing it finalizes the visit, whatever its type. If NeatPractice cannot check for an existing note, the button reads Note Unavailable, Retry instead, so a second note is never started by mistake. See Daily notes.

Visit journey#

Near the top of the visit screen, Visit journey shows where the visit stands from booking to payment, one step at a time. It reads the appointment, the note, the charges, the claim and the payments as they are now, so it is never out of date.

Each step shows its state (done, in progress, needs attention, blocked or not applicable) and one fact, such as Past due since Oct 11, Held until co-signed or $40.00 patient balance. Click a step to take its next action: open the appointment, write or open the note, review a charge, open the claim or take a payment. You only see the actions your role allows, and a step behind a permission you do not have shows No access instead of its facts. A payment taken from the journey applies to this visit's charges: the amount starts at what the patient owes on them, and you can still pick other charges or keep it on account.

Steps that do not fit the visit show as not applicable: Booked and Reminded & confirmed for a visit started without an appointment, Co-signed when no supervising provider must co-sign, and Claim submitted for a self-pay visit, whose balance goes straight to the patient. When a visit is voided, or its appointment was cancelled or a no-show, a Closed line below the journey says so and the steps it cut short no longer apply.

Visit status#

NeatPractice moves a visit between Draft and Ready to sign each time you save it. Your clinic can also hold signing until the appointment's scheduled start or end has passed (see Visit finalizing); visits without an appointment are never held. Signing the visit's note moves it on (see Sign and co-sign notes); a signed visit changes only through an addendum.

Long sessions#

Some payers cap how much time one note may cover (see Notes on the payer's rules), either as a length or as units of a code per note (15 minutes a unit). A visit longer than that shows a warning with a Split Here button. Splitting ends the visit at the cap and starts a new visit for the rest of the time, with the same provider, patient, episode, location and codes; each visit then gets its own note. The timed minutes stay with the first visit up to its new length, and the rest move to the new one. With ABA, a data session still running on the visit ends and a new one starts on the new visit, so collection carries on. Signed notes also print the session's start and end time in the payer's time format.

When the visit came from an appointment that only it uses, the appointment splits too: it now ends at the cap, and a new appointment with the same patient, provider, type and place covers the rest, so the calendar shows two sessions and each visit has its own. If you were clocked in for EVV, NeatPractice clocks you out of the first appointment and in to the new one at the split (both marked Split at the note cap), so each visit gets its own clock pair; clocking out later from your device lands on the new appointment. An installed app that is clocked in picks up the new appointment on its next sync while online, and shows it with the clock still running. Group and co-treatment appointments keep their booking, and the new visit stands on its own.

When you book an appointment longer than the cap, the booking offers Split into N sessions instead (see Split a long booking).

One note for related visits#

Several sessions with the same patient on the same day, in the same discipline and by the same provider, can share one note. Each visit keeps its own codes and charges; only the documentation is shared.

• On the visit whose note you want to use, the Note section lists the related visits that have no note yet. Click Document on This Note beside one to add it.
• A visit documented on another visit's note shows which visit that is, with Open That Visit, and has no note of its own.
• Signing the note signs every visit it documents. Each one must be ready to sign first.
• The signed note keeps the list of visits it covers, as they stood at signing: the note shows them under Visits covered by this note (date, time, codes and units), and its PDF prints the same list.
• Until the note is signed, click Unlink to take a visit off the note; it then needs a note of its own.

A visit that already has its own note cannot join another. When the payer caps how long one note may cover, each session keeps its own note and visits cannot share one.

Charges and counters#

When a visit is finalized, NeatPractice sends its treatment lines, units, minutes, modifiers, diagnoses, place of service and providers to billing. The visit screen shows it under Charges:

• Held until co-signed: the note waits for the supervising provider, so billing holds the charges. The co-signature releases them.
• Sent to billing with the date and time, once the visit is finalized.

Under Billing, the visit shows the status of each charge in charge review and, once the charges are on a claim, the claim number. People who can read billing open the charge or claim from there.

People who take patient payments see a Patient estimate of what the patient owes for the visit, with Collect to take it at check-out (see Collect at check-out).

Once the visit is finalized, people who can read patient accounts can click Itemized Bill at the top of the visit to print a PDF of its charges, what was paid and adjusted, and what is still due (see Billing in the chart).

Finalizing also counts the visit:

• Authorizations: each treatment line is matched to the most specific authorization that covers it on the date of service, and its units count as used. A visit without an appointment counts as a used visit once finalized.
• Treatment day: the visit screen shows which treatment day of the episode the visit's date is. A date counts once, however many finalized visits with billed units fall on it.

Void a visit#

If a visit was started in error, open it and click Void, give the reason and click Void Visit. The visit stays on record as void with the reason. When it was the patient's only visit on the appointment, the patient goes back to Arrived, so you can start the visit again.

AI documentation#

AI documentation on the visit shows whether the assistant may help document it. Follows consent means a clinician can ask for a draft under your clinic's AI consent rules, unless the patient asked for no AI at all. When the patient asks that no AI be used for this visit, click No AI for This Visit: drafting and ambient session recording are then refused for the visit's notes, whatever the consent says; dictation and read aloud stay available. Click Allow AI to undo it. Text already in a note stays as it is. A voided visit cannot change its choice.

Private notes#

In a mental health visit, the provider who treated the patient can keep a Private note: their own working notes about the session, kept apart from the visit note. Only you can see your private note. Nobody else in the clinic can open it, including owners, administrators and supervisors, and it never appears in prints, faxes, exports, records requests, billing or the assistant.

1. Open the visit and find Private note under Note.
2. Type the note and click Save Private Note. You can change it as often as you like.
3. Click Lock when you are done. A locked note can still be read and deleted, but no longer changed.

To remove it, click the trash icon next to Private note and confirm.

Locked visits and notes#

Your role decides how much of other providers' work you see on a shared chart. With List only, their visits and notes show a lock: you see the date, provider, discipline, type and status, but cannot open them. With Own only, they do not appear. An administrator sets this per role (see Other providers' visits and notes).

Permissions#

A provider with a PRN seat can render up to 25 visits in a calendar month. Starting one more shows a message; an administrator can move the provider to a Full seat (see Licenses).