Duplicate charts and merging

Two charts for the same person split the history: notes on one, coverage on the other. NeatPractice checks for a likely duplicate every time someone adds a patient, and a clinic administrator can merge two charts into one.

Likely duplicates when you add a patient#

When you click Create Patient, NeatPractice first looks for charts you can open that look like the same person. A chart is a likely match when:

• the last name and the first or preferred name are the same and so is the date of birth, a phone number or an email address (the guardian's phone and email count too), or
• it has a coverage with the same payer and member id, whatever the name.

Names are compared without regard to capital letters, accents, spaces or punctuation, so José O'Neil matches jose oneil.

If there are matches, the dialog lists them under This patient may already have a chart with the chart number, name, date of birth, what matched and the status. Click a chart number to open that chart in a new tab and check it.

• If it is the same person, close the dialog and use the existing chart.
• If it really is a different person (twins, or a parent and child with the same name), enter a Reason for a new chart and click Create Anyway. The reason is kept on the new chart so whoever reviews duplicates later knows why it was added.

Changing the name, date of birth, phone or email in the dialog checks again. You only see charts you have access to.

Merge two charts#

Merging needs the Merge permission on patient charts, which the Clinic Admin role has.

1. Open either chart and click Merge in the chart header.
2. In Other chart, type a name, chart number or date of birth and pick the duplicate.
3. Under Chart to keep, choose This chart or The other chart. Keep the chart with the most complete history; its name, date of birth and other demographics stay as they are.
4. Optionally enter a Reason, then click Preview Merge.
5. Check What moves: for each kind of record, how many move to the kept chart and how many stay on the merged chart. A module's records (for example ABA records) show as one line with their total; click it to list each kind under it. Click Merge Charts to confirm.

NeatPractice moves the merged chart's contacts and guardians, phone numbers and email addresses, care team, locations, service addresses, alerts, allergies, episodes of care (with their diagnoses, physicians and referral details), coverage, authorizations, eligibility checks, documents, consents, patient notes, and patient payments and refunds onto the kept chart (payment amounts and history stay as posted), including entries that were deleted, so the history stays complete.

Everything else recorded for the patient moves the same way: appointments, visits and notes with their reviews and deadlines, plans of care and goals, availability and scheduling limits, and, for ABA, programs and targets, sessions and collected data, behavior plans, assessments, reports and folders. Only the chart they belong to changes; signed notes, collected data and signatures stay exactly as recorded.

The merged chart stops appearing in the patient list and search. Opening it, for example from an old link, takes you to the kept chart.

Records that stay on the merged chart#

A few records would clash with what the kept chart already has. The preview counts them under Stay on the merged chart, and they stay where they are:

• a location the kept chart is already seen at;
• a care team entry for a provider already on the kept chart's care team for the same discipline and dates;
• a coverage of the same priority (primary, secondary or tertiary) whose dates overlap one on the kept chart, with its authorizations and eligibility checks;
• an open episode of care in a discipline where the kept chart also has one open, and authorizations for it.

To bring one of these across, fix the clash first (for example, end the old coverage or discharge one of the episodes), then preview again.

A few smaller adjustments keep the kept chart consistent:

• A primary phone or email moves as a secondary one when the kept chart already has a primary of that kind.
• A primary therapist moves as a treating therapist when the kept chart already has a primary therapist for that discipline on the same dates.
• If an active allergy moves in, No known allergies is cleared on the kept chart.
• The merged chart's external id moves to the kept chart when the kept chart has none; otherwise the kept chart keeps its own.

Undo a merge#

For 30 days after a merge, the kept chart shows a notice: Chart 1002 was merged into this chart. To reverse it:

1. Open the kept chart and click Undo Merge on the notice.
2. Confirm with Undo Merge.

The merged chart comes back with exactly the records it brought, and primary flags and roles that changed on the way in are restored, and an external id that moved goes back. Records added to the kept chart after the merge stay on it. No known allergies is not set again automatically; review the allergies first.

What is recorded#

Every merge and undo is written to the security audit log as Patient charts merged or Patient merge undone, and to the access log for both charts. Each moved record's change of chart is kept in the record's history.