Patient Access Clinic: Schegistrar

Patient Access Clinic
Schegistrar
Epic Cadence
Cadence Table of Contents
Contents
Introduction to Hyperspace .....................................................................1
1. Scheduling an Existing Patient Appointment ......................................1
Patient Lookup ...................................................................................................................... 1
Follow Along: ........................................................................................................................ 2
Entering Appointment Information ...................................................................................... 2
Date & Time Conventions ..................................................................................................... 3
Interpreting the Provider’s Schedule ................................................................................... 5
Test Your Understanding ................................................................................................... 9
Appointment Review and After Scheduling Questionnaire .............................................. 9
Components of Hyperspace ............................................................................................. 10
Using the Patient Sidebar ................................................................................................... 11
Try it out: Scheduling an Established Patient Appointment ............................................. 11
Using the Auto Scheduler to Find the Next Available Appointment .............................. 13
Follow Along: ...................................................................................................................... 13
Appointment Reminders ................................................................................................ 13
Warning and Error Messages at Scheduling and Check In ......................................... 13
Confirming Medicaid Eligibility ....................................................................................... 14
Try it out: Established Patient Appointment ...................................................................... 15
Marking Duplicate Patients for Merge .......................................................................... 16
If You Have Time: Review Exercise .................................................................................... 19
2. Scheduling and Registering a New Adult Patient ..............................1

Try it out: Scheduling and Registering a New Adult Patient .............................................. 8
Scheduling a New Self-Pay Patient ................................................................................. 9
If you have time…. ............................................................................................................. 10
3. Scheduling and Registering New Dependent Patients ......................1

Schedule and Register a New Dependent Patient, Same Guarantor/Subscriber ...... 1
Schedule and Register a New Dependent Patient, Different Guarantor/Subscriber ...... 2
If You Have Time… ............................................................................................................... 5
4. Scheduling from Active Requests ........................................................1

Scheduling a Lab Appointment from an Active Request .................................................. 1
Linking Multiple Active Requests to a Single Appointment ............................................... 2
Scheduling Radiology Appointments ................................................................................. 3
O2 Schegistrar: May 2022 ii

Transcribe Order for an Established Patient ........................................................................ 5

Exercise 5: Radiant Front Desk Orders ............................................................................. 10
5. Scheduling with Referrals .....................................................................1

Scheduling from a Referral .................................................................................................. 1
Creating and Assigning a Referral during Scheduling ...................................................... 2
6. Scheduling Variations ...........................................................................1

Scheduling Sequential Appointments ................................................................................ 1
Schedule Sequential Appointments Separated by Several Days using Patient Preferences
............................................................................................................................................... 3
Limit Search By ...................................................................................................................... 3
Scheduling Across Locations ............................................................................................... 4
Scheduling a Recurring Appointment ................................................................................ 5
Appointment Reminder Letters ............................................................................................ 8
Recalls ................................................................................................................................... 8
7. Canceling and Rescheduling Appointments .....................................1

Canceling and Rescheduling Appointments ..................................................................... 1
Rescheduling a Canceled Appointment............................................................................ 1
Canceling and Rescheduling Recurring Appointment ..................................................... 2
8. In Basket Messaging .............................................................................1

In Basket Folder Overview ................................................................................................ 1
Send, Reply and Done a Staff Message.............................................................................. 3
Sending a Patient Call Back Message................................................................................ 4
Using Flags and SmartPhrases to Streamline Patient Call Back Messages ...................... 4
Sending Schedule Messages............................................................................................... 7
Search for Messages ............................................................................................................ 8
Checking the Status of a Message ..................................................................................... 9
Chapter 8 Review Exercise ................................................................................................ 10
9. Insurance Verification ..........................................................................1

Insurance Eligibility Errors ..................................................................................................... 1
Tips for Viewing Eligibility Results ......................................................................................... 1
Real Time Eligibility (RTE) Response History ......................................................................... 1
RTE Plan to Subset Mapping ................................................................................................. 3
RTE Exact Plan to Plan Mapping .......................................................................................... 3
RTE Copay Auto Filing........................................................................................................... 4
O2 Schegistrar: May 2022 iii
RTE Error Responses and Follow-Up Actions ....................................................................... 4

Content Errors ........................................................................................................................ 5
Medicare Errors ..................................................................................................................... 6
Other Error Messages ........................................................................................................... 7
Re-running RTE Eligibility Query ........................................................................................... 8
Verification for Plans Not in RTE............................................................................................ 8
Terminating a Coverage Created in Error ........................................................................ 11
10. Department Appointment Report (DAR) ...........................................1

Viewing the DAR ................................................................................................................... 1
Configuring the DAR ............................................................................................................. 1
Concourse ......................................................................................................................... 3
The Concourse Jetway ..................................................................................................... 3
Using the DAR .................................................................................................................... 3
11. Checking in a Registered Patient Appointment ...............................1

Checking in a Patient Appointment ................................................................................... 1
Reprinting Receipts ............................................................................................................... 4
Try it Out: Check In ............................................................................................................... 5
12. Updating Registration Information at Check In ................................1

Check in and Update Registration Information ................................................................. 1
Adding a Secondary Coverage to Medicare .................................................................... 4
Adding a Medicare Replacement Plan.............................................................................. 7
If You Have Time… ............................................................................................................... 8
13. Scheduling Walk In and Workers’ Compensation Appointment ....1

Scheduling a Walk In Appointment .................................................................................... 1
Scheduling an Appointment for a Patient with Workers’ Compensation ......................... 2
14. Payments and Balancing ...................................................................1

Beginning of Day Cash Drawer ....................................................................................... 1
Collecting Office Visit Copay .......................................................................................... 1
Collecting for Clinic Based Procedure ............................................................................ 2
Collecting Payment for Hospital Based and Same Day Hospital Outpatient Procedures
............................................................................................................................................ 2
Collecting Deposits for Self-pay and Do Not Bill Insurance ........................................... 4
Collecting a Copay for Patient Not Billing Insurance ........................................................ 4
Collecting Payments Outside of Check In/Check Out ..................................................... 5
Processing Credit Cards for Payments ............................................................................ 6
O2 Schegistrar: May 2022 iv

Processing Cash or Check Refund on Date Received ...................................................... 6

Processing a Credit Card Refund .................................................................................... 8
Balancing the Cash Drawer ............................................................................................... 10
Cash Drawer Does not Balance .................................................................................... 10
Cash Drawer FAQs .......................................................................................................... 11
Common Cash Drawer Reconciliation Issues ............................................................... 11
Enterprise Cash Drawer Closing Report ........................................................................ 12
15. Workqueues.........................................................................................1
Workqueues Transferring Accounts .................................................................................... 1
16. Using the Wait List ................................................................................1

Adding a patient to the Wait List during scheduling .......................................................... 1
Adding a patient to the Wait List instead of scheduling .................................................... 2
Scheduling a patient from the Wait List after canceling an appointment ....................... 2
Answer Key ........................................................................................................................... 2
Answers - Adding a patient to the Wait List during scheduling .......................... 2
Answers - Adding a patient to the Wait List instead of scheduling ................... 2
Answers - Scheduling a patient from the Wait List after canceling an
appointment ....................................................................................................................... 2
17. Using Crosscheck to Maintain Accuracy .........................................1

Reading and Resolving Errors on the Crosscheck WQ .................................................. 1
Deferring Encounters on the Crosscheck WQ ................................................................ 1
Crosscheck User Scorecard Overview ............................................................................ 3
18. Downtime.............................................................................................1
Registration during RTE Downtime ....................................................................................... 1
Scanning and E-Signature Downtime ................................................................................. 1
Read Only Mode .................................................................................................................. 2
19. Lagniappe ...........................................................................................1

Collecting ABN Signatures ................................................................................................... 1
Checking in a patient in a Non-Provider Based Clinic Setting ......................................... 5
Check Out ............................................................................................................................. 5
Checking Out a Patient’s Appointment ......................................................................... 5
Exercise: Checking Out a Patient with a Follow-up Appointment................................ 5
Check Out Review Questions .............................................................................................. 6
Adding Medicare Railroad in Epic ...................................................................................... 7
Identifying a Medicare Railroad Retirement Card......................................................... 7
O2 Schegistrar: May 2022 v

No Existing or Incorrect Medicare Coverage ................................................................. 7

Maintaining Accurate Appointment Statistics.................................................................... 8
Confirming Appointments .................................................................................................... 9
Exercise: Confirm Appointments Report ......................................................................... 9
Confirming Appointments Review Questions ................................................................... 10
International and Transplant Patients ................................................................................ 11
International Patients ...................................................................................................... 11
Transplant Patients .......................................................................................................... 12
International, Transplant Patients Review Questions........................................................ 13
Appendix .................................................................................................... i
Glossary.................................................................................................................................. i
O2 Schegistrar: May 2022 vi

Cadence Introduction to Hyperspace
Introduction to Hyperspace
1. Hyperspace Title Bar Displays basic information about a Hyperspace session, such as the login
department.
2. Hyperspace Tool Bar Lists menu options most frequently accessed by a user.
3. Epic Button Contains menus such as Reports and Tools.
4. Workspace Tabs Tabs are linked to active workspaces including patient workqueues and
patient workspaces. A tab is generated when a workspace is opened.
5. Front Desk Dashboard The home workspace. This contains links to reports, frequent web links,
and alerts.
6. Chart Search Allows users to search all of Hyperspace
7. In Basket Displays new In Basket messages
8. Log Out Allows users to Log Out.
O2 Schegistrar: May 2022 Intro

Cadence Chapter 1: Scheduling
1. Scheduling an Existing Patient

Appointment
The Appointment Desk activity is used to make patient appointments. It is most often
used when scheduling from phone calls. Additional scheduling methods are provided in
later lessons.
Patient Lookup
It is important to understand the implications associated with selecting the appropriate

patient medical record number (MRN) when looking up patients. Incorrect choices can
cause overlays and duplicates, which can have legal ramifications and, in some cases,
lead to death.
There are several ways to look up patients. Enter at least two patient identifiers.
 In the Name/MRN field:
o The patient's full or partial name, in the format Last Name, First Name
o The patient's MRN
 In the SSN field:
o The patient's Social Security number
 In the Birth date field:
o The patient's DOB
Additional fields such as the patient’s phone number and zip code provide greater flexibility
with misspelled names.
Patient Lookup results will also display potential matching records with specific weight values and
corresponding colors. The higher the weight the closer the match resulting in the designated colors
changing from red to orange to yellow to green, respectively. With this, it will more closely match
the patient identifiers entered during Patient Lookup.
O2 Schegistrar: May 2022 1.1

Follow Along:
SCENARIO:
Mary, an existing patient, is experiencing headaches and calls to schedule an appointment with
Provider Drew. Schedule Mary an established patient visit (486) for one week from today.
Entering Appointment Information

Defining an appointment is the next step in appointment entry. To define an appointment, specify
minimally, these five pieces of information:
 Department
 Appointment Notes (Reason for the Visit)
 Visit Type
 Provider or Resource
 Start Search on Date
The Visit type drives the copay amount to be collected at registration. Be careful to select the correct
Visit type.
A visit type can be selected in a variety of ways:
 Enter the full or partial visit type name.
 Enter the visit type ID number.
 Enter a visit type synonym.
 Click the Selection tool or press F5 to view a list of available visit types.
Note: Two visit types may be listed: a specialty list and a general list. General visit types can be
scheduled by any department. Specialty visit types can only be scheduled when a user is logged in to a
department of a given specialty.

Visit type EP – PRIMARY CARE (OHS) [486] will trigger a decision tree, decision trees
help schedulers to schedule the right visit with the right provider and resources.
Decision trees can handle advanced logic to offer a consistent scheduling experience
for both schedulers and patients.
The questions in a decision tree appear one at a time for a scheduler to answer as
the system evaluates the logic in the decision tree for what needs to happen next to
evaluate what visit type should be used. The visit type is then automatically assigned
based on the answers to the decision tree questions.
Providers can be an actual person, a resource, a room, or a piece of equipment that

needs to be scheduled.
If you have a PCP defined for the patient that works in the department in which you
are scheduling, then the PCP’s name may automatically populate in the Provider
section based on system setup. If the patient is not being scheduled with their PCP,
remove it by highlighting the provider's name and pressing DELETE.
Date & Time Conventions

t (today)  today's date
 t+1 = tomorrow's date
 t-1 = yesterday's date
 t-3 = the date three days ago
w (week)  w+1 = the date one week from today

 w-1 = the date one week ago today, and so forth
m (month)  m+1 = the date one month from today (for example, if today is June
24, m+1 = July 24)
 m-1 = the date one month ago today
mb (month beginning)  mb = the first day of the current month

 mb+1 = the date one month from the first of this month
 mb-1 = the date one month earlier than the first of this month

me (month end)  me = the last day of the current month

 me+1 = the date one month from the last day of this month
 me-1 = the date one month earlier than the last day of this month
y (year)  y+1 = the date one year from today

 y-1 = the date one year ago today, and so forth
Hyperspace allows several other methods for entering a date:

 Month/day/year format (4/9/09 or 4.9.09 or 4,9,09)
 Month/day/year format, leaving out the slashes or other delimiters (040908)
 Combination of alpha and numeric characters (April 9 2008)
 Date and time convention (Example: t+1)
The Schedule Scanner allows quick view of how full a provider's schedule is for the next seven days.
When entering a provider in the Provider field or performing a department search, the provider
appears on the Schedule Scanner.
The percentage of the provider's schedule that is already filled appears in each cell, along with a color
that correlates to a percentage range. Double-click a cell to be taken directly to the provider's
schedule for that date. Click on the column headers to list providers by their schedule utilization
percentage.
The Schedule Scanner can be refreshed, viewed in a larger window or used to view future and past
dates by selecting the arrows above the Schedule Scanner.

Interpreting the Provider’s Schedule

The Provider Schedule form displays the schedule information for the provider(s) selected on the
Make Appointment form. The schedule located in the middle section of the form changes based on
the view options: whether the view is for open times only or all times, and one or more
providers/dates.
The first view displayed is defined by the view selected on the Make Appointment form. The view can
be changed by clicking the arrow next to the View field at the top of the form and selecting a new
view.
Number of Openings Indicates the number of regular available

openings for each slot (including additional
overbook openings). Note: Highlight colors are
customizable and might be different at each
facility.
Time The beginning of each period displayed on a

provider’s schedule as determined by the
provider's template. A provider’s schedule might
be divided into 15-minute or 60-minute (hour)
periods.
Pri? Indicates whether the slot is public or private.
If the column is blank, the slot is public and can

be scheduled into by anyone with department
scheduling access.
If Pri appears in this column, the slot is private

and requires private access to schedule.
MRN The scheduled patient’s Medical Record

number.
The word End in this column indicates a break at

this point in the schedule.
Name Displays name of scheduled patient. Alternately:

Can indicate time is blocked for a particular type
of visit or patient, or if provider is unavailable.

Restrictions Check Box Restricts view to time slots that match search
criteria. Must be cleared (unchecked) to view
the full schedule. For example, when searching
for a time slot for an EP appt, slots reserved for
New Patient Appointments or Procedures will
not be displayed.

Regular Openings (Green or Blue Time Slots): Regular openings can be scheduled into without
any problems. The number of open regular slots is indicated by the number located in the column to
the left of the time slot
 A green slot with a positive number indicates no regular appointments have been scheduled.
 A blue slot indicates at least one regular opening has been booked and at least one regular
opening is available.
 No special security is needed to schedule into these slots. (Note: All other time slots require
special security access, which may not be available to a Schegistrar.)
Overbooks (Yellow Time Slots): Overbooks may or may not be a part of a provider's schedule.
These openings are set up if the provider is willing to be overbooked in certain time slots. Users
cannot tell by looking at the schedule how many overbooks are allowed.
 If there is a zero and the slot color is yellow, there are no regular openings available, but the
provider has at least one open overbook available.
 Requires Overbook security to schedule into slot.
Held Time (Gray Time Slots): If a time slot is gray this means the time slot has been designated as
held time. This means that the provider wanted a portion of his or her schedule held for some reason.
For example, a possible meeting is coming up and the provider wants to make sure that time is
reserved for it. The hold reason is displayed in the Name column on the schedule.
 Requires Override Held Time security to schedule into slot. (Note: this is different from the
Override security below).
Unavailable Time (Red Time Slots): Unavailable time indicates the provider is unable to see
patients during this time. To understand red time slots, review the number in the slot.
 If there is a positive number, there are regular openings available, but the time has been
marked unavailable for scheduling. For example, time might be marked unavailable if the
provider must take a phone call and does not want any patients scheduled at that time.
o Requires Override security to schedule into slot.
 If there is zero, there are no regular openings or overbooks available.
o Requires Super Overbook security to schedule into slot.
 If there is a negative number, there are no regular openings or overbooks, and the slot has
been super overbooked.
o Requires Super Overbook security to schedule into slot.
 If there is no number, this indicates there is a break in the provider's schedule, or it is the end
of the provider's schedule for that day.

o Requires Override security to schedule into slot.
Name Column: may contain any of the following:

 Patient name
 Block Type
 Reasons/Comments for Held Time or Unavailable Time
Slot Types:
 Public Time Slot: Indicates no special security is required to schedule into a slot. Nothing in the
Pri? column indicates the slot is public and can be scheduled by anyone with scheduling access in the
department.
 Private Time Slot: Pri in the Pri? column indicates the slot is private. Special security is required for
scheduling in private slots. Private Access security is required for scheduling into private time slots.
All other column fields will fill with appointment data once a patient is scheduled into
the time slot.

Test Your Understanding

Dylan would like an appointment sometime this morning with Dr. Owen. The time slots below appear
on the provider's schedule. Which time slot can be scheduled into without having any special
security?
a) A yellow slot with a zero

b) A green slot with a 1 and Pri in the Pri? column
c) A blue slot with a 2
d) A red slot with a 1
Scenario 1: Susan would like to schedule an appointment for 3:00 P.M. tomorrow. That time slot is
yellow and has a zero.
 Is this slot available for scheduling?

_________________________________________________________
 If yes to the previous question, is special security required to schedule into the slot?
_________________________________________________________
Scenario 2: A scheduler is frustrated because he's trying to schedule a patient into a time slot that is
red and has a 1 next to it.
 List one reason he can't schedule into this time slot.

_________________________________________________________
Scenario 3: Jeremy would like to see Dr. Smith at 10:00 A.M. today. The time slot is gray.
 Why is the time slot gray? Give an example of when a gray slot would be displayed.
_________________________________________________________
Appointment Review and After Scheduling

Questionnaire
Always review the Appointment Review window with the patient to confirm the information is
correct. Once you select Accept, the appointment will be scheduled and a contact for the patient in
the system will be created! If you cancel instead of accepting, the appointment is not scheduled, and
you will be returned to the provider schedule.
For an appointment scheduled within 48 hours of the appointment time, select the Confirm now
button on the Appointment Review window. This will prevent the appointment from appearing on the
Confirm Appointments Report and the patient will not receive a reminder call from Televox.

Patients can be added to a Wait List from this screen by clicking Add to waitlist button. Wait List (Add
Appt) Activity will open automatically after clicking Accept.
The After-Scheduling Questionnaire will fire after scheduling an appointment in most clinics, except
for departments such as Executive Health, Smoking Cessation, Research, etc. As responses are given,
additional questions may deactivate, no longer requiring an answer.
Components of Hyperspace
Components of Hyperspace
1. Patient Storyboard Displays information about the current workspace and
patient.
2. Activity Tabs Tabs including Registration, Appt Desk, Appt Entry, and
Response History allow access to other activities
related to the current open activity.
3. Activity Toolbar Icons such as Appt Desk, PCP, Claim Info, used to
accomplish tasks related to the current activity.
4. Registration Navigator Navigators help users move through common

workflows quickly and in one place, all of the
information needed is immediately available on a
single scrollable page.
5. Section Header Edit a section by clicking the header, some sections
have important actions in the top right corner. You can
use keyboard shortcuts to help navigate registration.
F8 will navigate to the next section, F9 will open or
close the current section.

Using the Patient Sidebar

Sidebar reports allow users to access patient information while in another activity. It is a valuable time
and click saver. Displaying information about a patient’s recent encounters, orders, and referrals
allows users to avoid going back and forth between the Make Appointment and Appointment Desk
activities. For example, a user can review a patient’s future appointments to make the appointment
the user is scheduling correct. The Patient sidebar is always available, but users can collapse and
expand it depending on their preference.
There are four report settings to choose from on the Patient Sidebar:
 Appt Desk: A snapshot of the Appointment Desk
 Details: Expanded view with information regarding referrals and orders
 Summary: A concise and abbreviated view
 Summary Plus: Concise view with details

*You may see other report settings but in class today we are going to focus on
these four.
The Sidebar Checklist allows users to verify patient information and correct any errors for
the corresponding record. If any information should be corrected, click the hyperlink in
the error message that appears on the Sidebar Checklist to help resolve the issue quickly.
Select the information icon within a sidebar record to view details on the verification
status.
Try it out: Scheduling an Established Patient

Appointment
SCENARIO:
Jim, an existing patient, calls to make an appointment with Provider Drew for stomach aches. Jim
was referred to SLIC Family Medicine by Dr. Walt Whitecoat. Schedule the appointment for one day
from today.
Some visit types trigger Decision Trees which simply help to ensure the proper visit type
is utilized during scheduling by answering a series of yes/no questions.

TRY IT OUT:
 Using the Appts button, open Patient Lookup to find Jim.
o What information do you need to enter?
 ___________________________
 ___________________________
o What indicators do you see to ensure you have the correct patient?
 The patient’s Appointment Desk opens. Click Make Appt on the Activity toolbar.
 Which fields must be completed to schedule an appt?
o Department: SLIC Family Medicine
o Appt notes: stomach aches
o Visit type: EP – Primary Care (OHS) [486]
o Provider: Provider Drew (classroom information sheet)
o Start search on: t+1
 How can you tell which time slots are available for this visit?
o Hint: color, number, block type
 Select an available time slot with a block of Any on the Provider Schedule.
 Click Schedule.
o Has Jim’s appt been scheduled at this point?
 Review the appointment information with Jim to confirm it meets his needs.
 Since Jim’s appt is within 48 hours, what should you do before clicking Accept?
o ______________________
 The After Scheduling Questionnaire opens.
o Jim does not need to be seen today, the visit is not accident related and did not want
to be added to the waitlist.
 In Registration, what categories must be verified?
o Verify ________________
o Verify ________________
o Verify _____________________________
 Enter Jim’s Referring Provider: Dr. Walt Whitecoat.
 Verify Encounter on Checklist.
 Click Accept.

Using the Auto Scheduler to Find the Next Available

Appointment
The Auto Scheduler can search for solutions to visits in any order, not just the order in which a
scheduler entered the visits in the Make Appointment activity. This allows the system to potentially
return better solutions when the order of a patient's visits does not matter. Any sequencing rules
defined for the visits are still respected.
For example, a patient needs to see a speech therapist, a physical therapist, and an occupational
therapist, but not necessarily in that order. Speech therapy is available only in the afternoon and
physical therapy is available only in the morning. Occupational therapy is available all day. The Auto
Scheduler can rearrange visits to find the best solution.
Schedulers can search for visits in any order by selecting the ‘Visits in any order’ check box in the
Make Appointment activity or on the Recommended Solutions form in the Auto Scheduler.
Schedulers can set their own preference for whether the check box is selected by default.
Follow Along:
SCENARIO:
David, an existing patient, would like to schedule a visit with Provider Drew. He is having flu-like
symptoms and would like to be seen two days from today. This visit is not accident related. Schedule
David’s appointment and update his information as provided by the instructor.
Appointment Reminders
Patients can choose how they want to be reminded about their upcoming appointments. This includes
appointment reminder text messages, emails, phone calls, letters, and MyChart messages. In addition,
appointment reminders are sent in the following timeframes prior to the patient’s scheduled
appointment: Text messages: within 24 hours; Phone Call: 2 days; MyChart: 7 days or anytime the
patient updates their profile; and Letters: 14 days.
Patients must choose at least one reminder preference during scheduling or check in. If preferences
aren’t set, the patient will continue to receive a Letter, Phone Call, and MyChart appointment
reminders.
Warning and Error Messages at Scheduling and Check In

A Confirmation Messages Warning box will appear if appointment reminder preferences aren’t
selected for a patient during scheduling. If appointment reminder preferences aren’t entered at check

in, the warning becomes an error. The registrar will be required to enter at least one preference at
check in.
If the patient has selected “Yes-Wants to receive texts” but has not provided a mobile phone number,
the following message will appear during scheduling as a warning, and during check in as an error:
Confirming Medicaid Eligibility

Epic will automatically send a Medicaid eligibility query when registration is opened for the following
patients:
 Self-pay patients
 Patients with no active coverage on the guarantor account
 Patients with traditional Medicare coverage and no secondary insurance on the guarantor
account.
Currently, this query only receives eligibility information from Medicaid of LA. The patient may receive
benefits from another payor, but the eligibility query will only display Medicaid information.
*For new patients, coverage cannot be created until a guarantor account has been created. Allow the
response to flash until a guarantor account has been created.
FOR TRAINING PURPOSES: To move forward, you must ignore the response. However, in production
you must verify if the patient is eligible for Medicaid coverage.

The Coverage Eligibility for Medicaid window will provide details regarding the
patient’s eligibility for Medicaid. Users should thoroughly read the response to
determine if the patient is eligible for Medicaid coverage and which plan to choose.
If the patient is a Qualified Medicare Beneficiary and has a QMB policy, the initial
response may appear ineligible. Use the QMB Medicaid plan as necessary.
Try it out: Established Patient Appointment

SCENARIO:
George, an existing patient, calls to make an appointment with Provider Drew. George is having sinus
issues and would like to be seen tomorrow. George has Medicare and a supplemental coverage, but
he does not have his insurance information available. Set George’s appointment reminder
preferences to include Letters and Phone Call Reminders. George does not want to receive Text
Message Appointment Reminders. He was referred by Dr. Walt Whitecoat. The visit is not accident
related. Use Auto Search to schedule an EP – PRIMARY CARE (OHS) [486] appointment for George.
TRY IT OUT:
 Which activity will open George’s Appt Desk?
o _______________________________
 Fill in the 5 required fields on the Make Appt form:
o ____________________________________________
o ____________________________________________
o ____________________________________________
o ____________________________________________
o ____________________________________________
 Use Auto Scheduler to find the first available appt. (Hint: Look in Advanced Options)
o How do you know the Auto Scheduler is active?
– The _______________________________________ has disappeared.

 George would like his appointment after 9 am. Use Multiple Solutions to find an appropriate
time.
 Review George’s Appointment Review window to make sure the information is correct.
 Since this appointment is tomorrow, what should you do before exiting the Appointment
Review window?
 Update George’s Communication Preferences.
 Review George’s information. How do you indicate in Epic that the patient’s information is
reviewed and up-to-date?
o ________________________________________________
 Where do the RTE response notifications appear?
o ___________________________________________________
 Why can’t you verify George’s Insurance in EPIC?
o ________________________________________________
 Where can you see the appointment you have made for George?
o __________________________________________________
Marking Duplicate Patients for Merge
The Identity Mark for Merge utility enables end users to notify the EMPI group of
potential duplicates. Schegistrars are usually the first users to encounter duplicate
patients and often are in the best position to gather current demographic
information. Mark patients with similar demographics as possible duplicates. The
EMPI group will process merges.

Follow the steps bellow if you encounter a duplicated patient during check-in (skip to step 5 if
encounter during scheduling):
1. ALWAYS choose the patient with the scheduled appointment.
2. Within registration, add a patient FYI to immediately alert Nurses and Physicians of the duplicate.
Select Patient FYI under Patient Options on the toolbar.
3. Select a Flag Type of General. Enter a message regarding the duplication’s MRN and click Accept.
4. Click Close to exit the activity and return to registration.
5. After the patient is checked-in, access the Mark Patients for Merge Activity. Epic Button > Tools >
Identity Tools> Mark Patients for Merge
6. Patient Lookup opens.
7. Enter Name/MRN: First Patient, the patient with the scheduled appointment.
8. Patient Lookup appears again. Enter Name/MRN: Second Patient.
9. The Mark Patients for Merge window opens displaying First and Second Patients’ information
side-by-side. Click on the correct data in each column as provided by the patient. Note the First
Patient’s MRN is maintained. Selected information now appears in Merge Result column.

10. Enter a reason and any necessary comments for marking these patients for merge. Click Mark for
Merge.
The following warning may appear when updating a patient’s registration information:
To correct the social security number for the patient, replace the SS# of the potential duplicate
with 000-00-0000.

If You Have Time: Review Exercise
Kathy, an existing patient, calls to schedule an appointment with Provider Drew. She
has a fever and cough and wants an appointment tomorrow. Set Kathy’s
appointment reminder preferences to include Letter and Phone Call Reminders and
no text messages. Kathy has no significant changes to her billing or insurance
information. She was referred by Dr. Walt Whitecoat. This visit is not due to an
accident and should not be added to the Wait List. Schedule an Established Patient
appointment for Kathy using the Auto Search function.

Cadence Chapter 2: Scheduling New Patients
2. Scheduling and Registering a New

Adult Patient
Verifying No Record Exists for New Patients
Naming Formats: (Bold = What is entered in Epic)
 Lastname,Firstname: Martinez,Antonio
 Lastname,Firstname space Middle Initial: Martinez,Antonio M
 Lastname,Firstname space Suffix: Martinez,Antonio Jr
 Lastname,Firstname space Middle Initial space Suffix: Martinez,Antonio M Jr
 Lastname Lastname, Firstname: Smith-Martinez, Antonio
Additional Social Security Formats:
 0’s = Unknown
 1’s = Newborn
 2’s = No SSN (International does not have a Social Security #)
 9’s = Refused
To avoid duplication, exercise caution when creating a new patient record;

always check if the patient already exists in the system. If the patient has been
seen at a Community Connect clinic and were fully registered with Epic, a
Patient Creation warning may appear with this message: “SSN already in use by
(Last, First Name)”.

Scheduling a New Patient
Remember, when a new patient record is created, Epic automatically opens registration before
allowing an appointment to be scheduled using Make Appt. Once you’ve completed new patient
registration, you will be taken back to the Make Appt form.
Patient Demographics
When the following symbols are present with a registration field, you will encounter a warning or
error before you close the patient record.
Recommended fields are marked with a yellow yield sign. It may be possible to leave a form
without supplying recommended information.
Required fields are marked with a red stop sign and require completion before proceeding.
The Preferred Name appears throughout a patient’s medical record.

 Patient Header
 Department Appointments Report
When provided, always address the patient by their preferred name
A patient’s preferred first name should be captured during scheduling and

registration. The preferred name cannot be changed or updated while the patient
is admitted. If the Preferred Name field is not populated, a warning will display
during registration.
In certain situations, you will have to click the lock button to the right of the name
box to unlock the name record. In these scenarios, please update the preferred
name only.
Address Information
Correspondence names and addresses are pulled from registration data. Be sure to use proper title
case, spelling and grammar when entering patient data, so correspondence will look professional.
Do not use periods after abbreviations. Use the Tab key after entering a patient’s street address.
Using the Enter key after the street address inserts a blank line and creates a Checklist error. Review
the following examples:

Correct Name/Address: Martinez, Antonio

123 Main St
New Orleans, LA 70118
Incorrect Address: martinez, antonio

123 main st.
no, la 70118
Addresses containing “½ “: Martinez, Antonio

123 ½ Main St
New Orleans, LA 70118
* The “/”is the only symbol that will not trigger an error in Crosscheck.
The Demographics form includes tabs for a Permanent, Temporary and Confidential
Address. The Guarantor account must also have an address listed.
Permanent Address: used for patient correspondence (appointment reminders, lab
results, etc.), can be physical address or PO Box.
Temporary Address: used for patient correspondence when patient is temporarily

living at an address different from his Permanent Address. Requires a Start and End
date.
Confidential Address: holds patient physical address if Permanent address is PO

Box, does not require start/end date. Exception: Patient can choose to have
information and communication sent to the Confidential Address for the specific
period which would require a start/end date.
Guarantor Address: used for billing and statement related correspondence.
Collecting up to date phone numbers and email addresses is crucial at the time of scheduling as they
are used to communicate with the patient about appointment reminders. If a patient does not have
an email address or refuses to provide an email address, leave the E-mail field blank. Then, enter a
reason in the “Reason for no email” field.

No Known Address
When registering a patient with no known address, enter the following:
 In Patient Demographics, enter “No Address” in the Permanent Address field.

 In the City (or ZIP) field, enter “88888”. This will populate “NO ADDRESS AVAILABLE” as the
patient’s City.
 Once this is complete, all rules pertaining to the patient’s address will be satisfied and you can
proceed with the Scheduling/Check-In for the patient.
General Information
The following information should be gathered for each patient to prevent errors/warnings from firing
during check in and registration:
In addition to government mandates, our facility is committed to meeting the needs of every patient.
If the patient is deaf, or English is not the patient’s preferred language, our facility will provide
interpreter services if needed.
 When “yes” is entered in the Interpreter Needed field, the following will happen:
o Information about the patient needing an interpreter will appear on a report to be
worked by the interpreter scheduling department.
o Interpreter scheduling will schedule the interpreter for the patient.
For reporting purposes, it is important to obtain a patient’s ethnicity and race for their medical record.
These fields track healthcare disparities and cultural healthcare trends. Race and ethnicity are self-
reported fields. The registrar should never guess as to the patient’s race and ethnicity.
 Ethnicity: Pertaining to cultural factors such as nationality, regional, cultural, ancestry, and
language
 Race: Pertaining to physical characteristics such as bone structure, skin, hair, and eye color
o The following ethnicities and races should be used with caution:
 Other: Patient believes that he/she belongs to an ethnicity not listed.
 Patient Refused: The patient does not wish to list their ethnicity or race.
 Unknown: This should only be used when a patient arrives to the emergency
department in an unconscious state.

The following language is to be used when registering a new or existing patient in order to collect
information regarding a patient’s ethnicity and race:
Ethnicity- “How would you like for me to list your ethnicity in our system?”
Race- “How would you like for me to list your race in our system?”
*Multiple Race fields are provided for patients who identify as bi-racial.
Another field in General Information is Patient Type. This is used to identify a particular type of
patient. The information appears not only in the patient’s Demographics folder but also in the Patient
Header. If Break the Glass: All Other (patients requesting their record be privatized and employees) is
selected, a Break the Glass message will appear when the patient’s record is accessed. The user is
required to re-enter their password and explain the reason for accessing the account.
Collecting Patient Contact Information
Information entered in a Registration form is saved when the user exits

Registration.
When PCP information is entered in the Patient Care Team activity, the PCP appears in the patient
header and on the Patient Contacts form.
Use the following if the patient has:

 NO, PRIMARY DOCTOR: No PCP
 NOTINSYSTEM, PROVIDER: PCP who is not in the system
o Requires physician information on the Referring Provider Form
Patient are required to have at least one contact on file for emergency situations. The short list of
questions will assist should a patient contact need to be reached. If additional information is provided,
click the pencil icon to expand and edit the Patient Contact form.
 If the patient is a minor, always indicate if a patient contact is a legal guardian.
 If a patient refuses or does not have an emergency contact, enter No, Contact in the name
field. All other fields can remain empty.
Collecting Employment Information
The Patient Contacts form holds information about a patient's employment. Employer information is
stored in the system. When selected from the employer list, the employer's address and phone
number information populate by default. Not all employers are listed. If a patient's employer is not
listed, select Other. A Comment Entry window appears with a free-text Employer field. Enter the
employer and click Accept. Enter the rest of the employer's demographic information in the
appropriate fields.
Employment Status field contains options for patients who are not currently employed.
Collecting Billing Information
Each guarantor account can have only one guarantor. The guarantor can be the patient, another
person or a financial entity. Most adults are their own guarantors. A parent or legal guardian is usually
indicated as the guarantor for a minor. A patient can have multiple guarantor accounts.
Guarantor accounts do not hold insurance information. Insurance information is stored in a coverage
record.
 When a patient receives services that are covered by insurance, a claim is sent to the
insurance company listed in the patient's coverage record.
 Any balance not covered by insurance is billed to the guarantor.
When creating a new patient record, a Personal Family Guarantor (P/F) account will automatically be
created for all patients 18 years old and older.

Using Electronic Coverage Verification
The Coverage Selection form allows users to search for the patient's payor. If a payor uses electronic
verification, a query to verify the patient's coverage information will be sent electronically.
Verification for a payor that does not use electronic verification requires details about the insurance
coverage to be entered manually.
In Registration workflows you will notice some Subscriber ID formatting hard stops. These hard stops
are used to ensure that data entered is always in the proper format required by the payor/plan. If
entered incorrectly, these will advise you of proper ID formatting for the requested payor.
When users receive a response for an RTE-enabled coverage, it is important to check the Response
History to see coverage details, alerts, mismatched information, and any reasons why the patient
might not be eligible for coverage. From here, users can choose to create the coverage, or ignore the
response and try to create a new coverage.
Read the Real Time Eligibility (RTE) Response carefully to confirm the patient is
covered by the insurance plan selected. An error in matching the correct
payor/plan combination will result in a denial.
If Member effective from and Member effective to date fields are entered, the coverage will only be
available for visits and admissions that fall on or between those dates. The Member eff from field is
left blank unless listed on the patient's insurance card. A member effective from date may not be
required for some RTE payors.
On the Subscriber Info form there is an Address Link? field. If this field is set to Yes, there is a link
between the patient and subscriber's address. If you change or update the patient address
information, the subscriber address information is automatically updated and vice versa. Only check
“yes” if the Subscriber has a home phone number.
The following language is to be used when registering a new or existing patient to determine whether
or not the patient is covered by a secondary or tertiary coverage:
 “Do you have any additional insurance that you will be using for today’s visit?”
 “Is there any other insurance that will help pay for this visit?”
 “Are you covered under any additional/other insurance policy?”
 “Do you have any additional insurance cards that you use for any of your healthcare visits?”
 “Is anyone else responsible for your healthcare bills?”

Try it out: Scheduling and Registering a New Adult

Patient
SCENARIO:
Jessica calls the clinic to make an appointment with Provider Drew for a scratchy throat. She is new
and referred by Dr. Whitecoat. Complete her registration and schedule an appointment for tomorrow.
 DOB: 04/15/1980
 SSN: <enter any random nine-digit number>
 Sex: Female
 Address: 135 University Ave City (or ZIP): 70118
 Home Phone: 504-888-9999 Mobile Phone (Primary): 504-369-8888
 E-mail: Patient refused
 Interpreter Needed: No Language: English
 Marital Status: Married Religion: Catholic
 Ethnicity: African American Race: African American
Patient Contacts:
Jessica’s mother, Leann will be her contact. Leann prefers to be contacted on her mobile, 504-444-
5555. Jessica lives with her mother and would like her to be contacted on admission.
She would like to make Dr. Drew her PCP.
Jessica works full-time for Jefferson Parish Sheriff’s Office.
Jessica has Coventry insurance through her job.
Use the following info from her card to enter her coverage:
 Group number: 246
 Subscriber ID: 135791113
 Insurance ID: 135791113
 Group number: 246
 Auth phone: (888) 555-6666
 Group name: JEFF PARISH SHERIFF’S OFFICE
 Covered through: Current Employment
 Employer size: 100+ Employees (3 Enter)
 Co-pay: Primary $25, Specialty $35, ED $65
Jessica would like Phone Call & Text for her Appointment Reminders.

Scheduling a New Self-Pay Patient

Patients without health insurance coverage are considered Self-pay. A deposit must be collected for
these visits based on provider or specialty such as:
 $250.00 Primary Care  $500.00 Specialty Care  $125 Urgent Care
If the amount paid at time of check-in exceeds the amount of the visit, remaining credit will be applied
to outstanding balances. If no outstanding balance, the credit will be refunded after all charges have
been processed. Patients will be billed for any remaining outstanding balance. This does not apply to
Package Pricing.
If a patient indicates that he/she is not covered by any health insurance, the following scripting is to
be used during scheduling:
“Ms./Mr. X we have a self-pay deposit of ($250/ $500) for the physician/department you are
requesting to see. We ask that you bring this amount at the time of your visit and any charges
in addition to your deposit will be billed to you.
The information in the Coverage Info form applies only to the current encounter.
Coverages can be added, removed or edited for this encounter. When a patient
does not have insurance, select the “Self-pay” check box to indicate the patient was
asked and there is no insurance to add. This prevents Epic from pulling the patient
into a workqueue for missing registration information.

If you have time….

Sarah calls the clinic to make an appointment with Provider Drew. She is a new patient with a fever
and a cough. Set Sarah’s appointment reminder preferences to include Letters and Phone Call
Reminders. Sarah would also like to receive Text Message Appointment Reminders. She also indicates
that she was referred by Dr. Walt Whitecoat and this visit is not accident related. Schedule her
appointment one day from today and register her with the following information:
 Birth date: 2/19/1984

 SSN: <enter any random nine-digit number>
 Preferred Name: Sarah
 Address: 125 Morris Blvd City (or ZIP): 39215
 Email: sarahsmiles@email.com
 Home Phone: (601)788-9992, Mobile: 601-524- 8974 (primary)
 Interpreter Needed: No
 Language: Spanish
 Marital Status: Single
 Religion: Catholic
 Ethnicity: Hispanic or Latino
 Race: White
 PCP: Provider Drew
 Emergency Contact: Her brother, Sam
– Address: Same as Patient
– Sam’s (Primary) Mobile #- 504-999-5554
–Sam preferred language is English, does not need interpreter, and will be notified on
admission
 Employment Info: NASA, Stennis Space Center, full time
 Insurance Coverage: BCBS of Mississippi (All Out of State)
 Subscriber: Self
 ID: YAQ 976421332M
 Auth Phone 888-556-1254
 Covered through: Current Employment, 100+ people
 Co-pays: Primary $15, Specialty $25, ED $100

Cadence Chapter 3: Scheduling New Dependent
3. Scheduling and Registering New

Dependent Patients
Schedule and Register a New Dependent Patient, Same
Guarantor/Subscriber
All patients must have a guarantor account so that they can be charged and billed for
the medical services received.
Adding a Guarantor Account
1. The first step in establishing billing information is to add a guarantor account to the patient
record. Click the Pat Guar and Cvg activity.
 For new accounts, the system selects an account type of Personal/Family by default. If the
patient is a minor, the guarantor responsible for the account is not set to Self by default, as
it was for adult patients. Instead, you must select who is responsible for the account.
2. Click Add Guarantor
3. Epic can scan minor's emergency contact information to pull in if the patient is a minor.
4. Click Search for the Guarantor’s Patient Record to search for an existing patient/legal
guardian’s remaining information.
If the responsible guarantor is not an existing patient, you will need to enter the
patient’s Name, Sex, and Date of Birth.
5. Click Search/Create.
Note: Find Existing Account will not work with Individual Billing. You will receive a “No guarantor
accounts were found that matched the criteria” Error Message.
6. Click the Response Notification button. For training only, ignore any Medicaid queries.

Schedule and Register a New Dependent Patient,

Different Guarantor/Subscriber
SCENARIO:
Camille is suffering from earaches. Her mom calls to schedule an appointment with Provider Drew.
Camille is a new patient. She is a minor and lives with her mother and father. Her mother will be her
guarantor. Camille is covered under her father, Richard’s, insurance. Camille was referred by Dr.
Mickey Quinn. Complete her registration and schedule her appointment for one day from today.
Jessica indicates that she would also like to have Camille’s father, Richard [Your information sheet
name], added to her daughter’s contacts. Richard’s primary number is his mobile, 504-667-8989.
TRY IT OUT:
 Appts, search for Camille’s patient record.

o Name/MRN: [Your information sheet name], Camille
o Birth Date: 9/27/2008
 Create a new patient record:

o SSN: < assign any nine-digit number>
o Sex: Female
 Make Appt > Registration
 What’s the quickest way to enter Camille’s address and phone information?
o (Hint: Jessica is a patient too)
 Jessica refused to give an email address.
 Complete the remaining fields:

o Language: English
o Interpreter needed: No
o Marital status: Single
o Religion: Catholic
o Ethnicity: African American
o Race: African American
 Add Jessica as Camille’s contact.
o Legal guardian: Yes
o Notify on admission: Yes
o Hint: Use the pencil icon to pull info into Patient Contact
o How do you add an additional contact?
 Employment status: Student- Full Time, School: Ursuline Academy.

 Add Guarantor Account

o Who is the guarantor for Camille?
o What is the best way to fill the guarantor demographics?
 Coverage Selection
o Richard’s insurance coverage is United Health Care - Jefferson Parish Government.

o Select UHC Jefferson Parish Government, Accept
 Patient rel to sub: child, TAB
 Group Number: 987654
 Subscriber ID: 123789456
 Pull Info into Subscriber: Address Only, Guarantor
 Name: Richard
 SSN: <assign any nine digit number> write here:__________________________
 Sex: Male
 Birth date: 8/20/1979
 Member ID: 12378945602
 Enter the following information on for the UHC Jefferson Parish Government insurance:
o Auth Phone: 208-654-6199
o Covered Through: Current Employer
o Employer Size: 100 + Employees
o Copays: Primary: $15, Specialty: $30, ED: $100
 Enter Subscriber Info. Address link Yes.
 Richard works full time for Jefferson Parish Government.
 Appt Reminder Preferences: Letters and Phone Call Reminders, Yes to texts
o What do you need to do to clear the new warning?
o Hint: Jessica’s mobile number 504-369-8888.
 What visit type should Camille be scheduled for?
 Referring Provider: Dr. Mickey Quinn
 Close Camille’s Appointment Desk.
CHECK YOU WORK:
 Camille should have a New Patient visit for her ear aches with Dr. Drew tomorrow.
 Click on the appt registration. All items should be verified?

New Dependent Patient Under a Medicaid Healthy Louisiana Plan
In Louisiana, Medicaid programs include standard Medicaid and the Healthy Louisiana plans. Patients
who participate in a Healthy Louisiana plan will hold two identification cards: a standard Medicaid
card and their chosen health plan card. For patients in a Healthy Louisiana plan, the plan should be
registered as the insurance. The Standard Medicaid card is not a secondary insurance. Plans can
change; it is important to stay up to date with contracted Healthy Louisiana plans.
Remember, all Medicaid participants are the subscriber for their plan, including children and infants.
When adding Healthy Louisiana plans using RTE, be careful to identify the correct payor, as
many include the logo of large commercial payors, such as United Healthcare.
To safeguard against choosing a plan other than the Healthy Louisiana, use the search synonym
“Medicaid” when searching for each of the Healthy Louisiana plans. The Healthy Louisiana Plans
will have a Financial Class of LA Medicaid.
When adding Healthy Louisiana plans using RTE, be careful to verify the Mem Eff date reflects the
chosen Healthy Louisiana Plan and not the Medicaid benefits. Only the Healthy Louisiana plan
information should be entered into Epic.
Errors in subscriber information can cause denials and delays in payment. Some of the most common
errors occur when a middle name, initial, and/or suffix is listed with the insurance company but not
entered into the patient record. Be sure to use the Name on Card field if needed.

If You Have Time…
Maher’s mother, Sarah, calls to schedule a new patient appointment for him with Provider
Drew. Maher’s DOB is 1/25/2009. He is a new patient and needs to be seen for a sprained
finger. Maher lives with his mother, Sarah, and his father Cole. Sarah will be his Guarantor.
His father covers Maher under Humana PPO insurance. Complete Maher’s registration and
schedule his appointment one day from today.
Name: Maher
Preferred Name: Maher
SSN: <assign any nine-digit number>
Address: Pull from Sarah
Email: sarahsmiles@email.com
Interpreter Needed: No
Language: Spanish
Marital Status: Single
Religion: Buddhist
Ethnicity: Asian Race: Asian
PCP: Provider Drew
Emergency Contact: His mother, Sarah
Employment Info: Full time Student, Hynes Charter School
Insurance Coverage and Subscriber Information:
Name: Cole
SSN: < assign any nine-digit number>
Sex: Male
Birth date: 2/28/1982
Insurance: Humana PPO
Subscriber ID: 465789213
Member ID: 465789213-02 (do not include hyphen in field)
Auth Phone: 985-789-2525
Covered Through: Current Employer
Employer Size: 100 + Employees
Primary Copay: $15.00
Specialty Copay: $30.00
ED Copay: $50
Subscriber Employer: Wal-Mart in Harahan, Full time

Cadence Chapter 4: Scheduling from Orders
4. Scheduling from Active Requests

Active requests are linked to visit types. When scheduling from an active request, the system
automatically selects the appropriate visit type (or prompts the appropriate visit type to be selected
from a list). Scheduling from an active request is slightly easier than regular appointment scheduling
because the visit type is preselected. Scheduling instructions appear in the field under the visit type.
Scheduling instructions are linked to certain visit types to remind schedulers about something in
regard to that visit when they schedule it.
Scheduling a Lab Appointment from an Active Request

In this exercise, you will schedule an appointment for a patient from the active request tab on the
Appointment Desk.
PATIENT: Mary
SCENARIO:
Mary’s PCP has asked that she get some blood work done at the Slidell Lab. She has been complaining
of low energy. Her doctor has signed the orders for three non-fasting tests that should all be
performed tomorrow, during the same appointment. Schedule Mary’s appointment.
TRY IT OUT:
 Open your Mary patient's Appointment Desk.
 Hint: Mary has your assigned last name.
 Select the Active Request tab.
If there are multiple active requests of the same visit type (i.e. non-fasting lab) that need to
be performed during the same visit (such as blood tests) click and drag to highlight all of the
active requests that need to be scheduled for the visit. This will allow all of the active
requests to be scheduled at once without having to Link Requests later.
 Highlight all three requests.
 Click Schedule from request on the bottom toolbar.
 Indicate if the request will be Fasting or Non-Fasting.
 You are taken to the Make Appointment form.
 Note: The Visit Type field is already filled in based on your prior responses.

 Change the department, then enter appointment notes, resource and use the Start search
date from the scenario and info sheet.
 Schedule an appointment for Mary.
SLIH Laboratory is an example of a Hospital Outpatient Department (HOD). HODs

are departments in which patients are scheduled; however, these areas can see
both admitted patients and outpatients for the same treatment or care. These
include laboratories, radiology departments, and therapy departments among
others. Users must select which Patient Type will be seen during an appointment.
 Select Outpatient.
 Complete Mary’s registration.
 Notice the referral source was pulled directly from the active request.
CHECK YOUR WORK:
 Your patient has an appointment on the Future tab of her Appointment Desk. Move the cursor
over the clipboard in the ORD column. The clipboard indicates the three orders are linked to the
appointment.
 If these were the only orders that needed to be scheduled for Mary, the Active Request tab will
disappear.
 Close Mary's Appointment Desk.
Linking Multiple Active Requests to a Single Appointment

SCENARIO:
Madea’s PCP asks that she get some blood work done at the Slidell Lab. She has been scheduled an
appointment for only a sickle cell screening. The CB Auto Differential and TSH orders were also to be
scheduled with the same appointment. Link the remaining orders to Madea’s existing appointment.
TRY IT OUT:
 Locate Madea’s lab appointment.

 Right click on the appointment, select Link Request.
 From the Link Appointment to request activity, select the Request to be attached to the
encounter, click Accept.
 If the request is not listed, check the box in the lower left Show all available requests
that don’t match the appt visit type.
 Multiple requests may be listed. Take care to select the correct orders.

 A purple box indicates future orders and the clipboard in the ORD column indicates an order is
attached to that visit. Verify the linked orders by:
 Expanding the appointment
 Hovering over the clipboard
Scheduling Radiology Appointments

SCENARIO:
Susan calls to schedule the CT abdominal scan ordered by her provider. The electronic order must be
located prior to scheduling the procedure. Schedule Susan’s CT abdominal scan for tomorrow.
 Open Susan’s Active request tab, select the order for CT Abdomen with Contrast.
 Click Schedule.
 A questionnaire appears; answer all questions according to patient responses. (No)
o When completing a questionnaire, a red stop sign in the Answer field requires an
answer be provided.
Visit type questionnaires are useful during appointment scheduling in several ways:
 Guides schedulers in selecting the correct visit type based upon patient’s
answers
 Prevents certain visit types from being scheduled based upon patient
answers
 Department at the top of Make Appointment form serves as a filter. Certain visit types are
restricted to certain departments. For example, only users who are logged in to a department
with the specialty of Infusion Therapy might be able to access the Infusion visit type.
o In production, the department on the Make Appointment form may need to be

changed to gain access to a specific visit type.
 Appointment notes: Abdominal pain
 Visit type: CT ABD W CONTRAST, auto populates. CT IMAGING POOL appears in the Provider
field.
 Note: The provider field is already filled in. This visit uses pools. Read about pools below.
 A pool is a predefined group of providers or resources the system automatically pulls

from when scheduling certain visits.

 You don't always have to manually enter a provider for a visit.
 Providers and/or resources pull in automatically based on the type of visit being
scheduled. This is called a pool.
 Pools save time because you don't have to think about who to schedule with for
specific visits.
 Auto-search is automatically selected.
A provider or resource can be temporarily removed from a pool by selecting the

provider and pressing DELETE.
This change only applies to the individual appointment being scheduled.
 Start search on date: t+1.
o Note that the auto search check box has been selected. Auto search will make
scheduling this appointment faster and easier since there may be restrictions built for
when this particular machine is available for this procedure.
 Susan wants to have her scan performed at Covington, Hammond or Slidell clinic or hospital.
On the Schedule at option, click the Selection button (box with 3 dots) to see a list of available
locations.
 Choose Covington, Hammond and Slidell Hospital.
o A center is a geographical grouping of places of service that are close to one another.
They are useful for scheduling, and it is possible that there is more than one resource
or provider in each center. For example, there may be three CT machines in Slidell that
the system can choose from for this appointment.
 Select Schedule.
 Select Outpatient on the Appointment Review, Accept.
 Registration opens. Referring Provider, the referral source was pulled directly from the order.
 From the Checklist, verify all necessary information is present.
 Confirm that an order is attached to this appointment. The Active Request tab no longer
appears on the Patient’s Appointment Desk.

Transcribe Order for an Established Patient

Providers working in Epic will be placing orders electronically, so schedulers will no longer received
them on paper. For orders coming from doctors outside our organization, or from doctors not yet
using EpicCare, the orders will need to be transcribed from paper or another system into Epic.
Incoming paper and/or fax forms should be reviewed for completeness of information prior
transcribing into Epic.
SCENARIO:
Jessica has been having chest pain. Her physician's office faxed the order below for a chest X-ray.
Transcribe the order and schedule Jessica’s chest X-ray.
EHS
Epic Health Systems
Central Scheduling
Procedure Request Form
Phone: 504-271-9000
Fax: 504-557-3247
Date: Today
Patient: Your classroom information sheet last name, Jessica
Services Requested: X-ray Chest PA and Lateral
Diagnosis: Chest Pain RO7.9
Physician Name. Lic no: Horace Baltz, MD 75614
TRY IT OUT:
 Select the Transcribe Order button from the Hyperspace toolbar to open an Orders Only
Encounter.
 Find your Jessica patient using two patient identifiers, then click Accept.
 On the New Encounter for Jessica, enter the Authorizing Provider and Department:
 Provider: Baltz, Horace
 Department: SLIC FAMILY MEDICINE
Note: The authorizing provider is the physician who signed the order.

 Enter the services requested from the paper order in the +Add Order field.
 Search for new order: X-ray (or x-ray chest pa and lateral).
 The Preference List Search for the patient opens. Select X-Ray Chest PA and lateral, Accept.
 For multiple tests requested on the same order form, select Select and Stay and add any
additional tests to be performed.
 If the procedure does not appear on Preference List Search, expand the search by opening the
Facility List tab.
 The order window opens. If it disappears, simply click the Sign Orders button to reopen. Click the
order hyperlink.
 A Visit Orders Procedures (1 Order) form opens. Fields include:
 Status:
 Future: standard, default normally runs 1 year
 Normal: usually for an in-office procedure

 Standing: used for appointment occurring multiple times

 Priority:
 Routine: default priority, 24 hour turnaround time
 ASAP: 4 hour turnaround time
 STAT: order priority treated as high priority, 1 hour turnaround time
Choose the Order Priority listed on the transcribed order. If the priority is not listed,
then please contact the ordering provider.
 Class:
 Ancillary Performed: outpatient
 Hospital Performed: inpatient
 Verify the order information:

 Status: Future, Expected: t, Expires; y+1
 Priority: Routine
 Class: Ancillary Performed
 Reason for Exam: Chest Pain
 Is the patient pregnant: No
 Click Accept.
 Enter the diagnosis in the Add Diagnosis field. Located at the bottom of the Order Entry form. The
diagnosis can be entered two ways.
 Chest pain OR

 Enter the ICD-10 code: R07.9

 Press Enter.
Key Points on entering a diagnosis:
 If you are provided a phrase or ICD-10 code, enter the phrase or code. If there is more than
one ICD-10 code, and the phrase on the order matches one of the options in Epic, you should
then move forward with transcription by choosing the exact phrase match.
 If there is not an ICD-10 code, or an unspecified ICD-10, you should not proceed in
transcribing the order. Call the ordering physician to obtain the correct ICD-10 code.
 If only an ICD-10 code is given without a phrase for the diagnosis on the order, enter the code
in the Add Diagnosis field and press enter. The code will automatically display in the diagnosis
list below.
 If you are unsure of the appropriate ICD-10 code to select, and there is no phrase attached to
the order, contact the ordering Provider.
 Click Accept.
 Click Associate to link the diagnosis to the order.
 All orders must be associated with a diagnosis. An interlocking circle icon appears next to an
order to indicate the order and diagnosis are associated.
 An Order-Associate Diagnosis box opens, Select All and the Accept.
The Sign Orders button on the Activity toolbar allows the user to select Sign only, Sign & Schedule,
Selective Sign for specific orders or Sign/Nav for orders to be co-signed.
 Select Sign Orders.

 If Sign & Schedule is used please don’t forget to click on the Sign Visit Tab to close the
encounter.

 The Providers window appears.
 Order mode: Transcribed from signed paper order.

 Ordering provider: Order, Paper.
 Entered by: Transcription, Order.
 Click the Sign Visit tab to close the encounter.
 You must sign the visit. This closes the encounter and an InBasket Notification will not
be generated. If the encounter isn’t signed you will be held accountable for closing the
encounter from your InBasket.
 From the Jessica’s Appt Desk, verify to see if there is an Orders tab. If the Orders tab appears,
then an order has been placed for the patient that needs to be scheduled.
 Note Jessica’s appointment desk now has an Orders tab.
 Open Jessica’s registration.
 Navigate to the Documents form.
 Select a blank row on the Documents Table and enter “Physicians Orders”
 Enter “Faxed Order - Dr. Baltz - Chest X-Ray” in the Description field, Tab.
 Scan the paper order into Epic using your OnBase scanner.
 Without a scanned order under the Physicians Orders type, users will receive a Warning at
scheduling and an Error at Check In.
 Navigate to the Checklist and complete any needed verification.
 Click Accept to exit Registration. Close Jessica's workspace.

Exercise 5: Radiant Front Desk Orders

As a front desk user, you may float to the Radiology department’s front desk. To navigate to the
radiology front desk, follow the path below:
Epic (drop down arrow) > Radiology > Front Desk
The Front Desk activity is the main tool for those receiving patients in the diagnostic radiology
department. The Front Desk activity allows users to process the incoming orders that need to be
scheduled, check in and check out patients, and track the exams already in progress within the
department. Radiant relies on both appointments and orders, and the Front Desk is the place where
these two activities intersect.
The Front Desk activity contains two panes, which are work list-style reports for:
 Diagnostic imaging orders to be scheduled
 Progression of appointments through the radiology workflow.
In Front Desk activity, “Please select a report” will display in the Orders and Appointments Pane.
To setup your Front Desk report settings for Orders:

 Click in the empty box to activate the top portion of the activity.
 Select Views and Ambulatory/Inpatient Schedule Orders
To setup your Front Desk report settings for Appointments:
 Click in the empty box to activate the top portion of the activity.
 Select Views and All Imaging Appointments.
SCENARIO:
Doctor Docson has ordered a mammogram for his patient, Mary, who has a suspicious lump in her
breast. The order was written on a piece of paper and faxed to our facility. Before Mary arrives for her
exam, transcribe the paper order and schedule the first available appointment in Epic. All answers to
the scheduling questionnaire are “no” except for “Has it been over a year since last mammogram?”
EHS
Epic Health Systems
Central Scheduling
Procedure Request Form
Phone: 504-271-9000
Fax: 504-557-3247
Date: Today
Patient: Your classroom information sheet last name, Mary
Services Requested: Mammo Digital Bilateral with CAD
Diagnosis: Lump or mass in breast
Physician Name: Dougie Docson
TRY IT OUT:
 Select the Transcribe Order button on the Hyperspace Toolbar to transcribe the order.
Once you have finished transcribing the order, you should see the order listed under the Active
Request Pane.

 Select Schedule from the Activity Toolbar to schedule Mary’s appointment for today. Answer the
questionnaire appropriately.
 Is the patient pregnant? No
 Where was the last mammo performed? Ochsner
 Appt Notes: Mammogram
Once the order has been scheduled, you should see the appointment listed under the Appointments
Pane.

Cadence Chapter 5: Scheduling with Referrals
5. Scheduling with Referrals

Scheduling from a Referral
Referrals are purchase orders for medical services. They allow a patient to see someone (usually a
specialist) other than a primary care provider (PCP). Referrals in Epic can be configured to alert users
when a referral is required for an appointment being scheduled, checked in, or checked out. In this
case, the user might be prevented from continuing until a referral is assigned, or the user might be
allowed to continue without assigning a referral.
Scenario:
Audrey calls because her PCP wants her to schedule a treatment with Provider Chris, one of the
Physical Therapists at SMOC Physical Medicine and Rehab. Audrey’s insurance provider, Aetna,
requires a referral which her PCP has already entered in Epic. Schedule the first available appointment
for tomorrow.
Try it out:
 Navigate to Audrey’s Referrals tab.
 Click Schedule on the bottom toolbar.
The Department, Appointment Notes, and Provider can be pulled into the Make Appointment form
directly from the referral. If only the Department and Appointment Notes (Reason for Referral) is
listed, the Provider field will be left blank.
 Appt Notes: Knee injury
 Visit Type: Consult [2354]
 Provider: Provider Chris
 Start search on: t +1
 Select Auto search and Click Search.
 Schedule.
 Confirm that Dr. Walt Whitecoat is the referring physician. This was pulled from the referral.
 Update Appt Reminder Preferences.
 Audrey would like Letters and Phone Call Reminders.
 Audrey does not want to receive Text Message Appointment Reminders.
 Navigate to the Checklist to Verify all items and click Accept.

Check your work:
 Find the scheduled appointment on the Future tab and highlight.

 The Future appointment shows a red exclamation point in the RFL column, the referral is
assigned.
 Close Audrey’s Appt Desk.
Creating and Assigning a Referral during Scheduling

When scheduling Referrals from the Appointment Desk, users can select Assign Referral on the
bottom of the form to view the assigned referral number. A Referrals Action activity opens. A referral
number is assigned and a green check appears in the next column. Click Close to exit the activity.
SCENARIO:
Karen calls to schedule an appointment with Provider Chris. Her PCP works outside of our
organization and would like Karen to be seen by an SMOC Physical Medicine Provider for an EMG to
assess her chronic back pain. Karen's insurance requires a referral. Create the referral and schedule
Karen’s appointment for four weeks from today.
TRY IT OUT:
 On the Active Request tab, highlight the Procedure EMG- 2 Extremities.
 Right Click, Select Schedule.
 Department: SMOC Physical Medicine & Rehab
 Appt Notes: Chronic Back Pain
 Visit Type: Choose EMG-2 LIMBS and delete any other visit types.
 Provider: Provider Chris
 Start search on: w+4
 Use the Auto scheduler to find the earliest available appointment.
 A Point of Service Warning opens with a red warning alerting the user a referral must be
assigned.
 Assign Referral.

The Referral Action Activity lists the patient’s existing referrals. This form can be used to create new
referrals, edit existing referrals, assign referrals, and disassociate referrals assigned to a contact.
 Click New, a Referral for (Patient) form opens
Referral Details: Patient Demographics, Referral Information, Referral Notes,

Appointment Information.
General: General information associated with a referral to be entered
including: Priority-routine, Class-Incoming (originates outside of our
organization), Internal (from a provider within our organization to another
provider within our organization), Outgoing (from a provider within our
organization to an outside provider), Type, Referred by, Referred to, Visits for
recurring.
Dx/Px: includes the diagnoses and procedures associated with a referral.

When a referral is created while making an appointment, the visit type pulls
into the Procedures (free text) field.
 Click Next, to the General form and enter the following:

 Type: Diagnostic Test
 Class: Incoming
 Provider: McQueenie,Diana
 Referred to: Auto populated
 Requested Visits Total: 1
Patients covered under United Health Care Compass must have a referral from their PCP. Entering
“Self Referral”, “No Primary PCP”, “Not able to Obtain” or leaving the Referring Provider field blank
will lead to a denial from this payor. If the patient’s PCP cannot be found in the system, enter
“Notinsystem”.
Additional information about the patient’s PCP must be entered on the Referring Provider form.
 Click Next to the Diagnosis and Services forms. Enter Diagnosis and Procedure/Service
information, if applicable.
 Click Next three times to the Notes form. If a note is needed, then enter on this form.
NOTE: If the number of authorized visits has been used, a warning appears. Click OK to close warning.

The Referral Action activity displays the list of referrals, including any new ones created. A green
checkmark next to a referral indicates that the referral is associated with the appointment.
 Close Referral activity.
 The Point of Service Warnings form opens reflecting a Referral ID number has been assigned.
 Click Schedule to schedule the first date and time available.
 The Appointment Review Window opens, review information with Karen and click Accept.
 Karen does not want any changes made to her Patient Preferences.
 Registration opens. Verify the Patient, Guarantor and Member Coverage
 navigate to Encounter Info and ensure that ‘no’ is in Accident Related? field.
 Use the Checklist to Verify Encounter.
 The appointment appears on the future tab. On the Referrals tab, the Sched/Comp column
indicates 1/0, 1 appointment scheduled and 0 completed.
The Referrals Sidebar can give users all the information they need in one place, allowing users to view
relevant information referral/patient. In addition, this sidebar allows users to complete the referral
without leaving Referral Entry to look for information elsewhere, saving users time. If a change is
made to the referral in Referral Entry, users must accept the referral and then reopen it to see those
changes in the Sidebar.

Cadence Chapter 6: Scheduling Variations
6. Scheduling Variations
Scheduling Sequential Appointments
Two or more visit types scheduled in the same entry process are called sequential appointments.
Sequential appointments consist of any number of visit types and providers. What makes them
sequential appointments is simply the process of scheduling at the same time. Appointments may be
scheduled in any order and in any timeframe. When scheduling sequential appointments,
appointment information must be entered for each visit type, just as if scheduling a single
appointment. When multiple visit types are entered on the Make Appointment form, the Auto Search
check box is selected by default.
Scenario:
Fred calls to schedule two visits, an EP with his PCP to address a sore ankle and an eye exam with his
Ophthalmologist, Dr Alex. Schedule the visits back-to-back for the same day.
Try it out:
 Open Make Appt form from Fred’s Appointment Desk.
 Appointment note: Sore ankle
 The Share notes check box allows users to share the appointment notes onto all
sequential appointments. To view hidden appointment notes, check the Expand Notes
button.
 Visit type: PRIMARY CARE (OHS) [486]
 Provider field: Provider Drew. This combination represents Fred’s appointment with his
PCP for his ankle pain.
 Return to the Visit type field.
 Department: NSMC Optometry
 Visit type: complete eye exam [2325], Tab. A hard stop will appear to the left of the 2nd
visit type and in the appt notes.
 Provider field: Provider Alex. This combination represents Fred’s eye exam with his
Ophthalmologist.
 Appt notes for the 2nd visit: annual eye exam.
 Start search on: t+1.

 The Recommended Solution form appears.
 If not entered previously, the Appointment note for the 2nd visit can be entered from
the recommended solution.
If the Auto Scheduler cannot find solutions for some of the visits, schedulers can schedule the
appointments with solutions and then manually schedule appointments for those without. This
feature is called partial solutions.
Scenario:
Fred needs time to travel between his appointments. Hold the appointment with Provider Drew then
search for an appointment later in the day with Provider Alex.
Try it out:
 Select the drop-down arrow next to the first appointment listed and chose “Hold Appt”.
 Note: Other schedulers cannot schedule into slots that have been put on hold unless
they have Override Held Time security.
 Click Next, Previous or Date/Time to view different solutions. Select Multiple Solutions to
view additional available appointments.
 Select Schedule.
 On the Appointment Review click Confirm All for both appointments.
 Complete After Scheduling Questionnaire.

 Accept to close Registration.
Check your work:
 An "S" appears in the Appt Link Type column next to the two appointments just scheduled
indicating the visits are linked as sequential appointments.
NOTE: Appointment notes can be adjusted if need be by highlighting the appointment and clicking
Edit Notes from the appointment toolbar.
Schedule Sequential Appointments Separated by

Several Days using Patient Preferences
Fred's sequential appointments (two visits) were scheduled on the same day. Sequential
appointments can be scheduled with a break in time periods. The appointments are sequential
because they are being scheduled in one workflow. Sequential appointments do not have to be
related or fall within a specific time range.
Orders are linked to visit types. When scheduling from an order, the system automatically selects the
appropriate visit type (or prompts the appropriate visit type to be selected from a list). Scheduling
from an order is slightly easier than regular appointment scheduling because the visit type is
preselected. Scheduling instructions appear in the field under the visit type. Scheduling instructions
are linked to certain visit types to remind schedulers about something in regard to that visit when
they schedule it.
The preferences remain stored and will be used

every time an appointment is made for this
patient if the Use patient prefs check box is
selected. Only appointment solutions that match
the patient's preferences will appear in a search if
the box is checked. Clear the Use patient prefs
check box to not restrict search based on the
patient's preferences.
Limit Search By
The Limit Search By pane lets users set up search restrictions during the appointment entry process. Like
Patient Preferences, the recommended solutions form will only present appointments that fall within the Limit
Search by options. Unlike Patient Preferences, the Limit Search by options will not be stored for the patient’s
next appointment.

Scheduling Across Locations

SCENARIO:
Susan calls to schedule an annual checkup as soon as possible. She is new to the area and has only
been to our clinic once before. Susan does not already have a PCP and wants to see a provider at
either Covington or Slidell. Search for providers using Family Medicine Specialty, then to eliminate the
providers who work at locations outside of Covington or Slidell we will use a center filter.
 Open Susan's Appointment Desk. Make Appt.
 Appt notes: annual physical
Visit type: NP – PRIMARY CARE (OHS) [476]
 Next to the Provider field, select the radio button labeled ‘Specialty’
 Specialty: Family Med
 In Advanced Options:
 Schedule at: check Schedule at box, click the three dots in the field.
 Select Covington and Slidell Centers only and click OK.
 Check Auto search.
 Search.
 Schedule Susan’s appt.
 Susan feels that she does need to be seen today. This visit is not accident related.
 Susan wants to receive letters for her patient preference but no texts.
 Ensure all information on the Interactive Face Sheet has been verified.
 On Encounter Info form. Accident Related?: No.
 Referring Provider: Self Referral
 Navigate to the Checklist to Verify Encounter.
 Click Accept to return to Susan’s Appointment Desk.
 Close Susan’s Appointment Desk

Scheduling a Recurring Appointment

Recurring appointments are a series of appointments for the same patient and same visit type that
take place on a regular basis. Any kind of appointment can be scheduled to recur on a regular basis.
For example, a patient might need recurring appointments for allergy shots, chemotherapy, or
physical therapy.
SCENARIO:
Audrey's provider requested to see Audrey for 4 appointments to check her blood pressure. He
would like to see her two times in the first week and one time per week for the next two weeks.
Schedule a recurring appointment for Audrey.
TRY IT OUT:
 Open Audrey’s Appointment Desk.
 Make Appt:
 Department: SLIC Family Medicine
 Appt notes: blood pressure check
 Visit type: Nurse Visit (2373)
 Provider: Provider Drew
 Start search on: t+1
To schedule recurring appointments, define appointment information as usual

but the Recur check box must be checked. When Recur is selected on the Make
Appointment form, the Auto Scheduler is selected by default.
It is often helpful to map out exactly how the appointments should be
scheduled before moving on:
Monday Tuesday Wednesday Thursday Friday

Week 1 X X Period 1
Week 2 X
Week 3 X Period 2
 Under Advanced Options, select the Recur checkbox.

 Search; the Recur Appointments form opens.

Recur Appointments Form
Components of the Recur Appointments form
1. Assign referrals from first

Indicates referrals assigned to the initial occurrence
occurrence to all recurrences
will also be assigned to all of the recurrences.
2. Period Number
Allows more than one recur period to be specified for
the same recurring series. Change to the pattern of
recurring appointments can be changed part way
through but keep the recur link. For example, if the
patient needs to come in twice a week for three weeks
and once a week for five more weeks, separate recur
periods can be specified for each set.
3. Add Period Enter the criteria associated with that specific period
4. Time period
Options include daily, weekly, and monthly. Frequency
corresponds with the time period selected.

5. Multiple per Day

Allows users to specify the number of occurrences per
day the patient should be seen, the beginning or
ending times, and the minimum or maximum amount
of time between the visits.
6. Frequency
How often the appointments are to recur. Based on
the Time Period selected, the appointments occur in
days, weeks, or months.
7. Start Search Date

Date the system starts looking for appointments.
8. Occurrences to Schedule
End Date specifies the date by which the recurrences
should end.
Number of Occurrences specifies the number of
recurring appointments to be scheduled including
the first one.
9. Period Summary Displays the scheduling logic.
 Period Number: 1
 Time Period: Weekly.
 Tue and Thu checkboxes.
 Frequency: Number of weeks between recurrences: 1
 Occurrences to Schedule: Number of occurrences: 2.
 Review the Period Summary to verify that the information has been captured correctly.
 Click Add Period.
Audrey would like to return on Tuesdays for her remaining visits.
 Period Number: 2
 Remove the Thu checkmark
 Occurrences to Schedule: Additional occurrences: 2.
 Review the Period Summary to verify that the information has been captured correctly.
 Search.
The Recur Recommended Solution form appears and displays a recommended scheduling solution
according to the recurrence. Changes can be made to one or more of the recurrences or to the initial
occurrence and then synchronize the rest of the recurrences.

 Solutions appear for each of the appointments on the days specified. Starting with the first
appointment, click Next to search for another time on Tuesdays. If this time works for every
Tuesday, click Match Recurrences to match all of the other appointments to the day and time
specified for the first appointment.
 Schedule and Accept.
 Audrey does not feel that she needs to be seen today. This visit is not accident related and does
not need to be added to the Wait List.
 Audrey does not want any changes made to her Patient Preferences.
 Verify Patient, Guarantor and Coverage from the Interactive Face Sheet.
 Referring Provider: Provider Drew
 Checklist. Verify Encounter.
 Accept.
 The Recurring appointments appear on the Future tab. Recurring appointment indicated by “R”.
Recurring appointments are linked appointments. If one is canceled/rescheduled, Epic will prompt
users with a notification asking if the others should also be canceled/rescheduled.
Appointment Reminder Letters

If the patient’s appointment is scheduled within 14 days of the appointment and they would like a printed
reminder letter, it needs to be printed manually.
OHS Single Appt (Default) – Prints only the selected appointment

OHS Appt Letter – Single Day – Prints all of the patient’s appointments on the day of the
selected appointment.
OHS Appt Multi – Prints all of the patient’s appointments for the next 60 days. A maximum
of 40 appointments will be included in the letter.
Info Button: Opens Select Letter Override window. Allows user to print Spanish language
reminders.
Recalls
Recall functionality allows users to manually create recall records for a patient. Recall records are
used to send reminder letters informing the patient to schedule another appointment. Recall
appointments are then scheduled based on criteria specified in the recall record.
Significant Dates:
Notification Date: The date on which the recall letter is sent to the patient
Recall Date: The earliest date on which the recall appointment can be scheduled.
Expiration Date: The date on which the Recall record is no longer valid.

Templates are available for the Notification Date, the Recall Date, the Expiration Date, Visit Type and
Department. This information is pre-populated but can be edited to add any appointment or
scheduling notes.
Creating a Recall Record
 Open Lucy’s Appointment Desk.
 Click New Recall on the Appointment Desk Activity Toolbar.
o The New Recall button can be found on the Patient’s Appointment Desk Activity Toolbar,
Check Out Activity Toolbar and Check In Activity Toolbar. Regardless of from where the
button is accessed, the process and functionality are the same.
 In the template field, select the 6 Month Recall Template.
o Note that the notification date, recall date, and expiration date are populated. Any of
these dates can be changed manually, if necessary. The visit type is populated in the Visit
Type field.
 Visit Type: EP – PRIMARY CARE (OHS) [486].
 Provider: Provider Drew.
 Scheduling instructions can be added and will appear when this appointment is scheduled.
 Click Accept to create the recall.
 Refresh the Patient’s Appointment Desk if a Recalls tab doesn’t appear. Double-click the recall to
expand and view additional information.
Scheduling from a Recall
SCENARIO:
4 months later, Lucy receives a letter in the mail notifying her that she needs to schedule her 6 month
follow up with her PCP.
 Open Lucy’s Recalls Tab.
 Select the Recall, click Schedule from Recall
 Make Appointment form opens. Various fields have been populated based on the information
entered when creating the recall.

 Appt Notes: “Med Check”
 If a provider’s schedule shows “Unrlsd,” this indicates the provider’s schedule has not
been released for scheduling yet.
 Use Auto search and click Search.
 Click Schedule then Accept on the Appointment Review window.
 On Appointment Desk the scheduled recall appears on the Future tab.

Cadence Chapter 7: Canceling and Rescheduling
7. Canceling and Rescheduling Appointments

Canceling and Rescheduling Appointments
An audit trail is created for all activity within Epic. Double clicking on any appointment will open the
Expand window, detailing information about the appointment and any changes that have been made.
 Open the Appointment Desk.

 Select and highlight the appointment to reschedule.
 Click Cancel/Reschedule to access the Cancel Appts activity.
 Enter a Cancel reason and Comments
 Click Reschedule or Cancel
 When the Make Appointment form opens and information from the original appointment
appears by default, including the appointment notes, visit type, and provider.
a. The original appointment will not be canceled until the new appointment is scheduled.
Rescheduling a Canceled Appointment

SCENARIO:
David scheduled his appointment with Provider Drew earlier, but he calls back to reschedule that
appointment. David still has flu like symptoms and is feeling worse. He would like to come in
tomorrow morning. Reschedule David’s appointment.
TRY IT OUT:
 Access David's Appointment Desk.
 Find the appointment David would like to reschedule and click Reschedule.
 Ensure the checkbox next to the appointment is selected and click Reschedule.
 Notice most of the fields on the Make Appointment form are populated based on the previous
appointment. Fill in the search date according to the scenario.
 Schedule the appointment.
 Do not fill out any registration information at this point.
CHECK YOUR WORK:
 View the Future tab on David's Appointment Desk.
 The appointment that you scheduled should be listed. Double-click it.

 Open the Expand window to view original appointment details including who/when it was
scheduled and canceled. Notice the appointment has been rescheduled.
 Close the workspaces.
1. Reschedule options:
 Reschedule- use for future or no-show appointments. Just like the cancel/reschedule
workflow, the original appointment is rescheduled.
 Copy to Appointment- use for future scheduled appointment or past completed
appointment. It creates a new appointment copied from the original.
2. The Make Appointment form opens.
 Information, including appointment notes, visit type, and provider, appears by default
because the original appointment information is pulling into a new appointment. This
information can be changed as needed.
Canceling and Rescheduling Recurring Appointment

When canceling or rescheduling an appointment that was scheduled as part of a recurring series, the
system automatically pulls all the appointments in the series into the cancel/reschedule window. The
red line indicates that these appointments are linked.
SCENARIO:
Audrey has four appointments scheduled for her blood pressure. She needs to reschedule her third
and fourth appointments to any time after 2:00 pm because she has morning meetings on Tuesdays.
Reschedule Audrey’s appointments according to her request.
TRY IT OUT:
 Select multiple appointments to reschedule using the checkboxes.
 Enter a Cancel Reason and click Reschedule.
 Edit the form with the new criteria and click Search.
 Use Date/Time to adjust the Start Time field

 Match Recurrences button will change the Date/Time of the second solution.
 Return to the Cancel/Reschedule Activity. The appointments that have been rescheduled now
have an ‘R’ next to them to indicate that they have been rescheduled.
All rescheduled appointments appear on Appointment Desk and are part of the recurring series.

Cadence Chapter 8: In Basket Messaging
8. In Basket Messaging
In Basket Folder Overview
There exist several different folder types in In Basket. Folders will only appear if it contains a message with that
message type. Schedulers send the following message types: Patient Call Backs, Staff Messages, Schedule
Messages, Letter Messages, and Referral Messages.
There is a special set of tools along the navigation toolbar in In Basket. Each message type may require a
different message type.
The table on the next page contains a list of folders in an In Basket.

Folder Type Why do I have this folder? Actions to Take How do I remove
the message?
Staff Message Sent by staff members and require Review: view the patient’s chart Done button
action on a scheduler’s part. Note: do
Tel Call: create a telephone
NOT use staff messages for
encounter
actionable items on patients such as
telephone calls, medications, orders, Letter: send a letter to the patient
etc. These messages should be Appts: open the appointment desk
treated the same as e-mails. activity
Sec Pt Msg: send a MyChart
message to a patient
Patient Call Back Messages from patients sent by the Tel Call: create a telephone Tel Call or Done
front desk staff to a provider pool encounter buttons
when a patient calls.
Review: view the patient’s chart
Letter: send a letter to the patient
My Open Automatically sent when a user Enc: enter the encounter The only way to
Encounters opens an encounter (like an Orders remove these
Close Enc: close the encounter
Only Encounter) as a reminder that messages is to
(ONLY if all actions are complete)
there is still work to be done on it. Close the
These will remain in the user's My Letter: send a letter to the patient Encounter
Open Encounters folder until the Tel Call: create a telephone
encounter is closed. The messages for encounter
an encounter are displayed only for
the user who opened the encounter. Review: view the patient’s chart
Pt Schedule Used to inform clinical staff of a Take: (Clinical) Staff MUST take Complete button
Request patient request through MyChart. these messages
They will also see these if a patient
Reply to Pt: send the patient a
cancels an appointment. Users can
message through MyChart
choose to schedule an appointment
directly from the message. Appts: open the appointment desk
activity
Review: view the patient’s chart
Letters Contain hyperlinks to letters for Click the Hyperlink in the message Done button
printing and are usually sent by to open, edit, and print the letter
providers to their pools. The letters
Letter: send a letter to the patient
are usually patient-related and
typically contain information Review: view the patient’s chart
concerning upcoming appointments,
lab results, and immunization
reminders.

Send, Reply and Done a Staff Message

Navigate to/within the In Basket
On Tuesdays you monitor Workqueue 719. Its mid-day and you must leave work due to a
family emergency. Send a message to co-worker Sally via In Basket to see if she can monitor
the Workqueue for the afternoon.
1. Select In Basket tab on home workspace.

2. Click New Msg select Staff Message from the drop down menu.
3. In Recipient enter another student’s User ID.
4. Enter the Subject “Monitor WQ 719 on Tuesday?”
5. Type a message in the Note field.
6. Click Accept.
7. Click Refresh on the activity toolbar. A Staff Message folder should appear.
8. Click the Staff Message folder.
9. Single click message just received.

 Status changes from New to Read. This indicates that it has been opened.
10. Read the message and click Done on the navigation toolbar.
 Status changes from Read to Done. This indicates that it has been taken care of.
11. Click Refresh. The Message and Staff Message folder go away.

Status What it Means
New An unread message
Read Message has been opened
Pend Message has been opened and action has been taken (Tel Call; Replied; Refill Encounter etc.)
Done No further action needed
Sent The message was sent but has not yet been reviewed/opened
Sending a Patient Call Back Message

Pools are used to quickly send a message that requires action to a group of people, where only one
member of that group is needed to accomplish the required action. Each provider has their own
associated pool which will be monitored by him/her and any nurses working with him/her that day.
Pool messages are sent to everyone assigned to that pool, however, only one recipient may handle
that message. What one recipient does with the message affects all the recipients of the message.
Using Flags and SmartPhrases to Streamline Patient Call

Back Messages
Josh’s mother, Claudia, calls to ask Dr. Baez staff to discuss lab results from her son’s recent
visit. Send Dr. Baez’s staff a Patient Call Back Message.
1. Select the New Msg button to open a Patient Call Back.
2. Enter Dr. Raymond Baez’s Staff Pool in the To field.
3. Use Patient Lookup to enter Josh [Your classroom information sheet last name] in the Patient field.
4. Indicate that Claudia, Josh’s mother called in Who called.

A SmartPhrase allows users to insert specific text by typing a short abbreviation. Users can
create their own for ones used repeatedly. Type a period followed by phrase name and
press Enter.
The following SmartPhrases have been created for scheduling. Use along with flags to
streamline documentation.
.phresult: [Use Flag: Results] Patient is calling for {MRI, CT, Lab, ***} results. Please call
patient at ***-***-****. Thanks!
.phrefill: [Use Flag: Refill] Patient needs a refill on *** called into *** at ***-***-****.
Please call patient at ***-***-**** if you have any questions. Thanks!
.phlate: [Use Flag: Appointment Access] Patient is scheduled for *** and they called to say
they will be *** mins late to their appointment due to ***. Thanks!
.phappt: [Use Flag: Appointment Access or Same Day Access Requested] Patient needs
{first available/same day} appointment due to ***. Please call patient at ***-***-****.
Thanks!
.phrxcalled: [Use Flag: Pharmacy Authorization] *** pharmacy called regarding *** for
above patient. They are requesting one of the following: {Rx clarification/prior
authorization/Rx Substitution}. Thanks!
.phprocinfo: [Use Flag: Pt Advice] Patient states they have an upcoming
{procedure/surgery} and would like {date/arrival time/prop instruction} information. Please
call patient at ***-***-****. Thanks!
.phcxlproc: [Use Flag: Pt Advice] Patient is scheduled for *** {procedure/surgery} on ***
and requesting to {cancel/reschedule}. Please call patient at ***-***-****. Thanks!
.phptcallback: [Use Flag: Pt Advice] Patient states they have left previous messages
regarding ***, please call patient at ***-***-****. Thanks!
.phptadvice: [Use Flag: Pt Advice] Patient called asking for advice about ***. Please call
patient at ***-***-****. Thanks!
*NOTE* When in doubt as to which flag to use, select Pt Advice.
Wildcards *** are placeholders for free text. {SmartLists} contain a list of options to choose
from. Use the F2 key to navigate through the text to complete each. A message with
unsatisfied wildcards or SmartLists cannot be sent.
5. Enter “.phresult” in the Notes section of the message. A list of options will appear.
6. Select the star to make it yellow. This adds the SmartPhrase to a list of Favorites.

7. Double click or press Enter to select the SmartPhrase.
8. Press the F2 key to select the first SmartList or Wildcard.
9. Double click LAB from the SmartList and press F2 to move on.
10. Without touching the mouse, type the first three digits of Claudia’s phone number: 504.
11. Press F2
12. Without touching the mouse, type the next three digits, followed by F2 and the rest of the phone
number.
13. Navigate to the Options tab.
Enter Patient Call Back

15. Locate Flag types, check Results.
Flags on Patient Call Back messages that allow staff to view and sort categories and
prioritize message and complete tasks in a timely manner.

Results Patient is calling to find out results of a test/procedure
Refill Patient called to request a medication refill
Appointment Access Patient called to make an appointment and/or needs an appointment sooner
than can be scheduled by the phone staff
Same Day Access Patient called to make an appointment and/or needs a same day appointment. If
Requested the call is before noon the appointment should be booked that day. If the call is
afternoon the appointment should be booked before noon the following day.
Pharmacy Authorization Pharmacy called to request authorization or clarification regarding a prescription
Pt Advice Patient called for clinical advice, a request, procedure information, order
information, and/or referral information
Hospital Consult Hospital called for a specialist to see a patient in the hospital.
16. Click Accept to send the message.
Sending Schedule Messages

Schedule messages are sent to scheduler pools by other staff members. Within the message, a visit type,
provider, department, patient, phone number, appointment notes, and scheduling notes can be specified.
Schedulers in the pool can make an appointment for the patient directly from the message.
Audrey [Your classroom information sheet last name] calls in to schedule a two week follow
up appointment in the Allergy Department. Her DOB is 4/24/1979. Only schedulers in this
department have the security to schedule into this department. The line is busy and a warm
transfer is not possible. Create a Schedule message with Audrey’s information.
1. Select a New Msg type of Schedule Message.
2. Enter a Visit type of Established Patient Extended.
3. Select the NSMC Allergy Department.
4. Enter Dr. Cathryn Hasset as the Provider.
5. Enter or use Patient Lookup to find Audrey [Your classroom information sheet last name].
6. Click the Home Phone button.

7. Appointment notes: Two Week Follow-up.
8. Scheduling notes: Would like to be seen next Monday.
9. Click Accept.
The Pt Schedule folder contains messages from MyChart patients who are requesting
appointments, scheduling appointments and canceling appointments via MyChart. Users
can schedule appointments, cancel appointments, or send the patient a message from this
folder using the Navigation Toolbar.
Search for Messages

The My Messages view will only display folders when there are messages to be taken care of, however, once
marked “Done” messages never go away. They remain searchable and, depending on the message type, are
documented in the Patient’s Chart.
1. Verify that the My Messages view is selected at the top of the left pane.
2. Click the Search button on the Activity Tool Bar.
3. The Message Search Report Settings window opens. On the Criteria Tab indicate the following:
 Check My In Basket
 Message Types: All
 Statuses: check Done
4. Click Search.

Message Search Report Settings
5. The deleted message will be in the same folder as in the In Basket. Find the Message in the Ad Hoc
(Search Results) folder.
Ad Hoc (Search Results)
Messages in the Search Results Folder can be saved directly to the active In Basket by changing the status to
something other than “Done”.
6. Highlight a message, right click, select Mark as New.
7. Select the My Messages bar and click Refresh. The message is now back in its original folder.
Checking the Status of a Message

To confirm the status of a message sent:
 Navigate to Sent Messages>Patient Call Back.
 Sort by date or patient. Find the message and review the Status.

Users can also look up the status of a Patient Call Back message sent by another user by accessing the patient’s
chart.
 Epic button>Patient Care>Chart
 Chart Review, Encounters. Look for a Telephone Encounter.
– If there is no telephone encounter within 2-3 days from the date the message was sent, no one
has responded to the message
 Double click to open the telephone encounter. Click on Detailed Report to view the Routing History.
– If the Routing History section only shows that the message was routed to the physician that
means that the nurse/MA is awaiting a response. Once the physician responds, a Routing
History entry will appear, along with any documentation.
Chapter 8 Review Exercise
Scott’s mother, Jessica, calls for Dr. Michael Wasserman. Scott’s DOB is 11/19/2001. He saw
Dr. Wasserman yesterday and now has a 102 degree fever. Dr. Wasserman told her to call if
the fever was over 100 degrees. Send Dr. Wasserman’s pool a Patient Call Back Message.

Cadence Chapter 9: Insurance Verification
9. Insurance Verification
Insurance Eligibility Errors
Industry research has found that 1 in 4 claims are delayed, denied or rejected due to issues with
verification of insurance eligibility. Verifying insurance eligibility for all patient visits has been
identified as a best practice to combat these issues.
Verification can occur through various methods:
 Real-time Eligibility (RTE)- Epic
 Passport OneSource (clinic)
 Payor Websites- i.e., iLinkBLUE
 Phone
 Fax
Tips for Viewing Eligibility Results

 Check a patient’s insurance coverage at EVERY appointment. Eligibility and insurances can
vary from visit to visit.
 View the full eligibility response to read valuable information on eligible benefits and
additional insurance coverage.
 Read Medicaid coverage eligibility thoroughly. A patient may present with one payor card but
be enrolled with a different payor.
 Look beyond the eligibility banner to confirm primary coverage and any additional coverages
that replace the coverage presented by the patient.
– Medicare results show patient is Eligible for Medicare even if the patient has a
replacement plan such as Humana Gold Plus. The replacement plan, Humana Gold Plus,
would be entered into the system and verified.
Real Time Eligibility (RTE) Response History

 RTE responses are stored in the Coverage Eligibility folder, on the Response History form in the
patient’s Registration workflow.
 Electronic eligibility responses are displayed individually on the Response History form.
 Response details are displayed at the bottom of the window.
It is critical that users review all information returned in the RTE Response. This
includes but is not limited to covered services, effective dates and co-pay
amounts.

Components of Coverage Eligibility Reponses
Eligibility tells users whether the patient is eligible for the coverage.
Alerts If the information entered in the Eligibility Query form does not match what
the payor has on file, the Mismatched Information section opens
automatically to show the discrepancy. Use this information to correct the
information on file.
Ignore Response If the patient is ineligible select Ignore Response. The coverage will not be
created.
Create Coverage Click Create Coverage to set up the Coverage
File Response Click File Response to automatically save the response within Epic
Review the sections of the Response Received message carefully. Some or all of the following sections
will appear in the Response.
 Highlights: Snapshot of outpatient and emergency benefits. May include Plan type and
coverage status.
 Patient Info: Subscriber demographics, co-pay information, and effective dates.
 Covered Services: Lists active benefit types
 Benefits: Indicates In and Out of Network service types, co-insurance and co-pay information.

 Limitations: Specifies limits based upon lifetime and/or calendar year. May include specialties
such as Mental Health and Therapy.
 Miscellaneous: Other covered and non-covered services.
 Other Entities: Primary Care Provider and other Patient/Payor affiliates.
RTE Plan to Subset Mapping

Plan to plan mapping will map RTE coverages to the correct plan according to the information that is
returned on the RTE response regardless of which plan is chosen by the user. When creating
coverages that are available for Plan Mapping, the coverage creation process is identical to any other
coverage.
 Submit an insurance query by selecting the plan which most closely matches the patient’s
insurance card.
 When the response returns it will indicate if the wrong plan was selected and give the name of
the proper plan.
 Click Create Coverage.
– The Payor/Plan select window will open with fewer plan options. Select the plan
indicated in the response.
 The proper plan is added to the Patient’s registration.
RTE Exact Plan to Plan Mapping

Plan to plan mapping will map RTE coverages to the correct plan according to the information that is
returned on the RTE response regardless of which plan is chosen by the user. When creating
coverages that are available for Plan Mapping, the coverage creation process is identical to any other
coverage.
 Enter the name of the payor and select the plan which most closely matches the patient’s
insurance card.
 When the response returns it will indicate if the wrong plan was selected and give the name of
the proper plan.
 Clicking Create Coverage will add the proper plan to the Patient’s registration.

RTE Copay Auto Filing

Epic automatically files Specialty, ED, and Primary Care copay amounts based upon the information
received in the RTE response for the following payors:
 Medicare
 Medicaid
 Blue Cross Blue Shield
 Aetna
 Humana
Remember, copays will file every time a RTE query is sent. If there is an issue with an
incorrect copay amount, consult your manager.
RTE Error Responses and Follow-Up Actions

Patient, Subscriber, Guarantor Demographic information
When demographic information in Epic differs from that in the payor’s database, a data mismatch is
created. This demographic information cannot be changed unless the patient is present. Information
entered in patient records must match the information on the patient’s ID.
 One common error is when a middle name, initial, and/or suffix is listed with the insurance
company but not entered into the patient record. Under the Payer-Returned Demographics
in the subscriber section of the Coverage Edit form to enter information to match the payor’s
records.
 Another common error is a discrepancy in the member’s DOB. Again, always enter information
into Epic according to the patient’s state ID. Patients are responsible for correcting inaccurate
information with their insurance company. Enter the payor’s alternate DOB under Payer-
Returned Demographics in the subscriber section of the Coverage Edit form. If RTE responses
continue to reflect data mismatches, verify via payor website, Passport, or call the insurance
company.
 Insurance Subscriber (self/spouse/etc) – An error may occur when the subscriber is not the
patient. An incorrect subscriber may be listed or have mismatched demographic information.

Confirm the correct subscriber with the patient. Review the “Rel to subscriber” field and the
source used to Pull Information into Subscriber Demographics.
 Subscriber ID – The most common mismatch with Subscriber ID is the addition or deletion of
member numbers. Users should replace the sent value with the returned value. If the patient
is eligible, rerun the query.
o Example: Subscriber ID Sent W00386276601; Subscriber ID Received W003862766
 Group Number –The RTE can be run without a group number. The group number normally
automatically populates. If not, enter the returned group number in the patient file.
Content Errors
Content errors differ from data mismatches; instead indicating the eligibility query contained
incorrectly formatted ID, gender, name, or incomplete data. RTE Content Error responses contain a
Reason Code number and error reason.
Common Error Reason Codes:

Reason 75: Subscriber/Insured Not Found
Reason 73: Invalid/Missing Subscriber/Insured Name
Reason 72: Invalid/Missing Subscriber/Insured ID
Reason 71: Patient Birth date Mismatch
Reason 67: Patient Not Found
Reason 64: Invalid/Missing Patient ID
Reason 42: Unable to respond at current time
Reason 15: Required Application Data Missing

Review and correct data errors. Confirm updated data matches the patient’s insurance card. If the
content error remains, verify via Passport, payor website, phone, or fax.
Content Error Reason Code 42 indicates the payor is down. Verify these insurances
through Passport, payor website, phone or fax.
Medicare Errors
Replacement Returned
Indicates Medicare (or possibly another payor) does not want to be responsible for the patient’s bill.
This response indicates who SHOULD be responsible in the eligibility response. Check the insurance
card to confirm the correct insurance plan.
Other Insurance Returned
Other Insurance Returned will display whenever a patient has another insurance returned in the RTE
response as either a supplement or an additional coverage. If the error persists after adding the
secondary insurance, verify the Medicare plan via Passport.

Plan Mismatch
This error only occurs with Medicare insurances. The response indicates patient eligibility and
whether the correct Medicare plan was selected. When creating the new coverage, select the plan
listed on Indicated in Response.
Other Error Messages

Connectivity Error
If the website is unable to respond, an RTE error will direct users not to resend the query. When the
site is back in operation, the response will be received automatically. If verification is needed
immediately, verify eligibility by phone. Indicate the Status as verified by phone and enter verification
information in the Guarantor Account Notes.
Claim Address
Add the claim address for Non-RTE payors and generic plans. The claim address is on the back of the
insurance card. Click the Claim Address hyperlink on the Coverage Info form to add the address and
phone number.
Elapsed
Insurance marked as elapsed must be re-verified. RTE insurance verification is valid for one month.
Click the Verify Member hyperlink on the Checklist to resend the query and re-verify coverage.

E-rejected
Check with the patient for a different coverage when the response indicates Not eligible. Select
Ignore Response to clear the eligibility query. Mark patient as Self pay if no other coverage exists.
Re-running RTE Eligibility Query

Once errors or data mismatches have been corrected and eligibility rerun, they fall off the response.
 Locate the corrected coverage on the Checklist. The status indicates an error occurred.
 Click the Status hyperlink.

 Change the status to New.
 Click Verify to resend eligibility query.
Verification for Plans Not in RTE

Users can utilize the following websites:
 Passport OneSource, www.onesource.passporthealth.com

 Blue Cross, www.bcbsla.com/ilinkBlue
 Cigna, https://cignaforhcp.cigna.com
 Humana, www.humana.com
 Humana Military, www.humana-military.com
 Louisiana Medicaid, www.lamedicaid.com
 United Healthcare, www.unitedhealthcareonline.com
Scanning Insurance Eligibility Documents - Not RTE Plan
Always document and secure coverage verified via an external website by printing
and scanning the eligibility into the patient’s Document table.
 In the Documents folder enter a Document Type of Eligibility.
 Enter the name of the verification source, i.e. Passport, iLinkBlue, etc. in the Description field.

 Scan the document.
Passport Tips and Tricks: Medicaid
On the Medicaid response, look for:
 Eligibility
 Plan Name
 Eligibility date is listed in Plan Begin Date field.
Passport Tips and Tricks: Medicare
The Medicare response includes:
 Benefit Coverage
 Plan Effective Dates
The Medicare Advantage Plan is indicated in the

Health Benefit Plan Coverage section.

Benefit information is listed in the Health Benefit Plan

Coverage section.
Plan details are listed in the Health Benefit Plan

Coverage section.
Obtaining and Documenting Insurance Verification via Telephone
If RTE and/or websites are unavailable, contact the insurance company by phone. For phone
verifications, a Guarantor Account Note must be added with details of the phone call.
 Locate the provider’s phone number on the back of the insurance card.
 An Insurance Representative or Automated System will ask a series of questions related to
patient information. Once the patient’s record is located they will provide eligibility
information.
 If eligible, change the insurance verification status to “Verified by Phone.”
 Enter a new Guarantor Account Note with a note type of General.
– Guarantor Notes include:
 Phone Number called
 Representative’s name
 Benefit and eligibility information
 Call reference number
 Any specific information given pertaining to the visit
 For appointment specific notes, enter the date of service and
appointment specific guarantor information in the free text field.

Terminating a Coverage Created in Error

Coverage created in error can be terminated by accessing Coverage Info and entering 1/1/1900 in the
Member eff from: and Member eff to: fields. This date indicates the coverage was created in error
and never valid for the patient.
Some payors do not accept a date of 1/1/1900, please select an appropriate year and make the
member effective dates the same (i.e. 1/1/2012-1/1/2012).

Cadence Chapter 10: Department Appointment Reports
10. Department Appointment Report (DAR)

Viewing the DAR
Activity toolbar settings include:
Refresh: refreshes the Department Appointments Report

Settings: used to customize the DAR
Appt Desk: opens the patient’s appointment desk
Walk In: schedules walk-in appointments
Sign In: updates the patient’s status to present
Check In: used to check in patients before being seen by a provider
Cancel: opens the cancel appointment activity to cancel or reschedule the appointment
Reg: brings users to the Interactive Face Sheet
Canc ChkIn: cancels a checked in appointment
Change: provides the ability to change the visit type, date, department, provider, and appointment notes
Configuring the DAR

1. Click Dept Appts on the Hyperspace tool bar to access the Department Appointments Report.
 Available settings will display the following:
User: a user’s private reports.
Public: departmental reports available for clinics and centers by location.
 Criteria tab: enables users to change departments, provider/resource, visit types, appointment
status, and search by date and time.
 Display tab: allows the configuration of columns and order of display, Available and Selected
Columns.
 Appearance tab: allows users to change the font and colors for rows and columns.
 Print Layout tab: provides the ability to change how the report prints.
 General tab: public or private options, public is seen by all users, private seen by user who created it.
 My default: defaults to a specific report.
2. From the Available settings menu, click on Check In DAR.
3. Click Run.
 The DAR for SLIC FAMILY MEDICINE will open. The DAR will have preset columns. However,
users can also customize the DAR.
4. Review the current settings of the Check In DAR.
O2 Schegistrar: March 2020 10.1

 The triangle seen on the Appt Time column indicates this DAR is set to sort by appointment
time. Click the column header to reverse the order in which the appointments are listed. Click
the column header again to return to the previous order.
5. Click Settings on the Activity Toolbar.
6. Click the Display tab. The Display tab contains two columns: Available Columns lists the columns users can
add to the DAR. Selected Columns lists columns currently included on the DAR.
7. Select unwanted columns on the Selected Columns list and then click the Left Arrow to remove. Hold
down CTRL to select multiple columns.
Remove the following columns: (These have been selected in training but may be useful in real-world)
 Appt Link Indicator

 Patient Info with Comments
 ES PRIVATE ENCOUNTER
8. Select new columns on the Available Columns list then click the right arrow to add.
Add the following columns:

 APPT COVERAGE
 Appointment Status
 Patient Name
 COPAY PAID
9. New columns appear at the bottom of the Selected Columns list. Use the up and down arrows to reorder
column placement on the DAR.
10. Click Save As and name the report. This will create a private report.
11. Check the My default report box. By checking this box, the saved report will automatically open each
time the user logs into Epic.
12. Click Run.
13. Click on the column header Pt Info to sort by patient name alphabetically.
14. Type the first letter of the last name of your patient. The DAR will navigate to the patients’ last names
beginning with that letter.
15. Right click on the Prov/Res column header. Choose Filter by and select your Provider Drew. The DAR now
only shows appointments scheduled for that provider. The header is bold with an asterisk, indicating a
filter is being used.
16. To remove the filter, right click on the column header and choose Clear all filters.

Concourse
The Concourse workflow allows registrars to assess wait times and track patients in areas where we are using
either patient sign-in or patient self-sign in (Welcome/Kiosk). Concourse allows you to:
 Have patients sign themselves in for encounters to be called when registration is ready to avoid long
lines and wait times.
 Arrive patients to reg, giving them a placeholder so that they can be serviced without waiting in line.
 Use the Department Appointments Report (DAR) and/or Today’s Patients Report (TPR) to sign in and
track patient wait times
 Measure overall department or location patient wait times to ensure we are providing the most
pleasant experience for our patients.
Each facility is not currently using Concourse. Please check with your leadership team to
see if available.
The Concourse Jetway

There are three ways that a patient can appear on your Concourse Jetway as ready to be admitted or checked
in.
1. Welcome Kiosk Sign In
2. DAR Arrival to Reg/Sign in
3. Today’s Patient Report Arrival
The Concourse Jetway enables the Today’s Patient Report Activity to display patients that have been either
arrived to registration, signed in, or arrived for their admission. Each registrar should open their appropriate
Today’s Patient Report Concourse Jetway to access their Jetway at the start of every shift. You may open
multiple sessions of the TPR. This report will only show patients that are waiting to be checked in or admitted.
Each facility has a different policy on checking in multiple appointments or admissions on

the same day. Please refer to your operational leadership to determine which
appointments or admissions should be signed in and their designated order.
Using the DAR

Patients will be placed in the Jetway preferably by marking as “Arriving at Reg” on the DAR toolbar. Once the
Patient is marked as Arrived at Reg, they display on the Jetway.

“Signing In” the appointment from the DAR will also arrive to the Jetway but will display on the Jetway as
“Registration completed.” This will not affect your score, but since not all facilities launch registration at sign
in, this is not a recommended workflow.
In addition to the Jetway, the DAR can be modified to display wait times.
From the display tab, these available columns can be added to the selected columns on the DAR.
Sign In Time [100627] – Encounters signed in using the kiosk, or by a registrar using the ‘Sign In’ button. OHS
Jetway Total Wait Time [103836] – Displays the total amount of time that the patient has been waiting since
they were signed in or arrived to reg.
Check In Time [103830] – Displays the time that the patient was checked in for their appointment. When a
check in time is populated, the Total Wait column will show as blank indicating that they are no longer waiting.

Cadence Chapter 11: Checking in a Registered Patient Appointment
11. Checking in a Registered Patient

Appointment
Checking in a Patient Appointment
Patients arriving at a clinic must be checked in before being seen by a provider for their appointments. The
front desk uses a DAR for patient check-in. The Check In DAR was set as our default in the last chapter, so it
should automatically open when logging into Epic. If not:
1. Click Dept Appts on the Hyperspace Toolbar.
2. Select the Check In DAR [10865].
3. Select the My default report checkbox and click Run.
MyChart Activation
MyChart gives patients secure access to healthcare information online. If a patient has not signed up, users
can help them do so from within the normal registration workflow:
 Click the Patient Portal hyperlink to launch the activity

 Click Send Email to send the patient an activation code to the email address currently on file.
 Click Print to print the activation code for the patient. The MyChart letter window opens. Select a
printer and click Print.
 Click Patient Declined if the patient does not want to enroll at this time. The MyChart Signup window
will not appear again for this patient.
 Click Ask Later if the patient wants to be asked again after today.
Collecting Co-Pay and Obtaining E-Signatures
Remember, visit types drive co-pays. Always refer to the Appointment Notes when determining if the co-pay
populated in the Co-pay due field is accurate. If not collecting a co-pay, users should still complete the copay
workflow and indicate the reason for not collecting.
Documents are either “Signed” by an electronic signature pad, or “Received” by scanning into an On-Base
Scanner. The documents table serves as a storage tool and an indicator of receipt. At minimum, three
documents require an E-Signature: OHS Provider Based Facility Disclosure (signed once each day they are

seen at an OHS facility), Clinic Authorization (signed once annually), and Notice of Privacy Practices
Acknowledgment (signed once per policy update).
 OHS Provider Based Facility Disclosure: The OHS Provider Based Facility Disclosure document
informs patients that OHS is a participating provider contracted with their health insurance and
some independent physician services may be charged separately.
Patients must be marked either “Contracted” or “Not Contracted” for upcoming appts. Upon
arrival, patients will be informed of their status and asked to sign the document. All patients must
When collecting documents during registration, a window will appear displaying the E-
Signature Document with the patient’s information and document sidebar. To collect the
required document information, registrars should:
•Type the patient/guardian’s name and witness’s name prior to collecting the required
signatures. The patient/guardian’s name and witness’s name can be typed or copied and
pasted into the Document Content section on the left hand side of the Epic E-Sign
document. Click on the blue highlighted ‘Patient or Guardian’ or ‘Witness Name’ –this
hyperlink will take the end user to the item that needs to be completed in the Document
Content section.
•Once the printed names are completed, collect the required e-signatures and follow the
usual document collection workflow. If the signatures are collected first, the data fields for
the printed names are locked down and cannot be completed unless the signatures are
cleared.

be given a copy of this form at each visit. Change the Document Status column to Signed, you will
not be able to complete check-in without changing the status column.
Documents Scanned In Error
SCENARIO:
A patient’s insurance card accidentally scanned into the wrong Patient ID folder can be removed from the
database or moved to the correct document or patient folder.
1. Click the paperclip next to the incorrect document.

2. Click Send to Misfile Process at the top right of the display window.
3. A note will automatically be added to the bottom of the document flagging it as a misfile.
 Other end users will be able to see this message as well.
4. The Document Correction Request form will open on the right side of the activity window.
The end user’s name, misfile status, user ID, today’s date, and patient’s MRN will auto
populate.
 Complete the two required fields:
End User’s phone number is needed in the event Chart Correction has any questions
about the document marked as misfiled.
End User’s facility.
 Next, use the bottom two sections to indicate what is incorrect on the scanned document.
In this scenario, the end user will select ‘Fix Doc Type’ since the patient’s insurance card
was scanned under the Patient ID folder and needs to be corrected. End User’s facility.
 Then, add a comment for more details. Ex. “Insurance Card, not a patient ID.”
5. When finished, click Save and Close.
6. Click OK.
7. The document has been submitted for review to Chart Correction.
8. If the end user would like to submit an additional note:
 Click Add Note icon or Right-click on the document and select Notes >Add Note…
9. Enter a note in the box with the additional message.
10. When finished, close the scanned image.
 Note: If you need additional assistance, please contact the LAN Desk and open a ticket for the
Chart Correction Team.

The document will be sent to an HIM workqueue for error correction. Contact the HIM
Department for urgent issues.
Verify Encounter Information
Hospital Account Records (HARs) are used to keep track of charges, payments, and adjustments related to
hospital or technical fee billing. HARs are usually specific to a single patient encounter and must be linked to a
single patient and a single guarantor account. If a HAR is not created prior to patient arrival, it is automatically
created upon check-in.
The information in the Coverage Info form within the HAR applies only to the current encounter. Coverage can
be added, removed or edited for this encounter. Coverage can be edited, removed or added. For visits not
covered by insurance, remove insurance coverage(s), check “Do not bill insurance”.
Occasionally, users might need to enter additional registration information during check in. The Checklist will
alert users if any additional information is needed. Use the link in the error message to resolve errors quickly.
The Sidebar Checklist allows users to navigate directly back to where any necessary information can be
entered.
Reprinting Receipts
A receipt can only be Reprinted if it is printed in the first place.
To Reprint a Receipt you will have to navigate to the Appointment Desk and locate the amount paid under the
payment history section of the patient Sidebar.

Try it Out: Check In

SCENARIO:
Jessica has arrived for her appointment with Provider Drew. Find Jessica on the Department Appointments
Report and begin to check in her appointment. Jessica does not want to sign up for MyChart or make any
changes to her appointment reminder preferences and opts out of taking a photo. This visit is not accident
related. Indicate that Jessica has given her completed HIPAA Notice of Privacy, Clinic Authorization, OHS
Facility Disclosure, State ID (Expiration Date: 12/2021), and Insurance Card. Jessica does not want a copy of
the Plain Language Summary or no surprise billing. Verify that all of Jessica’s information is up to date and
continue the check-in process by collecting her copay. Jessica will pay with check #4321.
Hint:
 Review and Verify Patient Record
 Confirm the Hospital Account and Coverage
 Collect Co-Pay and Obtain E-Signature
 Collect and Scan Documents
 Verify Encounter Information

Cadence Chapter 12: Updating Registration Information at Check In
12. Updating Registration Information at Check In

Check in and Update Registration Information
Update Demographic Information
Patient: Kathy
SCENARIO:
Since her last visit, Kathy was scheduled for her appointment; she has a full-time job at AT&T, which provides
her with insurance. Kathy is now responsible for her own medical expenses. Check-in Kathy for her
appointment and update her information.
 Find Kathy on the DAR. Check In.
 PCP: Provider Drew.
 Mobile (Primary): 504-564-2178.
 Kathy would now like to receive text messages.
 Kathy does not want her photo taken.
 Send Email to activate Kathy’s MyChart.
 Employment: AT&T, Full Time.
Terminate a Coverage
Terminating a coverage is the process of indicating that a coverage is no longer effective and should no longer
be used.
 If coverage is no longer effective for all family members on a plan, users need to terminate
coverage in each member’s patient record. Terminating Kathy’s coverage will not terminate the
coverage for Robert.
 Entering an Effective to date terminates a coverage. The coverage is valid up to and including that
date but cannot be selected for future encounters.
 Terminating allows the system to maintain historical records for the coverage. ONLY delete a
coverage if it is created in error.
 Aetna Coverage Info.
 Member eff to: me-1.

Inactivate an Account and Add a New Guarantor Account
When guarantor account was once valid but should no longer be used for future visits, it should be
inactivated. Inactivating a guarantor account prevents that account from being assigned as a visit account in
the future.
 Patients under 18 years of age and responsible for their own medical expenses are considered
emancipated minors. On the Guarantor Info form in the Account status field, enter Emancipated
Minor and create a Guarantor Account Note with further details.
Kathy currently has her father as guarantor; indicating him as the responsible party. Now that Kathy is an
adult, she is responsible for her own medical expenses.
 Patient Guarantors and Coverages.
 Check the Show Inactive Guarantor Accounts? Checkbox
 Click the Active? Checkbox for Robert to make Robert inactive.
 Click the Active? Checkbox for Kathy to make Kathy active.
 Guarantor Info
 Click Kathy’s P/F Guarantor account hyperlink that was just activated.
 Link Kathy's address.
 Pull Info, All Information, then click Accept.
Add a New Coverage

Kathy has new insurance coverage, Humana PPO, provided by her full-time employer.
 Coverage & Additional Info.
 Add Coverage.
 Create a New Coverage: Humana, Search.
 Humana PPO Plan
 Use the card below to fill out the eligibility query:

 Notification: Response Received. Create Coverage.

 Click Humana PPO. Click Accept.
 Kathy is covered under her current employer which has over 100 employees.
 Add the Co-pays and Auth Phone.
 Subscriber Info:
 Link Kathy’s address.
 Pull Info, All Information.
When a guarantor account is inactivated, the account remains on the Interactive Face Sheet until the patient
record has been exited and re-entered. To collapse sections of the Interactive Face Sheet, click the blue double
arrow icon.
Hospital Account (HAR)

 Accident related: No
 Referral source: Dr. Walt Whitecoat.
 Hospital Accounts
 Kathy’s Hospital Account was created prior to her registration updates. Next to the OP-Clinic folder.
 Click the Change Guarantor button.
 Select Kathy’s P/F Self Guarantor Account and click Assign Guarantor.
 The Add Coverage Questionnaire opens asking if Kathy’s existing Humana coverage should be
added. Click Accept and Finish to exit the Wizard.
When a Hospital Account Record (HAR) is created prior to registration updates it is important to verify the
correct guarantor and coverage are attached to the HAR prior to completing check in.
Complete Check In
 Review and verify the correct Guarantor and Coverage have been assigned.
 In the Encounter Guarantor and Coverages section. Kathy’s Humana PPO coverage should be listed.
 Documents to collect Kathy’s documents.
 Kathy does not want a copy of the Plain Language Summary.
 Verify any unverified information.
 Continue to Check In.
 The Check In activity opens to the Co-pay form.
Kathy pays her $10 Office Visit Copay with a ten dollar bill. Collect Kathy’s co-pay.
 Click Collect Payment in the Payments Section.
 The $10 copay is listed in Collecting.
 This Visit, click the pencil.
 Under Copay, select Office Visit.

 Click Accept.
 Click Collect Payment.
 Select Cash.
 Check the box next to the Receipt type Kathy prefers. Fill in any accompanying free text fields.
 Collect Payment.
 Click Accept to complete check-in and return to the DAR.
Adding a Secondary Coverage to Medicare

SCENARIO:
George arrives for his appointment with Provider Drew. George provides two insurance cards, Medicare Part
A&B and Seafarers coverage. Check George in for his appointment and complete his Registration information.
TRY IT OUT:
 Find George on the DAR. Select Check In.
 Verify George’s Demographic information.

 George does not have an email, does not want to sign up for MyChart
 No changes to his patient preferences.
 Do you notice any issues in his patient demographics?
 George’s PCP, Dr. Brown, has retired. Click End.
 Change requested by: Location.

 Reason for change: PCP Leaving Clinic.
 Add Provider Drew as George’s new PCP.
 George does not have any coverages in the system. Add Coverage.
 Enter Medicare Part A&B.
 Exercise caution when entering Medicare coverage. Medicare Part A covers inpatient
care, skilled nursing facilities, and home health. Medicare Part B covers clinic visits,
outpatient services, and physician fees. If a patient has both parts A &B, it is important
to make this selection to streamline the billing process.
 Select subscriber.
 Use the following insurance card to complete George’s eligibility query:

 George is eligible for Medicare A&B. Create Coverage.
 Subscriber Demographics. Link and Pull George’s info.
Adding Secondary/Supplemental Coverage
A Secondary or Supplemental plan for Medicare is in ADDITION TO the patient's primary Medicare. This kind
of plan (like AARP or other commercial plans) pays in addition to what Medicare may cover.
George is retired and has coverage through his previous employer. His secondary coverage through Seafarer’s
became effective 2 months ago.
 Add Coverage.
 Search Seafarers.
 Seafarers (Cigna) Secondary to Medicare (Commercial).
 Enter George’s information using the information and card below.
 Member relationship to subscriber: Self

 Member eff from: mb-2
 Subscriber ID: 90114759
 Covered through: Retirement
 Auth Phone: 800-768-4695
Some payors listed in Epic are not verifiable by RTE. Verify the eligibility either by Passport or phone and
update the Verification Status accordingly.
You must contact Seafarers; Rep Nancy Cobra confirms George’s coverage has been effective for two months.
He has no copays, and the information printed on his card is correct. Document George’s eligibility and create
the coverage.
 Verification Status: Verified by Phone
 Link George’s Subscriber address and Pull Info, All Information.

 Click Finish to exit the Wizard.
 Add Account Note
 Enter Guarantor Account Note information in the New Note and click Add and then Close.
 Accident Related: No.
 Referring Provider: Dr. Walt Whitecoat.
 Coverage Info.
 Add to attach insurance coverage.
 Select an Existing Coverage, Select Medicare A&B and Click Finish.
 Add to add Seafarers coverage.
 Seafarer’s will be listed first in the filing order (FO), which indicates the order of payment
responsibility.
Medicare Secondary Payor Questionnaire
 Click MSPQ button on activity toolbar.

 Ask George the questions and fill in the answers as given below:
 Are you receiving Black Lung benefits? No

 Are the services to be paid by a government research program? No
 Are you entitled to benefits through the DVA? No
 Was the illness/injury due to a work related accident/condition? No
 Are you entitled to Medicare based on Age? Yes
 Are you entitled to Medicare based on End-Stage Renal Disease (ESRD)? No
 Are you currently employed? No
 Date of Retirement: “m-2”
 Do you have a spouse who is currently employed? No, Never employed
 MSPQ indicates that Medicare is the Primary Payer.
When the MSPQ is completed, the hospital account’s filing order will automatically reflect the MSPQ COB
Status. The filing order will become fixed and unable to be changed manually. If the filing order needs to be
changed, the user will have to re-complete the MSPQ or find a supervisor who can override it.

 If a patient has:
o An employer group health plan:
 Covered through Current Employment and Employer Size: 100+ employees
 This plan it will remain primary payor no matter what the MSPQ’s COB status.
 If incorrect, users will have to change the coverage information in the Coverage Info box to change the
number of employees or how the patient is covered.
 Collect George’s Documents.
 Scan and label his Patient ID and Insurance cards. (Hint: Use the blank space to add his second Insurance
Document)
 George needs to Sign the Provider-Based Acknowledgement in addition to HIPAA, Clinic

Authorization, and OHS Provider Based Facility Disclosure.
 George does not want a copy of the Plain Language Summary or the No Surprise Billing
Document.
 Verify any remaining items.
 Continue Check in.
Adding a Medicare Replacement Plan

SCENARIO:
Two weeks later, George stops by the front desk to update his patient information. He presents his new
insurance card, Humana Gold Plus, that has replaced both of his previous insurance plans. Update George’s
Registration.
 From his Appointment Desk click Registration.
A Medicare Advantage Plan, like Humana Gold Plus, replaces the patient’s traditional Medicare
coverage. Medicare Part A&B should be removed and not listed as the secondary insurance.
 Medicare Part A &B Coverage Info hyperlink.
 Seafarers Coverage Info hyperlink.
 Add Coverage.
 Humana Medicare HMO. Use the cards below:

 Create Coverage.
 Humana Coverage Info hyperlink

 Name on card: See Card
 Copay Amounts: See Card
 IME Subscriber ID: 2R22-AK9-MN33 (George’s Medicare Claim number)
 Subscriber Demographics. Pull Info. Link Address? Yes
If You Have Time…

Robert has a sore throat and would like to make an appointment with Provider Drew three days from today.
Robert already has Aetna insurance listed in his registration. Robert retired from Tulane at the beginning of
the month. Terminate Robert’s Aetna insurance which he received through his employer, Tulane University.
Enter Medicare Part A&B as Robert’s supplementary coverage, AARP as a secondary payor and schedule his
appointment. Robert would like to add his mobile number 504-874-9821. His PCP is Dr. Walt Whitecoat. Set
Robert’s appointment reminder preferences to include Letters and Phone Call Reminders. Robert would also
like to receive Text Message Appointment Reminders.
AARP Subscriber ID: 457657234
Authorization Phone Number: 1-888-687-2277

Cadence Chapter 13: Walk In and Workers’ Compensation Appts
13. Scheduling Walk In and Workers’

Compensation Appointment
Scheduling a Walk In Appointment
When a patient comes in without an appointment, you can schedule a walk-in appointment to combine
scheduling and check in to speed up the process.
SCENARIO:
Audrey approaches the front desk and asked for an appointment today. She is experiencing fever and chills.
Schedule a walk-in appointment for Audrey.
TRY IT OUT:
 Open the Department Appointments Report (DAR).

 Click Walk In on the Activity Toolbar.
 Search for Audrey using two patient identifiers. The Patient Lookup window appears.
 The Walk In Activity opens. Enter the following information:
 Visit Type: Established Patient
 Provider /resource: Provider Drew
 The next available slot is selected automatically and highlighted in blue.
 Enter Appointment Notes on the bottom of the form.
 Click Schedule to schedule the appointment.
 Select Confirm Now.
 Registration opens. Ensure that you have verified the patient, guarantor, and coverage member.
 Audrey would like to receive Letter Reminders. She declines text messages and the patient photo.
 Collect Audrey’s copay amount due and necessary documents for check in.
 This visit is not accident related.
 The referral source is Dr. Whitecoat.
 Resolve any registration issues listed on the Checklist.
 Click Continue Check In.

Scheduling an Appointment for a Patient with Workers’

Compensation
When an appointment is flagged as Accident Related at scheduling, the Pre-Service team works to register the
appointment correctly with a Workers’ Comp Guarantor account, Coverage, and HAR.
If the visit is for a work-related injury, the patient’s registration will be adjusted to account for the workers’
compensation claim. This process would need to be done at the front desk.
To register a visit as Accident Related, Workers’ Comp, the following must be attached:
1) Workers’ Comp Guarantor Account

2) Workers’ Comp Insurance Coverage
3) Claim Information Record
4) Occurrence Code
Schedule an Existing Patient Appointment

SCENARIO:
Mary calls the front desk and asks for an appointment today. She injured her left arm.
 Schedule Mary for the first available appointment with Provider Drew.
SCENARIO:
Mary presents to the clinic. She informs you that she slipped on the floor at work yesterday and injured her
left arm. Mary works for East Jefferson Hospital. Mary has some information from her organization’s
Employee Health department in reference to Workers’ Compensation.
 Begin Check In for Mary’s appointment.
 Verify Mary’s information:
 Confirm Mary’s P/F Guarantor and Coverage information is correct.
 Although this visit is Workers’ Comp related, it is critical to verify the patient’s P/F
guarantor account and personal coverage to have on file in the event the Workers’
Comp claim is denied.
 Mary does not want any changes made to her Patient Preferences. She declines to have her
photo taken.
 Accident Related?: Yes.
 Self Referral

 Mary’s P/F Guarantor account and coverage has been attached to the HAR. Change Guarantor.
 Note: If the patient does not have all of the necessary workers’ compensation information, the
encounter will remain attached to the personal/family guarantor account.
 Add New Guarantor from Patient Guarantors and Coverages
 If a W/C guarantor account already exists for the Workers’ Compensation employer pertaining
to this injury, select and continue to insurance verification step.
 Add Guarantor Account Questionnaire
 What type of guarantor account?: Workers’ Comp.
 Who is responsible for this guarantor account?: Employer
 Review and/or complete the Employer field.
 Enter “t-1” in the Date of Injury field.
 Create New Account.
 The Guarantor Edit form opens.
 Verify the Employer’s Address is in the Guarantor Demographics and Guarantor Employment.
 Address link?: No
 Guarantor Demographics: patient’s SSN, Sex and Date of Birth (10/07/1978).
 Employment status: Full Time
Create a Claim Information Record

Claim Information Records created for workers’ comp and third-party liability cases keep track of
visit/admission information relating to a claim. Each new Claim Information Record is named with the date of
injury followed by the body part injured.
 Create a New Claim Information Record.
 Type: “[date of injury] [Body Part Injured]”.
 The General Claim Information form opens. The General Claim form stores additional information
regarding the patient’s injury and is sent to the insurance company with the claim.

 General Claim Information:
 Is this Ill/Inj/LMP: Accident
 Date of injury: t-1
 Authorization #: Leave blank
 Worker’s Comp/TPL:
 Accident Type: Workers’ Compensation
 Injury Date: t-1
 Time of Injury: 0900 (Mary had the accident at work yesterday at 9:00 am.)
 Place of Injury: Work
 Auto accident state: [complete only if applicable]
 Body part injured: Left arm
 Condition related to: Patient Employment
 W/C Employer: East Jefferson Hospital
 Injury Description:
o Injury Description 1: Mary slipped on the floor and injured her left arm.
o Field 1: [enter the cause of injury and Body Part injured]
o Injury Description 2: Adjuster David William, Phone 800-945-7887, Fax 800-945-7886
o Field 2: [enter the Adjuster or Contact’s name, phone number, and fax number]
o Injury Description 3: East Jefferson Hospital
o Field 3: [enter the Employer’s name]
Note: The amount of information you enter on this form will vary based on the patient’s specific case.
 Next. The claim has been created.
 Click Primary claim info selection tool and select the claim you created. The claim name populates into
the field.
 Next.
Enter Coverage Information for a Payor Not Found in the System

The workers’ compensation documentation lists the coverage as EJ Workers’ Comp Insurance and includes
the subscriber information (East Jefferson Hospital is the subscriber).
 Enter “EJ Workers Comp Insurance” and click the selection tool.
 A warning appears, click OK.
 An employer’s workers comp insurance provider may not be listed in the system. When not
listed, enter "Generic" in the Create a New Coverage field and manually enter the provider’s
member and subscriber information. If a provider is in the system, verify the address prior to
adding.
 Search for “Generic Workers Comp”

 Generic Workers Comp.
 Select the Guarantor/Employer subscriber
 The name of the W/C guarantor account includes the initials of the patient, the date of injury,
and the responsible employer. This helps distinguish between workers' compensation
guarantor accounts when the patient has more than one.
 [Last Initial, First Initial, Date of Injury, Employer Name]
 Account/Coverage Wizard:
 Claim address hyperlink.
 On the Claim Information window, enter a claim address, phone number and the
Attn/Insurance Co:
 500 Main St
 ZIP: 70114
 Phone: 504-908-7765
 East Jefferson Hospital 200
 Member relationship to subscriber: Employee.
 Insurance ID and Subscriber ID: Enter the patient’s SSN without hyphens. This can be copied
from the Registration from the Interactive Face Sheet.
 Member eff from: t-1 (enter the date of the injury).
 Verification Status: Verified by phone (select how you verified the claim).
 Covered through: Current employer.
 Employer size: 100+.
 Next.
 Subscriber Info
 Pull Info: Guarantor. All Information.

 Subscriber Demographics and Subscriber Employment addresses should be the same. If
the Employer is ‘Other’, input the correct address in the Demographics section but leave
Employment section blank.
 Finish.
 Coverage Info. Verify the Workers’ Comp coverage is attached, if is not attached, click Add.
 Select an Existing Coverage, highlight the W/C Coverage, click Finish.
 Verify the Hospital Account Information lists Mary’s W/C Guarantor account.
 Close Detailed view
 Navigate to the green guarantor account folder
 Click “Change Guarantor”
 Assign the W/C Guarantor
 Accept the Generic Workers Comp insurance
 Click Finish
Claim Info and Occurrence Codes
Occurrence Codes are required for inpatient and outpatient accident claims, outpatient maternity claims, and
non-accident medical emergency outpatient claims. Occurrence Codes indicate the “Onset of Illness”; when
the patient first became aware of the symptoms or illness being treated. Some payers are requiring this
information to be included on the claim form.
 Claim Info form. Click the Claim Info button.
 The Hospital Account Claim Information Selection window lists any existing claim information records
for this patient.
 Highlight the claim information record associated with the patient’s encounter. Select.
 A red check mark will appear indicating that the claim information record is associated
with the patient’s encounter.
 Edit Claim Info button.
 Move to the UB Occ Codes & Remarks section. Enter the following:
 Enter Occurrence Code [04].
 Enter “t-1” in the Date field. (Date of Injury)
 Enter Occurrence Code [11].
 Enter “t-1” in the Date field. (Date of Injury)

 Return and Finish to close out of the Claim window.
 On Interactive Face Sheet click on the W/C Guarantor Demographics.
 Review the following:

 Address link is “No”.
 Rel to patient is “Employer”.
 Guarantor Demographics and Guarantor Employment addresses are the same.
 Employment status field is populated with the patient’s employment status.
 Ensure that Mary’s name is not in the Associated Patient field.
 Ensure Mary’s SSN, Sex, and Birth date are completed.
 Verify guarantor.
 Add Account Note.
 Add a New Note documenting the phone verification for the W/C insurance.
 Scan Mary’s Workers Comp paperwork into an Insurance Documents field. Description: W/C.
 Mary does not want a copy of the Plain Language Summary.
 Verify any unverified records.
 Continue Check in.

Cadence Chapter 14: Payments and Balancing
14. Payments and Balancing

Beginning of Day Cash Drawer
To begin the day, users log in to Epic, run the DAR, and check the cash drawer balance. Before the first patient
checks in or calls, users verify the cash drawer has a zero balance.
 Log into Epic, on the Epic toolbar, select Cash Drawer.

 Verify the balance is zero.
 Close Cash Drawer.
 Follow your department’s guidelines for cash handling.
Collecting Office Visit Copay

 Find patient on DAR, verify Visit type is consistent with Appointment notes; if discrepancy, follow
Appointment notes, select Check in.
 Patient’s Registration opens. Verify patient’s registration information, co-pay amount, and follow
normal check in procedure.
 Check In activity Copay form opens.
 On the Activity Toolbar select Enterprise Pmt.
 POS Payment Posting opens.
 This Visit tab displays amount due for current encounter.
 Previous Balance tab displays any unpaid balance.
 Total Collecting displays sum of This Visit and Previous Balance amounts.
 Under Copay, select Office Visit.
 Click Accept.
 Select the appropriate payment option:
 Cash- Reference number is blank.
 Check- Record check number in Reference number field.
 Credit Card- Record last 4 digits of credit or debit card in Reference number field
 Other: EOB or Voucher
 Check the box(es) to select the type(s) of Receipt(s) the patient requests. If text or email is requested,
fill the free text field with the appropriate information.
 On the Check In activity Copay form, click Accept.

Collecting for Clinic Based Procedure

Clinic Based or Professional Based (PB) occur in the clinic setting. Examples of these procedures include
Coumadin screening and toenail clipping.
 From the patient’s registration, complete Checklist, click Continue Check in.
 Click Enterprise Payment on the activity toolbar.
 Under Prepay, select Same Day Services.
 Enter the payment in Due.
 Click Accept.
 Click, Collect Payment.
 Select the payment source.
 For checks and credit card payments, in Reference record check # or last 4 digits of credit card
 Verify Receipt type(s) is checked.
 Check in activity, Accept.
Collecting Payment for Hospital Based and Same Day Hospital Outpatient
Procedures
A Hospital Based (HB) procedure occurs in the clinic but is billed through the hospital. Some examples are CT
scans, nuclear medicine encounters, and PET scans.
An outpatient procedure can occur in both the clinic and hospital setting. Examples of outpatient surgeries
include colonoscopies and endoscopies.
When a patient arrives for a procedure in a specialty area where hospital procedures are performed, there are
some key differences in the payment process. The copay for patients checking in for a procedure is entered by
Pre-service and stored in Benefit Collection. The Pre-service team updates any patient financial liability based
on the coverage used for the procedure. If the Pre-Service team has determined pre-payment is due, the
prepayment amount will display on the Interactive Face Sheet. To quickly collect a payment, click the blue
Collect Payment hyperlink.
 Find patient on the DAR, select Check in.
 Patient’s registration opens, verify patient’s information.

 In Hospital Accounts, select OP – Procedures (green) folder.
 Select Benefit Collection on the activity toolbar.

 Locate Notes, identify amount due from patient.
 Click Pre-Payment to enter the amount to be collected.
 Click Close to exit Benefit Collection and return to the patient’s registration.
 Complete the Checklist, select Continue Check in.
 The Check In activity opens.
 On the Activity Toolbar select Enterprise Pmt.
 This Visit, click the pencil.
 Under Prepay, select Hospital Billing.
 Collect Payment.
 Select the payment source.
 Verify Receipt is checked.
 Click Collect Payment.

Collecting Deposits for Self-pay and Do Not Bill Insurance

A patient who either does not have insurance or their insurance is not to be billed for a scheduled visit, is
considered Self-pay. A deposit must be collected for visits based on provider, PCP or Specialty. Deposits
include PCP- $250 and Specialty-$500. Refer to location policy and procedure regarding pricing and when to
refer a Self-pay patient to a Financial Counselor.
If the amount paid at time of check in exceeds the amount of the visit, remaining credit will be applied to
outstanding balances. If no outstanding balance, the credit will be refunded after all charges have been
processed. Patients will be billed for any remaining outstanding balance.
Collecting a Copay for Patient Not Billing Insurance

Do Not Bill Insurance for Service
When a patient has coverage, but the insurance company should not be billed for the scheduled visit, the
Hospital Account Record should reflect: Do not bill insurance.
SCENARIO:
Audrey has arrived for her appointment. Audrey does not want any updates to her Appt Reminder Preferences
and opts out of taking a photo. She does not want a copy of the Plain Language Summary. She tells you that
she does not want her insurance billed for this appointment. She hands you a check for $250.00. Check in
Audrey and indicate that her insurance will not be used for this visit.
TRY IT OUT:
 Begin Check In.

 Update and verify Audrey’s demographic information. What information is missing?
 Accident Related? No.
 Referring Provider: Provider Drew.
 Hospital Account, select Coverage Info.
 Remove insurance coverage, if listed.
 Check Do not bill insurance.
 Collect Audrey’s documents.
 Click Continue Check in.
 The POS Payment Posting window will open. Click on Enterprise Pmt on the Activity Toolbar.
 Under Prepay, select Self Pay Patient.
 Due: $250.00

 Collect Payment. Check. Reference #: 3456
 Select type of Receipt(s) requested is checked.
 Click Accept to complete checking in Audrey.
Collecting Payments Outside of Check In/Check Out

Payments may be received outside of the regular check in process. These payments may include co-pays for
previous dates of services, agency collection, and charges in the Legacy system, or previous balances. Collect
via the POS Payment Posting form. Epic >Enterprise Billing >POS Payment Posting. Under the Epic button,
click the star next to this activity to save as a favorite. It will remain on the user’s personal menu of activities.
Users collecting on an open balance must manually select the appropriate visit/service by placing a check mark
beside the charge in the Hospital Accounts section. This designates where the payment should be applied.
Typically, the payment is applied towards the oldest account, unless the patient designates otherwise.
SCENARIO:
Julie has approached the front desk with a check. She would like to make a payment on an outstanding
balance. Collect Julie’s check and enter her payment into Epic. Julie gives you $200.00 in cash. Enter Julie’s
payment in Epic.
 Epic >Enterprise Billing >POS Payment Posting.

 Patient Lookup opens.
 POS Payment Posting form opens.
 Click the pencil icon.
 Choose the appropriate Post type:
 Manual – patient paying on a previous balance and applied to a specific charge and/or service.
Check the box next to the charge to designate where the payment should be applied.
o For co-pays not yet posted, NO charges should be selected. Enter the DOS and provider in
the comments section.
 Legacy Payment – patient paying on an amount posted in the Legacy system. Legacy payment
details are documented in the Comment field.
 Agency Payment – patient is paying on a balance assigned to a collection agency.
o Note: When selecting Agency and Legacy payments, a Remaining Amount box opens.
Choose Leave Undistributed.
 Oldest First – patient is paying on a previous balance and does not identify a charge, specific date,
or episode.

 Weighted – patient is paying on several accounts, payment will be distributed amongst all of the
accounts. Charges will Auto select.
 Package Price – a stipulated price for a service, or bundled group of healthcare services. Only for
self-pay patients without insurance or with non-covered benefits.
 Pre-Payment
– Elective – Self-pay package pricing items. Example: Plastic Surgery etc.
– Self-pay – patients who are Self-pay and not filing an insurance claim on a specific
service/visit. Not used for package price items.
 Post Type, select Manual.
 Enter Collecting $200.00
 In Hospital Accounts place a check beside the charge/visit payment is to be applied.
 Select payment source, add any Reference number or Comments. Select receipt type, click Collect
Payment.
Processing Credit Cards for Payments
To process credit cards, in the Payment Source field select Credit Card. The Electronic Payment window
opens.
 Click Swipe.
 Swipe credit card.
 The credit card information can be entered manually. Click Manual, enter the credit card
information, Process.
NOTE: When the electronic payment is processed two steps occur simultaneously. The payment is posted in
Epic and charged to the patient’s credit card in Passport.
 Print a receipt for the patient, click Accept to exit Payment Processing.
Processing Cash or Check Refund on Date Received

Refunds processed on the date received are handled via the POS Refund. Credit Card refunds are handled
differently than Cash/Check refunds.
SCENARIO:
Mary approaches the desk and says a co-pay was not required for her visit today with Provider Drew. Refund
the $15.00.
POS Refund can be accessed from:
 Check In, Check Out, the POS Refund icon on the Activity Toolbar, or the dropdown menu from the
More button.
 Epic >Enterprise Billing>POS Refund
 The Patient Lookup window opens. Locate patient.
 POS Refund activity opens.
 Select the payment to be refunded by clicking the checkbox next to the payment if there are multiple
payments.
 Select Give Back then choose a Reason for the refund, Payment Made in Error. Add a Comment to
further clarify the reason.
 Click the Magnifying glass for a list of reasons:
– Other (requires comment to be entered)

– Overpaid
– Patient Left Without Being Seen
– Patient Payment Not Needed
– Payment made in error
– Product returned
 A POS Refund Section opens, verify the payment should be refunded, select Give Back and Close.
 Print a receipt for the patient. Refund the cash.
Note: Refer to supervisor for refunds for payments made after date of service.

Processing a Credit Card Refund

A credit card payment refund is a two-step process. Credit card payments must be voided from both Epic
and Passport OneSource.
1. Void the transaction from Epic using the directions for Processing a Refund from POS Refund.
2. Access Passport OneSource and Log In.
3. Move to Fast Client Switching, select Ochsner-Ochsner Clinics.
4. Financial Services.
5. PaymentSafe.
6. Search Payments 2.0.
7. Search Payments 2.0 window opens.
8. Credit Card Last 4, enter the last four digits

of the credit card number.
9. Search.
10. Report lists all transactions for that card on

given day of service. Locate transaction by
Patient Name and Amount. Amount is to
the right of the visible screen; use the slide
at the bottom of the screen to see all the
data.
11. Click the Gateway Profile ID hyperlink.

12. Payment Information window opens, confirm correct transaction, click Issue Void.
13. Issue Void window opens, enter reason for void in Notes field.
14. Confirm Void.
15. Select Print Preview to print the patient’s receipt.
16. Adobe Reader opens, click Printer icon. Print two receipts, one for patient, one for cash drawer.

Balancing the Cash Drawer

1. Access the Cash Drawer
2. Tally and Record Physical Money in the System
3. Verifying Credit Card Transactions via Passport OneSource
4. Count and Record Checks
5. Balance and Close the Cash Drawer
 The reconciliation report prints when the drawer is closed.
 Write the collecting supervisor’s name and extension on the reconciliation.
 Count the total amount of cash in bag including the starting cash amount, write it on the
reconciliation. Place in reconciliation in cash bag.
 Have the senior representative, lead on the floor, registrar from another clinic, financial counselor,
supervisor, manager, or as a last resort, clinician, secondarily sign off on the amount collected in
the bag during regular clinic hours. During non-regular clinic hours, have a clinician secondarily sign
off on what was collected in the bag.
 Give cash bag to closing supervisor for verification.
 If closing after the supervisors have left for the day, complete the Registration Cash Bags Log as
usual in the cash office.
Cash Drawer Does not Balance

The cash drawer is not balanced if the Difference field has an amount other than zero. Discrepancies can arise
if a patient's copay was returned without using the POS Refund process, the Select all of the payments step
was skipped when balancing the previous day, a refunded payment was originally recorded in the system by
another cashier, items were entered wrong in Step 1, etc.
If drawer is not balanced:
 Unselect All, then Select All again in Match Drawer Contents to Posted Payments.
 Count cash again and confirm that the numbers were entered correctly.
 Confirm each check and credit card slip is properly entered in the Other section.
 If drawer doesn’t balance (if 0.00 does not appear in the Difference field), select a reason from the list
AND enter a Comment explaining the difference.
 Print a user batch to aid in viewing and correcting the error at the department level.

Cash Drawer FAQs

Q. My closing cash drawer report shows I’m long and short, but I am in balance? Why did this happen?
A. The Check and Credit Card totals have not been entered correctly on the Cash Drawer Contents form.
Double check entries; a check may have been entered as credit card or credit card as check.
Q. I posted a credit card payment to the incorrect account. How can I fix this?
A. This must be corrected on the same day. Go to POS Refund, refund the incorrect account. Go to Enterprise
Payment Posting find the correct account, post the payment again use a Post Type of voucher, and enter a
Comment with details.
Q: Is it possible that a payment was taken at a different workstation-logged in as a different user?
A: If Yes, work with the other cashier to physically give the person the check etc. so that both cash drawers will
balance.
Q: Was starting cash included in the totals?
A: Starting Cash should not be included in the cash drawer totals.
Q: Do the checks and credit card receipts match?
A: Match receipt and check totals to Epic transactions listed.
Q: Was a refund made from a different cash drawer, than where the original payment was posted?
A: This difference cannot be resolved in Epic. Record the reason for the discrepancy in the Comment section.
Q. I posted a payment as a check, but it should have been cash (or any variation). What should I do?
A. DO NOT CLOSE THE CASH DRAWER UNTIL THIS IS RESOLVED. Go to POS Refund button to “refund” the
incorrect entry. Open the patient co-pay form and click Enterprise Payment and re-post the payment
using the correct source.
Common Cash Drawer Reconciliation Issues

1. Previous days payments are listed in new day’s cash drawer.
a. The Cash Drawer shows no payments at the beginning of shift.
2. The cash drawer is over (long).
a. Payment was not posted in the EPIC system. Make sure patients are getting receipts for payments.
b. Count change for self AND count out change to patient.
c. Check if a refund was entered in system, but NOT returned to patient.
d. Incorrect amount was posted to patient account.
e. Incorrect amount was entered in the EPIC cash drawer.
3. Cash drawer is under (short).
a. Incorrect amount was posted to patient account.
b. Incorrect amount was entered in the EPIC cash drawer.
c. Money, check, or Credit card receipt was misplaced and not entered in EPIC.
Enterprise Cash Drawer Closing Report

The Cash Drawer Closing report offers a high-level view of the contents of an envelope, a list of payments that
were removed from the drawer, and information related to any voids that were recorded to the drawer. Click
the Closing Report button in the cash drawer. Enter envelope number and closing date restrictions to re-print
any Closing Report.
Closing Information
The Closing Information section of the report contains the following information:
 Drawer name and ID

 The date and time of closure
 The user who closed the drawer
 The department in which the drawer was closed
 The envelope number associated with the drawer

Cadence Chapter 15: Workqueues
15. Workqueues
Workqueues Transferring Accounts
Transfer (Do not work) accounts with errors belonging to Transplant, Executive Health, International Patients,
Coding as follows:
TRANSPLANT recipient or donor - transfer to WQ #498/Transplant
EXECUTIVE HEALTH - transfer to WQ #395/Executive Health
INTERNATIONAL PATIENT - handled by the International Patient team
IMPORTANT: Patients with an international address may not necessarily qualify as an INTERNATIONAL
PATIENT account. Patients are identified when “International” appears in the Patient Type field on the
Demographic page.
CODING ERRORS - transfer to WQ #143/Supervisor Review
ACCOUNT IS NOT VALID – no action required

Cadence Chapter 16: Wait List
16. Using the Wait List

Adding a patient to the Wait List during scheduling
In this activity, you will practice adding a patient to the Wait List during scheduling.
PATIENT: Susan
SCENARIO:
You receive a call from Susan. She would like to be seen for an office visit with your Estrum provider regarding
his abdominal pain. Your Estrum provider does not have any openings for some time and the earliest
appointment you can make for Susan is in one month. As you are reviewing the appointment information with
Susan, she asks if she can keep the appointment next month but also be added to the Wait List right away.
TRY IT OUT:
 Access Susan's Appointment Desk.
 Fill out the Make Appointment form according to the scenario.
 Remember to change your Department to NSMC Gastroenterology
 Hint: Use the Start search on field to change the date to one month from today.
 In training, there will be plenty of openings on the provider's schedule. Imagine that the
Schedule Scanner for your Estrum provider was showing no availability for weeks.
 Continue scheduling the appointment. Stop when you get to the Appointment Review window.
 On the Appointment Review window, add Susan to the Wait List.
 Hint: Look for a button you can click.
 What happened when you clicked Add to wait list?
 Click Accept on the Appointment Review window.
 Complete the Wait List (Add Appointment) form.
 Susan's appointment has a normal priority.
 You do not need to update any registration information; return to Susan's Appointment Desk.
CHECK YOUR WORK:
 Susan's future appointment with your Estrum provider should appear under the Future tab.
 You should see a Wait List tab on your Susan's Appointment Desk with the entry you just created.
 Close Susan's Appointment Desk.

Adding a patient to the Wait List instead of scheduling

In this activity, you will practice adding a patient to the Wait List instead of scheduling a future appointment.
This is useful if the patient would prefer to just be placed on the Wait List instead of making an appointment.
 PATIENT: Julie
SCENARIO:
You receive a call from Julie. She would like to be seen for an office visit with your Estrum provider regarding
her acid reflux. As you are scheduling her appointment, you notice that your Estrum provider does not have
any openings for a month. You offer Julie the option of being placed on the Wait List.
TRY IT OUT:
 Access Julie's Appointment Desk.
 Fill out the Make Appointment form according to the scenario.
 Hint: Use the Start search on field to change the date to one month from today.
 Click Wait List.
 In training, there will be plenty of openings in the provider's schedule. Imagine that the Schedule
Scanner for your Estrum provider was showing no availability for weeks.
 What information pulls into the Add to Wait List activity?
 Why is the Remain on list until field blank?
 Complete the Add to Wait List form using the details below:
 Julie would like to stay on the Wait List for one month.
 Her priority is normal.
CHECK YOUR WORK:
 You should NOT see a future appointment with Estrum.
 You should see a Wait List tab on your Julie's Appointment Desk with the entry you just created.
 Close Julie's Appointment Desk.
Scheduling a patient from the Wait List after canceling an

appointment
In this activity, you will practice scheduling a patient from the Wait List after an appointment is canceled.

 PATIENT: Susan, Julie
SCENARIO:
You receive a call from Susan. She needs to cancel her upcoming appointment with your Estrum provider. She
does not want to reschedule at this time.
TRY IT OUT:
 Access Susan's Appointment Desk.
 Select her future appointment with your Estrum provider and cancel the appointment.
 Hint: Use the Can/Rsch button to launch the cancel activity.
 What appears next to the canceled appointment?
 Close the Cancel activity.
 What happened when you clicked Close?
 Click Jump to the Wait List and find your Julie's Wait List entry in the top half of the screen.
 Select the open slot in the bottom half of the screen and schedule the appointment for Julie.
 Hint: Click Sched. When the Quick Appt activity opens, click Schedule. Continue to schedule
the appointment.
 Close the Wait List.
CHECK YOUR WORK:
 Open Julie's Appointment Desk. You should no longer see a Wait List tab. Her appointment with your
Estrum provider that you just scheduled should appear under the Future tab.
 Close Julie and Susan's Appointment Desks.

Answer Key
Answers - Adding a patient to the Wait List during scheduling

 What happened when you clicked Add to wait list?
 The button turned blue.
Answers - Adding a patient to the Wait List instead of scheduling

 What information pulls into the Add to Wait List activity?
 Information about the appointment that you entered on the Make Appointment form -
appointment notes, visit type, and provider.
 Why is the Remain on list until field blank?
 There is not a linked future appointment, so you have to enter the Remain on list until
date manually.
Answers - Scheduling a patient from the Wait List after canceling

an appointment
 What appears next to the canceled appointment?
 A yellow C
 What happened when you clicked Close?
 A window appeared letting you know that there are patients on the Wait List to see the
provider you canceled the appointment with. You had the option to Jump to Wait List
or Don't Jump.

Cadence Chapter 17: Crosscheck
17. Using Crosscheck to Maintain

Accuracy
Reading and Resolving Errors on the Crosscheck WQ
When a patient encounter is highlighted, all the items that need to be updated in the registration can
be viewed in the Details section of the Crosscheck WQ. You should take note of the things that need
to be resolved on the patient.
1. Once you are ready to make the necessary corrections to the encounter double click the
encounter. This will jump you into the registration for the selected encounter.
2. When all the WQ errors are resolved, you can exit the registration by clicking Accept.
3. When you return to the WQ, if all errors are resolved the patient will no longer be on the WQ.
If there still errors left to be resolved, only those will remain in the details of the WQ.
Deferring Encounters on the Crosscheck WQ

Deferring encounters temporarily removes them from the Active tab on the Crosscheck WQ.
Encounters should be deferred when they are unable to be resolved or when they are the exception
to the rule that qualifies them for the WQ. This action of defer sends the account for leadership
review. An account deferred no longer applies to the 3 day review rule.
For example, a patient presents with Humana Managed Medicare coverage, but the patient is only 45
years old. This is usually not correct, but our patient is entitled to Medicare by a disability, not age, so
they legitimately have this coverage.
1. In a scenario where a contact needs to be deferred, with the encounter highlighted, Click
Defer. This will open the Defer Until window.

2. In the Defer activity select the date and time until which the contact should be deferred.
3. In the Message field explain why this encounter should be deferred and reviewed by your
supervisor. Your supervisor should be monitoring the deferred queue daily. If your supervisor
finds that the error is in fact legitimate, the contact will be returned to the Active tab on your
WQ.
Once a contact is deferred, it will move to the Deferred tab, and no longer be found in the Active tab
for the amount of time specified in the Defer activity.
A summary of the deferred encounters can be found on the Deferred tab. The summary includes:
 The name of the person who deferred the contact
 The reason the patient hit the WQ
 The reason for the defer
 The date the contact will go back to the Active tab of the WQ (Deferred Until)

Crosscheck User Scorecard Overview
Using the Crosscheck User Scorecard, you can view your productivity on a specified group of metrics
and a date range. You can view your metrics by day, week, month, or quarter. We recommend
viewing by week, as your numbers will change throughout a day.
For example, if you choose “week” as your interval you can then choose the amount of weeks you
would like to have display. Each metric contains a row of data. If applicable, the values listed fall into
thresholds that display if the users data is satisfactory, needs improvement, or poor; this is,
respectively, displayed as green, yellow, and red.
Key Metrics
1. Avg Check In Time- This metric tracks the average amount of time spent per check in
workflow.
 4+ mins- Red
 3-4 mins- Yellow
 0-3 mins- Green
2. Visits Checked In- This metric indicates how many visits were checked in over a given period of
time.
3. Avg Admit Time- This metric indicates how long on average it takes to complete the admission
workflow during the patient arrival process. The admit time is determined by comparing the
time when the admission workflow was started by a user and the time when the admission
workflow was completed.
 5+ mins- Red
 4-5 mins- Yellow
 0-4 mins- Green
4. Encounters Admitted- This metric indicates how many patient encounters were admitted over
a given time period.
5. Crosscheck Score-This indicates your overall productivity based on the Crosscheck WQ. If
errors are not corrected in 72 hours of entry to the WQ, they reduce your overall score. The %
is calculated by comparing the number of encounters left unresolved in this WQ vs. the
encounters check in or admitted.
Additional Metrics
1. Avg Reg Time- This metric indicates how much time per patient is spent updating registration
information.

 4.5+ mins- Red

 3.5-4.5 mins- Yellow
 0-3.5 mins - Green
2. Avg Reg Time (New) - This metric indicates how much time per patient is spent updating
registration information. Only patients that are new to the organization are included in this
metric.
3. Avg Reg Time (Existing) - This metric indicates how much time per patient is spent updating
registration information. Patients that are new to the organization are excluded from this
metric.
4. Workflows Completed- This metric indicates the number of check in, sign in, check out, or
admission workflows that were completed.
5. % of Workflows Without Warnings- This metric indicates the percentage of sign in, check in,
check out, or admission workflows that were completed without ignoring any registration
warnings.
 0-90%- Red
 91-95% Yellow
 96-100% Green
6. Contacts Added to Crosscheck WQ- This metric indicates how many workqueue encounters
were added to the Crosscheck WQ over the specified time period.
7. Contacts Resolved on Crosscheck WQ- This metric indicates how many workqueue encounters
were resolved on the Crosscheck WQ over the specified time period.
8. Coverages Created- This metric indicates how many coverages were created over a given time
period.
9. Contacts Deferred on Pat WQ- This metric indicates how many encounters were deferred over
a given time period.
You can click on any blue number to view drilldown reports that display the encounters qualifying for
that number, and the details of the encounter. This is for your reference and self-assessment. You can
use the View Graph to examine how you trend throughout a given time period.

Cadence Chapter 18: Downtime
18. Downtime
Registration during RTE Downtime
If RTE is down when verifying a payor electronically in Epic, users may experience an extended response wait
time. If ‘Awaiting Response’ displays for an extended period, override the query to manually enter the
insurance information. Verify via Passport, payor website, phone or fax.
1. Select the Add Coverage hyperlink on the Interactive Face Sheet.

2. Type the name of the insurance company and click Search.
3. Select the insurance plan and click Accept.
4. Enter the Coverage and Subscriber information from the insurance card.
5. Click Override Query on the toolbar.
6. Enter the member and subscriber information manually and click Finish.
Scanning and E-Signature Downtime

1. Make a copy of both the front and the back of the patient’s ID and Insurance Card.
2. From Ochweb ( home page), select Job Resources, click Find a Form link.
3. Select Clinical/Miscellaneous Forms. Expand Access Forms tab.
4. Locate and print the HIPAA Notice of Privacy Practices (NPP) Acknowledgement of Receipt form and
Registration Authorization form – Clinic Authorization and HIPAA documents.
5. Have the patient sign the paper copy of each.
6. Right Click the patient’s appointment on the Appointment Desk. Print Patient Labels for each document
photocopied.
Note: If Label printer is unavailable, label each of the documents with:
– The Patient’s NAME and MRN
– The Visit Date, Time and Provider
When scanning is working again:

1. Enter the Patient’s Appointment Desk.
2. Select the correct visit from the Future Tab.
3. Click Reg Appointment Contact at the bottom toolbar.
4. In the Document’s folder, scan the paper copies of the Patient ID and Insurance Documents.
5. For the Registration Authorization document, add the Document Type ‘Clinic Authorization Scanned’
and scan the document into Epic.

Cadence Chapter 18: Downtime
6. For the HIPAA Notice of Privacy Practices (NPP) Acknowledgement of Receipt, add the Document Type,
‘HIPAA Notice of Privacy’ and scan the Document into Epic.
Read Only Mode

During an Epic downtime, users will be able to use Epic in read only mode. An Epic Read Only icon should
appear on each desktop. Epic Read Only will be accessible during a downtime when Epic Hyperspace is
unavailable.
Just double-click the desktop icon and log in. In read only mode, users can look up patient information.
Some information/functions may not be available, such as OnBase scanned documents or registration forms.
Epic Read Only will close when Epic Hyperspace is back online and available.

Cadence Chapter 19: Lagniappe
19. Lagniappe
Collecting ABN Signatures
An Advance Beneficiary Notice of Non-coverage (ABN) Form is a standardized notice that a health care
provider/supplier or his/her designee must give to a Medicare beneficiary, before providing certain
Medicare Part B (outpatient) or Part A (limited to hospice and Religious Non-medical Healthcare
Institutions only) items or services. The ABN must be issued when the health care provider believes that
Medicare may not pay for an item or service that Medicare usually covers because it is not considered
medically reasonable and necessary for this particular patient instance. The ABN allows the beneficiary
to make an informed decision about whether to receive services and accept financial responsibility for
those services if Medicare does not pay.
The ABN serves as proof that the beneficiary had knowledge prior to receiving the service that Medicare
might not pay. If a health care provider/supplier does not deliver a valid ABN to the beneficiary when
required by statute, the beneficiary cannot be billed for the service and the provider may be held
financially liable.
ABNs will also trigger for patients with Humana-Managed Medicare listed as their primary coverage.
Providers will see the existing pop up for ABNs while placing orders but will receive a slightly modified
waiver form that reflects the Humana-Managed Medicare coverage.
 Initial ABN Warning is triggered when the order is placed. Either Review Diagnoses to update them
according to the physician’s order (in the event of incorrect entry) or select the Waiver Form for
evaluation. Notice Status must be updated before order can be signed.

 Scheduling an appointment from an order with an ABN attached triggers a warning that must be
viewed prior to scheduling the appointment.
 Schedulers can click Accept and continue scheduling the appointment with the order linked.
If a signature can be obtained during scheduling, the ABN must be located using the ABN Follow Up
Report.
1. This Report can be found under: Epic Button > Reports > ABN Follow Up Report
2. Run the ABN Follow Up Report by selecting the Follow Up Report and clicking Run.
3. Find the patient on the report and select View/Edit ABN on the toolbar.
ABN Follow Up Report shows patients with unsigned ABNs. A similar report can also be used to locate
signed ABN records.
1. The ABN with the Patient’s Signature must now be scanned in the Patient’s Registration via
Media Manager. Access Media Manager via the Epic button (Epic Patient Care Media
Manager).
2. Enter the patient’s info in the Patient Lookup window and Media Manager opens.

3. Identify where new files will be attached. The default level is Patient. Click the dropdown
arrow and select Choose an Encounter.
4. Choose the appropriate encounter from the list, which changes to Encounter and reflects the
selected encounter.
5. Click Scan from the Activity Toolbar. The Scan activity opens. In the Document Type field
choose Advance Beneficiary Notice, click Index, click Exit Scan Server.
6. The Media Manger window displays the scan information.
 Once a signature is obtained, the user can update the Notice Status to a more appropriate
option.
 The final ABN warning appears during check in, once ‘Continue Check In’ is selected.
A Medical Necessity Warning appears after ‘Continue Check In’ is selected. The user can view the
status and if the signature is pending, select the ABN attached: ### hyperlink to access the Advanced
Notice Form seen in ABN Image 5. The document is printed, signature obtained from the patient and
the status is updated by the user.

 Scan the signed ABN into Registration directly from the Check In Activity by selecting the
Documents button on the toolbar. Clicking the LCD/ABN button brings the Medical Necessity
Warning box back up.

Checking in a patient in a Non-Provider

Based Clinic Setting
A Hospital Account is not created for Outpatient visits in Non-Provider Based Clinics. Instead, during
Check In
 Navigate to the Visit Info form.
 Use the radio buttons to ensure the proper Guarantor account is selected.
 Ensure the correct coverage(s) are selected. If a patient is classified as a self-pay patient, or if
he does not want insurance to be billed, select the Self Pay or Do not bill insurance.
 Continue through the rest of registration and complete check in.
Check Out
Checking Out a Patient’s Appointment
Unlike check in, check out is an optional workflow. Since most tasks in both workflows are the same,
organizations typically use check out to do two things: 1) schedule follow-up appointments and 2)
maintain accurate statistics on how long appointments take from check in to check out.
When a patient is checked in, the appointment status changes from Scheduled to Arrived; when a
patient is checked out, the appointment status changes from Arrived to Complete.
Exercise: Checking Out a Patient with a Follow-up Appointment
Your patient, Jessica, has finished her appointment and needs to be checked out. She tells
you that she needs a follow-up appointment one week from today.
 Click Check Out.

 If any Registration information needed to be updated, this could be completed now. Click
Continue Check out.

 To schedule a follow-up appointment for your patient, click Follow Up on the activity toolbar.
 The patient’s PCP appears by default in the Provider field.
– Appt Notes: "follow up on coughing and fever"
– Visit type: EP – PRIMARY CARE (OHS) [486].
– Start search on: "w+1."
 Schedule the appointment.
 You are returned to the Check Out activity. Click Accept to complete check out.
– The status of the appointment is now Comp, meaning the appointment is complete.
Check Out Review Questions

1. What is a common reason you would check out a patient?
2. Is it possible to create a follow-up visit from Check In?
3. Why do you think you are unable to schedule a follow-up visit during check in?
4. When you check out a patient, their appointment status changes from what to what?

Adding Medicare Railroad in Epic

Identifying a Medicare Railroad Retirement Card
This is a Medicare Railroad Retirement Card. If a patient presents this card, you should create
coverage for Medicare Railroad Retirement. This is not a Medicare part A&B card. The benefits for
these two plans are different, so you must choose the correct coverage.
No Existing or Incorrect Medicare Coverage

If a patient has a Medicare Railroad plan, you will have to take a few extra steps to verify this plan
through RTE.
1. Begin by terminating any incorrect insurance coverages such as Medicare part A&B that may exist,
but make sure to note the effective date of the coverage (you will have to input this information
later).
2. Add the Medicare coverage.
3. Select Medicare Railroad Retirement in the Payor/Plan window.
4. When the coverage wizard opens, click the Override Query button on the activity toolbar.
5. Manually enter the required information into the appropriate boxes and click Finish.

6. Once you have entered the information, click on the Purple Medicare Coverage Folder.
7. Click the New E-CVG button on the activity toolbar.
8. Fill in the following information on the Coverage Eligibility Query form:
 Payor: Medicare
 Patient rel to sub
 Subscriber ID
9. When the Response Received button starts to flash at the bottom, click on it to view the coverage
eligibility.
10. Click on the Medicare Railroad Plan, under Update Existing Coverage, and click Update Coverage.
11. Select the blue Coverages folder and update your filing order if needed.
Maintaining Accurate Appointment

Statistics
End of Day Processing, is designed to help track and manage patients who have completed
appointments, canceled appointments, or not shown for appointments.
End of day (EOD) processing ensures that patient and appointment statistics are accurate, and that
unnecessary data is removed to reduce clutter. It also deletes old statistics and other kinds of data
according to system settings.

EOD processing runs on an offset. This means that when EOD processing runs in the evening it might
be running appointment information from a few days ago. This allows users a window of opportunity
to update appointment statistics. This is accomplished using the EOD Status.
Confirming Appointments
Sometimes you might schedule an appointment for a patient that is a month away. When
appointments are scheduled far into the future, it's possible that the patient might forget to come in if
he doesn't receive some type of reminder. The Confirm Appointments report helps reduce the
number of no-shows that happen because of this type of scenario.
Exercise: Confirm Appointments Report
To help reduce no-shows, you have been calling patients who are scheduled within
the next few days to remind them about their appointments. You need to call
Sophie now to remind her about her upcoming flu shot and office visit. She confirms
that she will make her scheduled appointment.

Confirming Appointments Review Questions

1. What happens when you select an appointment on the Confirm Appointments report and click
Confirm?
2. If you attempt to call a patient but are unable to reach her, how can you document this?
3. When appointment slips are printed for appointments within the next 14 days, what other
appointments will also be printed on this letter?
4. True or False. A patient has two appointments scheduled 4 weeks from today. You have selected
one of these appointments and printed an appointment letter. Both appointments will appear on
this appointment letter.

International and Transplant Patients

Key Terms
Patient Financial Services: A department in the Revenue Cycle that provides financial counseling to
patients, and has a team dedicated to International and Transplant patients.
International Patient: A patient that elects the healthcare facility they would like to travel to for
specific medical procedures to be performed.
Transplant Candidate- Transplant patient that has not yet received a transplant.
Transplant Recipient- Transplant patient that has already received a transplant.
Package Pricing- Special discount pricing, determined by Patient Financial Services, for patients having
multiple procedures performed during their stay at our organization.
International Patients
All international patients report to the International/Transplant team at their first appointment to fill
out all necessary paperwork and determine all special or package pricing. At this first appointment, all
international patients will be given a patient type of International. This patient type ensures that you
can identify true international patients. Just because a patient is not from the USA, does not make
them an international patient, they must have the correct patient type assigned. Also, Schegistrars
should not be assigning this patient type, the International and Transplant team will assign it.
To locate the Patient Type, click on the blue Demographics folder and look at Patient Type located
under the General Information section.
Collecting Money
Most International patients will be Self Pay patients. These patients will have special “package”
pricing that will be worked out with the Patient Financial Services team. Registration will not collect
money from an International patient unless they have health insurance. If an International patient
does have insurance, it will be entered and treated as a regular insurance. If the insurance requires a
co-pay, the co-pay can be collected at check in. International patients with insurance can choose to
defer their co-pay and be billed for it later. If this happens, simply put a note in the Guarantor Acct
Notes section and do not collect a co-pay.

Registration Tips
Most international patients will not have a social security number. If this is the case, the proper
generic social security number 222-22-2222 should be entered for patients that do not have a social
security number.
To enter the patient’s address properly, you must first change the country. Then you will able to
enter the zip code.
Transplant Patients
Transplant patients are broken up into two types, candidates and recipients. Candidates have not yet
received a transplant, whereas recipients have already received a transplant.
Transplant patients will be identified in Epic with Patient FYI flags. These flags are entered by the
Patient Financial Services team. They will appear in the top right hand corner of the Patient Header.
If you hover over the FYI flag, it will tell you the information contained in the FYI.
Candidates are part of a global transplant billing structure. All billing and collection of monies will be
done through the Patient Financial Services department. Also, all calls concerning these patients will
go to Patient Financial Services and be handled through that department.
Recipients are considered regular patients, and they are billed accordingly. If they have insurance, the
insurance is billed and they are responsible for any co-pays or unpaid services based on the insurance
coverage. Recipients, however, cannot be denied care for any unpaid balances or bad debts.

International, Transplant Patients Review Questions

1. True or False: Any patient that resides outside of the USA is an International Patient?
2. How are International Patients identified?
3. How are Transplant Patients identified?
4. What department is responsible for indicating if a patient is an international or transplant

patient?
5. What are the two types of Transplant patients?

Cadence Appendix
Appendix
Glossary
Activity Toolbar: Buttons appearing at the top of an activity used to perform tasks related to the current
activity.
Appointment Review: Used to review relevant appointment information with a patient before the appointment
is officially scheduled. From Appointment Review, an appointment can be confirmed if it is within the next 48
hours. For appointments scheduled in HODs, a patient type of either Outpatient or Inpatient must be selected
prior to the appointment being scheduled.
Assigning a Referral: Assigning a referral is the act of associating a referral with an encounter. Only one
referral can be assigned to each visit.
Auto-Scheduler: Located on the Make Appointment form as a check box next to Auto Search. This is the most
efficient method for finding the earliest available appointment. The auto scheduler will not present a
recommended solution that does not match appointment specifications or the provider’s schedule preference.
The auto scheduler will present available time slots based on the scheduler’s security level.
Block: a time slot reserved for a particular type of visit or patient. During the scheduling process, blocks serve as
visual indicators on the provider’s schedule. Blocks appear in the name column on the Provider Schedule.
Cadence: Name for Epic’s Enterprise Scheduling application used to schedule and track patient appointments.
Cancel: Original appointment is canceled. The patient will not come back for another visit.
Center: A geographical grouping of places of service that are close to one another. Centers are used when
scheduling with pools and across locations.
Check In: process of checking in patients for clinic appointments prior to being seen by a provider.
Completion Matching: A short cut used in fields requiring entry of a pre-defined value. Users enter a partial
value (for example, "ep" for established patient) and the system returns all related matches. Any related terms
starting with the characters entered are returned. For example, pa = patient refused.
Confirm Now Button: Located on the appointment review window, this button can be used to confirm
appointments made within 48 hours of the appointment and cancels the Televox automated appointment
reminder call. The Confirm Now button allows the appointment to be confirmed in the Confirmation Report.
Dashboard: Appears on the Home Workspace and contains information including reports and links. This space is
always open and can be accessed outside of any activity.
Date Conventions: (t, m, y, mb, me) Date abbreviations used in Epic to quickly enter a date. Example: m+1 =
one month from today.
Department Appointment Report (DAR): a list of all patient appointments in a department today.
Documents Folder: table listing e-signed or scanned documents.
Duplicate: Occurs when two (or more) medical record numbers are assigned to one patient. Often, a new
medical record number is created in order to avoid selecting an incorrect medical record number.
Emancipated Minor: A minor who is freed from parental control. Emancipation is not available in all states.
Emdeon Mailed Reminder: Vendor that handles mailing appointment reminder letters. The letters are
automatically sent out 14 days prior to the patient’s appointment.
Enterprise Payment: used to post payments received at front desk including co-payments, pre-payments,
O2 Schegistrar: March 2020 i

Cadence Appendix
specific purchases, and payments on existing clinic or hospital encounters balances.

Epic Button: Contains a drop down menu listing all of the user activities. Located on the upper left in
Hyperspace.
Epic Hyperspace: Hyperspace™ is an integrated network of different Epic applications.
E-Signature: electronic signature and storage of forms.
Fasting/Non Fasting Lab: Visit types attached to some lab orders. Fasting indicates that the patient cannot eat
prior to the lab visit. Non-fasting does not require the patient to fast.
Filing order: The order in which insurance is billed.
Form Navigator: Series of forms and folders navigated through to collect registration information. Can be
accessed after appointment scheduling from the Future tab on the bottom toolbar and on the Appointment
Desk Activity Toolbar.
Guarantor: The person ultimately responsible for the patient’s medical expenses.
Hospital Account: Hospital accounts are used to keep track of charges, payments, and adjustments related to
hospital or technical fee billing. Hospital accounts are usually specific to a single patient encounter and must be
linked to a single patient and a single guarantor account. The Hospital Account is created in Registration in the
red folder, Hospital Account.
Hospital Outpatient Department: Departments in which patients are scheduled, however, these areas can see
both admitted patients and outpatients for the same treatment or care. These include laboratories, radiology
departments, and therapy departments, among others.
Hyperspace ACE1: Environment containing providers, patients, and encounters used to train Epic Cadence
activities.
Hyperspace PLY (Playground): Environment containing providers, patients, and encounters used to practice Epic
activities. Access to this environment is granted to all users after the completion of training.
Hyperspace Toolbar: Customizable toolbar containing frequently used activities. Located adjacent to the Epic
Button.
IME (Indirect Medical Education): Payment associated with Medicare Risk plans that is provided to teaching
hospitals
In Basket: Epic’s workflow based-internal messaging system. In Basket organizes and prioritizes user’s workload
more effectively than current paper-based stacks of notes.
Incoming: Referral originates outside of our organization. These referrals will either be faxed or brought in by
the patient.
Interactive Face Sheet: Contains summary information and hyperlinks to patient specific information contained
in the Blue folders. First folder (labeled with the Patient’s Name) located in (Red) Encounter Specific registration.
Registration view seen by clinical staff.
Internal Referrals: Used when rendered services remain "in house" or internal.
Log In Department: When logging in to Epic, a user may have a Log In department defined. A Log In
department can determine what a user sees and does in Epic. Users can change a Log In department during log
in or by selecting Change Context from the Log Out drop down menu.
Member: Individual covered by an insurance policy.
MRN (Medical Record Number): Unique numeric patient identifier that stays with the patient for life, the clinic
O2 Schegistrar: March 2020 ii

Cadence Appendix
number in Legacy Systems.

MSPQ (Medicare Secondary Payor Questionnaire): Determines the filing order of Medicare and secondary
insurance plans.
MyChart: Patient who are enrolled in MyChart receive a notification 7 days prior to their appointment via email.
Notification Date: The date on which the recall letter is sent to the patient.
Order: A procedure to be scheduled in Cadence.
Outgoing: Referral is from a provider within our organization to a provider for services outside of our
organization.
Overlay: Occurs when one patient record is overwritten with data from another patient record creating a
serious obstacle to patient safety.
Passport OneSource: Online coverage verification website used to verify patients’ coverage. Passport is used
(outside of Epic) to verify coverage for payors not RTE enabled.
Patient Appt Status: indicates the patient’s encounter stage.
Patient Preferences: Listed under Patient Options in the Make Appointment form. Date, time, provider sex
preferences, and more can be entered and used each time an appointment is scheduled for the patient.
Patient Workqueue: A tool used to identify appointments or admissions with informational errors or certain
characteristics.
Patient Workspace: Tab containing activities specific to a patient. Only four tabs can be open at one time.
Payor: Insurance Company, ex: BCBS, Aetna, Humana.
PCP (Primary Care Provider): Added during registration or check-in on the Patient Contacts form or the PCP
button in the Registration Activity Toolbar.
Plan: Set of benefits offered by an insurance company to a group of its members, and determined by the plan.
Pool: A pre-defined group of providers or resources the system automatically pulls from when scheduling certain
visit types.
Pools (In Basket): In Basket pools are used to catch messages that are intended for users with a specific role.
For example, nurses working with a particular doctor will be part of the pool receiving his messages. The pool
that the users would be part of is named P space ‘Provider’s Name’. Different users may be responsible for this
pool each day. Within a pool, messages are sent to everyone assigned to that pool; however, only one recipient
may need to handle that message. What one recipient does with the message affects all the recipients of the
message.
POS Warnings (Point of Service Warning): A warning that appears during the appointment scheduling that
informs the user that the appointment requires a referral. The Required Referral warning occurs when a visit
type requires a referral per the patient’s coverage plan.
Primary Payor: The first payor in the filing order. The insurance plan which considers and pays its eligible
expenses without consideration of any other coverage.
Pull Info: Extracts and populates information from another field containing the same information. Used when
collecting emergency contact, guarantor, and subscriber information.
Recall Date: The date on which the patient should aim to schedule his/ her return appointment.
Recall Expiration Date: The date a recall record will be deleted from the system. Upon deletion, a recall letter
will no longer be mailed to the patient.
Recommended Solution: Window displaying the next available appointment. Is based on the criteria entered
O2 Schegistrar: March 2020 iii

Cadence Appendix
into the Make Appointment when using the Auto Scheduler to schedule an appointment, takes into account
provider availability, provider scheduling restrictions, and users scheduling security.
Referral: A place to document authorization from an insurance company for services or a way to track patient
movement from physician to physician. A referral is a purchasing order for medical services, often in a specialty
area, written by the patient’s PCP.
Replacement Plan/ Medicare Advantage Plan: Private health plans that have contracted with Medicare. These
plans are paid fixed subsidies by Medicare to provide Medicare beneficiaries’ benefits.
Reschedule: Original appointment is canceled. The patient will come back for another visit.
Resource: Refers to equipment, room, or non-specific representation of staff that can be used in place of a
provider. A resource has a schedule but is generally non-human.
RTE (Real Time Eligibility): Automated insurance coverage verification directly through Epic.
Schedule Scanner: Located at the bottom of the Make Appointment form, when a provider is selected during
manual scheduling (not auto search). The schedule scanner allows users to quickly assess how full a provider’s
schedule is for the next seven days. The percentage of schedule used appears in each cell along with a color
that correlates to a percentage range.
Schegistrar: Model combining Scheduling and Registration in the same workflow. This term can also be used to
describe an individual who schedules and registers appointments.
Secondary Payor: The second payor in the filing order. The insurance plan that has the responsibility for
payment of any eligible charges not covered by the primary coverage.
Sequential Appointment: Two or more appointments scheduled in the same workflow. An ‘S’ next to the
appointment on the Appointment Desk indicates the appt was scheduled sequentially. When a sequential
appointment is canceled, the system prompts the user to cancel the other sequentially made appointments.
Subscriber: Owner of the insurance policy.
Supplemental insurance: Medicare Supplement Insurance Plans help cover some of the costs not covered by
Medicare Parts A and B, such as deductibles and coinsurance. Patients are still in the Medicare program.
Medicare Supplement plans are not managed care and are also called Medigap policies.
TeleVox: TeleVox is an automatic telephone reminder service. Patients receive a telephone call two days prior
to their appointment and have the option to confirm or cancel their appointment directly on the phone.
Temporary Address: Used when a patient requests their correspondence other than bills (appointment
reminders, lab reports, etc.) be delivered to an address other than their permanent address. Requires a start
and end date. Located in the patient's Demographics folder.
Verification Duration: time, typically 30 days, a patient, guarantor and member remains verified.
Waitlist: List of visits that a patient would like to reschedule if earlier times become available.
Walk In: patient arriving without a scheduled appointment.
Wizard: Guides users through a specific workflow.
Workqueue List: Shows all workqueues that a user has access to including billing, referrals, and patient
workqueues. From the Patient tab, users can see a list of all the patient workqueues that they have security to
see. The Active Count column displays the number of patient encounters that need to be worked.
O2 Schegistrar: March 2020 iv

Patient Access Clinic: Schegistrar

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Patient Access Clinic

2. Scheduling and Registering a New Adult Patient ..............................1

3. Scheduling and Registering New Dependent Patients ......................1

4. Scheduling from Active Requests ........................................................1

O2 Schegistrar: May 2022 ii

Transcribe Order for an Established Patient ........................................................................ 5

5. Scheduling with Referrals .....................................................................1

6. Scheduling Variations ...........................................................................1

7. Canceling and Rescheduling Appointments .....................................1

8. In Basket Messaging .............................................................................1

9. Insurance Verification ..........................................................................1

RTE Error Responses and Follow-Up Actions ....................................................................... 4

10. Department Appointment Report (DAR) ...........................................1

11. Checking in a Registered Patient Appointment ...............................1

12. Updating Registration Information at Check In ................................1

13. Scheduling Walk In and Workers’ Compensation Appointment ....1

14. Payments and Balancing ...................................................................1

O2 Schegistrar: May 2022 iv

Processing Cash or Check Refund on Date Received ...................................................... 6

16. Using the Wait List ................................................................................1

17. Using Crosscheck to Maintain Accuracy .........................................1

19. Lagniappe ...........................................................................................1

O2 Schegistrar: May 2022 v

No Existing or Incorrect Medicare Coverage ................................................................. 7

O2 Schegistrar: May 2022 vi

3. Epic Button Contains menus such as Reports and Tools.

6. Chart Search Allows users to search all of Hyperspace

7. In Basket Displays new In Basket messages

8. Log Out Allows users to Log Out.

O2 Schegistrar: May 2022 Intro

1. Scheduling an Existing Patient

It is important to understand the implications associated with selecting the appropriate

 In the Name/MRN field:

o The patient's MRN

 In the SSN field:

o The patient's Social Security number

 In the Birth date field:

o The patient's DOB

O2 Schegistrar: May 2022 1.1

Entering Appointment Information

A visit type can be selected in a variety of ways:

 Enter the full or partial visit type name.

 Enter the visit type ID number.

 Enter a visit type synonym.

O2 Schegistrar: May 2022 1.2

Providers can be an actual person, a resource, a room, or a piece of equipment that

Date & Time Conventions

w (week)  w+1 = the date one week from today

mb (month beginning)  mb = the first day of the current month

O2 Schegistrar: May 2022 1.3

me (month end)  me = the last day of the current month

y (year)  y+1 = the date one year from today

Hyperspace allows several other methods for entering a date:

O2 Schegistrar: May 2022 1.4

Interpreting the Provider’s Schedule

Number of Openings Indicates the number of regular available

Time The beginning of each period displayed on a

Pri? Indicates whether the slot is public or private.

If the column is blank, the slot is public and can