Documenting Assessment Plan Details You can document your impressions and comments, differential diagnoses, and patient or provider plan details for an assessment using the A/P Details tab.
Document an Assessment Plan You can document patient plan and provider plan details for the patient's assessment.
Document Follow-up Details You can enter follow-up appointment and disposition details on the Follow-up/Disposition template.
Record Postoperative Concerns You can document the type and date of postoperative complications if the patient goes through an unplanned re-operation, hospital readmission, or surgical site infection within 30 days of the operation.
Save the Documented Assessment Details After you have completed documenting the patient's plan and associated details, there are different options for proceeding with the encounter.
Documenting Referral Orders You can place or manage orders for referrals of other specialists, locations, therapies, and durable medical equipment (DME) in the Referrals Orders or Referral Management template.
Document Therapy and Treatment Orders The Therapy Orders template enables you to enter detailed information about prescribed therapy and treatment orders for the patient including the diagnosis, treatment type, physician goals and the number of authorized visits.
