Understanding Associations
An association is a logical grouping of practices that have a business interest, activity, or purpose in common. Associations are specifically designed to help you meet HIPAA Privacy regulations by limiting access to person records at the association level.
A default association with an ID of 000 is automatically created in the database for new installations and for upgrades. Any default associations from previous versions of NextGen® Enterprise EHR or NextGen® Enterprise PM are mapped to the new default association.
New person records created prior to the creation of any associations other than the Default Association 000 or existing person records not assigned to a specific association (for example, the records exist in the Master Patient Index (MPI) due to a demographic conversion from another system) will remain attached to the Default Association 000.
The following list provides details of how associations work within the application:
- When a user upgrades, every person (globe) or patient (chart) record is copied into the person_association_xref table and assigned to the newly created Default Association 000.
- If a user has not created additional associations when new person records are created, they are still assigned to the default association.
- If a user creates a new person record from the practice that is assigned to a new association, the record is assigned to the new association only.
- When a user creates a new association, all records that have an affiliation with that practice are assigned to the new association based on the following:
- Insurance authorizations have been added to a person (with a person or patient record).
- An appointment has been made for a person (with a person or patient record).
- Eligibility information has been requested or referral information has been obtained for a person (with a person or patient record).
- A person (with a person or patient record) is a patient’s contact on a chart.
- A person has a chart.
- If an existing person record assigned to the default association is opened and edited in a new association via a secure lookup, the record is then assigned to the new association and the default association.
- If a guarantor, who is assigned to the default association, becomes assigned to a patient in a new association, then the record for the guarantor will be assigned to the new association and the default association. The user in the new association will have to perform a secure lookup to obtain the guarantor’s people record from the default association.
- If a user does not have the secure lookup permission, he or she can still obtain access to a record outside of the practice’s association through the DupeCheck function. DupeCheck traps any instances of a duplicate record being created within the MPI, then the user can choose to use this record. If the user opens the record and edits the demographic information, the record is also assigned to the new association.
The following scenarios provide some examples of how person records are handled through associations.
Mike is Cindy’s guarantor/parent prior to the upgrade. Both Mike and Cindy are automatically assigned to Default Association 000 after the upgrade. The practice Cindy is a patient in becomes a member of Association 001. Because Mike does not have a chart in the practice, his person record remains in Default Association 000 and he cannot be found through a generic lookup in Association 001. Once Mike’s demographic record is accessed and an edit is made to the record and saved, then Mike’s person record can be found through the generic lookup in Association 001. Mike’s person record has been retrieved and moved to Association 001.
Mike becomes Cindy’s guarantor/parent during the process of creating an encounter. In this case, Mike can be found through the generic lookup in the new association, because the person record was edited when Mike was added as a relationship.