In Touch EMR allows you to set up the following patient alerts so you and your staff can stay up to date with patient care.

To set up patient alerts, go to the Patient Dashboard, and click on the Edit Patient tab at the top.

In this lesson, we will discuss the different types of alerts, functions, and locations.

Types of Alerts

Physician Certification - this alert will notify you if a certification is missing, or about to expire, and allows you to assign the signed certification to a POC.
Progress Note - this alert will notify when a progress note is due
Re-evaluation - this alert will notify if a re-evaluation is due
Custom Alert - this option allows the user to add custom notes or alerts
KX Modifier- this option allows the user to append the KX modifier for those patients who are close to their Medicare cap.

Physician certification

You will need to add the physician prescription in the Plan of Care on your documentation.

Once you get back an approved Plan of Care from the referring physician, you can set up a Physician Prescription alert on your patient's chart in In Touch EMR.

Here are the steps on how to add a physician script

Upload the signed physician script or signed plan of care (optional).
Select yes for question 'Do you have the physician prescription on the plan of care?' This will open the plan of care selector.
Assign the Plan of Care associated with the physician prescription. The rest of the fields will auto-populate with the information based on what was entered in the Plan of Care document

Note: The highlighted fields in yellow are pre-populated based on the initial prescribed visits and number of weeks on the chosen Plan of Care. These are still editable fields even if the information came over from the Plan of Care. The days remaining, the number of visits and visits remaining are all computed and provided by the system.

The information on this page will show on the header of the patient chart and will count down whenever there is a finalized visit.

To review the lesson on how to keep track of all the expiring prescriptions within your In Touch EMR account, click here.

Progress Note Count Down Alert

This alert will notify when a progress note is due. Medicare requires that providers create a Progress Note every 10th visit or 30 days whichever comes first. In Touch EMR has a built-in reminder alert that pops up to remind you that you have "x" amount of days before a progress note and re-evaluation is due for a specific patient.

At a minimum, a licensed therapist must complete a progress note for every patient by his or her tenth visit. In it, the therapist must:

Include an evaluation of the patient’s progress toward current goals.
Make a professional judgment about continued care.
Modify goals and/or treatment, if necessary.
Terminate services, if necessary (see the discharge note section below).

Choose either YES or NO in either counting the days or visits. You can choose yes for both and the system will just provide you both information and whichever comes sooner.

To avoid missing the reminder alerts, you now have the option to enable the 'Forced Pop Up Alert' which will require you and your staff to finish a progress note before continuing on with a patient episode of care.

Based on your settings within the Progress Note Alert tab (e.g. Progress Note due to every "x" visits, or "x" days) will determine when the force popup will occur.

Note: If you have already done a progress note for a patient then this popup will not occur until the next one is due. Also, if you choose to use the Force Popup feature, the force function will activate in addition to the normal reminder alerts.

For maximum accuracy, the progress note should be associated with a date of service. Once it is set up, the progress note alert starts counting down, based on the most recent initial evaluation or the most recent progress note.

If an initial evaluation/progress note is not associated to an appointment, then the countdown occurs on the basis of the first associated appointment date (this assumes that the countdown is enabled/marked as YES for a certain number of days).

As mentioned, the normal reminder alerts will continue to appear and count down letting you know you are getting close to a Progress Note being due for a patient. The force pop up function will then kick in when the progress note is due, forcing you to finish a progress note before you will be allowed to continue on.

When the Force Popup is enabled, you will see this alert on the screen, forcing you to complete a Progress Note for that patient before you can continue documenting that episode of care.

The Progress Note and Re-evaluation Alert can be episode specific.

Choose which episode you would like to set up the alert for. Example: PT episode will have 2 visits remaining before a Progress Note is due while in the OT episode there are 5 visits remaining.

The number of remaining visits/ days will appear on the page.

Click on the UPDATE button to save the settings.

The Progress Note alert will also appear on the header and the middle part of the page of the Patient Dashboard. If the user did not choose the force pop up, this information will still appear here.

For example:

Every time you create a Daily note for Episode 1, this will only affect the remaining visits for Episode 1.

Episode 2 will have its own countdown depending on the number Daily Notes created under Episode 2.

For example, the New episode already had an IE and 5 Daily Notes meaning the progress note is due on 7/27/20 or 5 visits.

While for the Knee episode for the same patient, there were no documents created yet. So there are still 10 visits remaining.

Re-Evaluation Count down Alert

This works exactly the same way as the Progress Note Count Down alert.

The Re-evaluation alert will notify you if a re-evaluation is missing or needs to be updated based on the settings you choose.

You also have the option to enable the Force Pop Up Alert, which will force you to complete a reevaluation Note before you are allowed to continue on based on when you set your notes to be due (example: re-evaluation is due every 3 days, the third day the system will force you to complete the re-evaluation note.)

Custom Alert

The custom alert function allows you to add custom notes or alerts to the patient dashboard. You can use this feature to create notes about the patient, financial notes, or reminders regarding the next date of service/treatment plan.

Click on the green + Create Message button, then enter the custom text you wish to include in your alert.
Click on the pencil icon to edit the current message.
Click on the 'X' button to delete the current message.
Make sure to hit Update when you are done.

KX Modifier alert and Medicare Cap Information

The KX Modifier is used for therapy services that exceed the financial limitations and meet the automatic exceptions process for services rendered.

Medicare Cap

In Touch EMR allows you to enter the current Medicare cap utilization information into the patient chart and will help you track how many estimated visits remain before the Medicare Cap is reached.

Choose which year you want to compute since there is different computation for each year because of the changes in Medicare maximum cap utilization amount.

The most accurate source for patient and claim data is the C-SNAP Website.

To add Medicare Cap information to a patient record in In Touch EMR, go to the Patient Dashboard and click on Edit Patient. Under the Alerts, click on the KX modifier tab.

You will then want to enter the following:

Current Medicare Cap Utilization
Average Claim Amount per visit
Estimated visits remaining (before Medicare cap is reached) - automatically calculated based on the Current Medicare Cap Utilization and Average claim amount per visit
Then hit UPDATE

The system will put an alert on the Patient Dashboard and count down as visits are documented for, and alert you when the Cap has been reached (based on the estimated data you entered). If you think you may be close to the cap we suggest that you turn on the KX Modifier for all claims going forward.

Appending KX Modifier

By adding the KX Modifier to a patient claim, the provider is attesting that the services billed:

Are reasonable and necessary services that require the skills of a Physical Therapist (see CMS pub 100-2, Chapter 15, Section 220.2).
Are justified by appropriate documentation in the medical record, (see CMS pub 100-2, Chapter 15, section 220.3).
And qualify for an exception under the automatic exception process.

In Touch EMR allows you to add a patient's Medicare Cap information, as well as append the KX Modifier to the patient's claims going forward.

Answer "Yes" or "No" to append the KX modifier to your claims going forward. We recommend you turn this option on if you think you are close to your Medicare Cap.

True Medicare Cap information is updated daily on the C-SNAP Website; please use this as your primary information source for patient and claim data.

The cap utilization calculation is independent from each episode. Episode 1 can have a different cap utilization and remaining visits than Episode 2. This allows you to monitor the Medicare utilization between PT and OT.

By selecting the episode, you can set different settings for each episode.

Alerts Locations

Once the alert has been created, it will be available in different areas of the patient chart.

Upper Header of the Patient Dashboard - this will show the Prescription Alert, Progress Note and Re-evaluation Alert
Patient Dashboard Mid Area - this will show all alerts that have been created