Not Seen Attestation

Audience

DocNow administrators and users. 

Overview

A DocNow team member must enabled the Not Seen Attestation practice permission before this feature is available for customers. Not Seen Attestation allows Admins the ability to establish a list of Not Seen Reasons to be used by providers and additionally set an attestation period which will prevent users from creating new notes or charges if previous attestations have not been completed. 

This feature creates opportunities for better: 

• Data for missed visit reasons
• Provider accountability
• Productivity metrics 

Table of Contents

• Admin Portal
• Provider Portal
• Provider Workflow
• Operational Report
• Glossary
• FAQ

Admin Portal

When the practice permission is enabled for Not Seen Attestation, a company setting screen for Patient Not Seen Configuration is available. 

Managing Not Seen Reasons

1. Navigate to the Admin Portal>>Settings (Welcome banner)>>Patient Not Seen Configuration
2. Manage not seen reasons intended to be selected by providers (Add, Edit, Delete)
   1. Select Add Not Seen Reason
   2. Enter text for the Not Seen Reason
   3. Select the blue check icon to save your configured Not Seen Reason
      
3. Reasons may be dragged and dropped to change the order they appear in the admin portal and in the provider selection interface. 
4. Select OK when finished configuring to save changes. 

Configuring the Attestation Period

1. Navigate to the Admin Portal>>Settings (Welcome banner)>>Patient Not Seen Configuration
2. Set a Attestation Period in units of days (0 = No attestation required)
   • Attestation Period represents the number of days the provider has to complete attestation for their census by either specifying a user was seen (e.g. Status toggle set to true) or a patient was selected as Not Seen. If a census is lacking either one of these notations for a patient and the census is beyond the Attestation Period the provider will not be allowed to chart for the current DOS until these past census issues have been resolved.

Provider Portal

When the Not Seen Attestation practice permission is enabled and viewing the Census List, two new columns are available:

Not Seen Attestation

• Complete - All patients within the census have either been seen (e.g. Status toggle is ON) or have been marked as Not Seen by the provider
• Incomplete - One or more patients exist on the census without a seen status or not seen status selected.

Not Seen Patients - Total count of patients designated as 'Not Seen' on the census.

Attestation Period, as configured by the admin, represents the number of days the provider has to complete attestation for their census by either specifying a user was seen (e.g. Status toggle set to true) or a patient was selected as Not Seen. If a census is lacking either one of these notations for a patient and the census is beyond the Attestation Period the provider will not be allowed to chart for the current DOS until these past census issues have been resolved.

Provider Workflow 

Attestations

When Not Seen Attestation is enabled providers must address the status of each patient on their census to prevent restrictions for creating notes and charges on subsequent censuses. 

Providers can address the status of a patient in the following ways: 

1. Toggle the Status button. Click the status button which indicates that you have seen the patient or intend to see the patient for the corresponding date of service. 
   
   
    
2. Draft a Note. Drafting a Note will automatically toggle the not seen button. 
   
   
3. Toggle the Not Seen button and choose a not seen reason.  
   
   
    
4. If you need to cancel or change a Not Seen reason toggle the button off and then leave off if creating a note or changing the status, or toggle again to choose a new not seen reason.  

Note Restrictions

Depending on the Attestation Period your practice has set, if you do not complete attestations for a past date of service you will not be able to begin documentation. For instance, if the Attestation Period is set to 1, when a provider does not finish attestations they will not be able to create notes or charges for the next day. 

You may still open a restricted census and view all available census information, but you will receive a pop up informing you of the restriction and the icons for creating a note or charge will not be selectable. 

To see which past census has attestations that need to be completed, refer to the Not Seen Attestation informational column while looking at the census for any given facility. 

Important Notes: 

• Restrictions are limited to the facility that you have not completed previous attestations for. This means that a restriction on one facility will not create restrictions for a different facility's census. 
• The system will check for census completeness for the last 30 days. In other words, if a census older than 30 days has not been attested to there will be no restriction applied.
   

Patient Not Seen Attestation Report

Dashboard Overview

Provides data at a glance for the following metrics, along with the same detailed information by provider.

• Total Patients Assigned - Total number of patients assigned to the census for the given date range. 
• Completed Visits - Total number of completed encounters for the filtered results.
  • Encounter complete = there has been a signed note and charge submitted for a patient on a census. 
• Projected Completed Visits - Total number of patients on a census in the given date range with status = true (green).
  • Similar to Total Patients Assigned The number is total and not just unique patients. I.E. The provider could toggle the status to true for the same 5 patients every day for 5 days and the total projected completed visits would be 25.
• Incomplete Visits - Total number of encounters not completed for the filtered results. 
• Completion Rate - Total completion rate (= Patients Seen / Total Patients x 100), rounded to nearest tenth. 

Filters: 

• Facility
• Provider
• Date of Service

Missed Visit Analytics 

Provides data at a glance for Missed Visit Reasons, along with with detailed information by patient for the following fields for the filtered results: 

• Date of Service
• Patient MRN
• Provider
• Facility
• Reasons

Reporting Use Cases

• Identifying Patterns in Missed Visits
• Improving Provider Productivity
• Staffing and Resource Allocation
• Revenue Cycle Optimization
• Quality Assurance and Compliance
• Facility Performance Benchmarking
• Provider Accountability and Coaching
• Forecasting and Capacity Planning
• Validating Process Improvements
   

FAQ

What is Not Seen Attestation?
Not Seen Attestation is a feature that requires you to account for every patient on your daily census. For each patient, you must indicate whether you saw them (or plan to see them) or mark them as "Not Seen" with a reason. This helps your organization track missed visits and improve productivity metrics.

How do I mark a patient as seen?
You have two options: toggle the Status button to green, or draft a note for the patient (which automatically toggles the status for you).

How do I mark a patient as not seen?
Toggle the Not Seen button and select a reason from the dropdown list. Your administrator has configured the available reasons for your practice.

What if I selected the wrong Not Seen reason?
Toggle the Not Seen button off, then toggle it back on to select a different reason. If you've decided to see the patient after all, simply leave the button off and update the status or create a note instead.

Why can't I create a note or charge today?
If your practice has an attestation period set, you must complete attestations for past dates of service before documenting on current ones. Check the Not Seen Attestation column in your census list to find which past census needs attention.

How do I know which census is incomplete?
Look at the Not Seen Attestation column when viewing your census list. It will show "Incomplete" for any census where patients still need their status addressed.

Does a restriction at one facility affect my other facilities?
No. Restrictions are facility-specific. An incomplete attestation at one facility will not prevent you from charting at a different facility.

How far back does the system check for incomplete attestations?
The system checks the last 30 days. Any census older than 30 days will not trigger restrictions, even if attestations were never completed.

What does the attestation period mean for me?
The attestation period is the number of days you have to complete your census attestations. For example, if it's set to 1 day, you must finish yesterday's attestations before you can document for today.

Can I still view patient information if I'm restricted?
Yes. You can open a restricted census and view all available information, but you won't be able to create new notes or charges until you resolve the outstanding attestations.

Glossary

Attestation Period
The number of days providers have to complete attestation for their census before being restricted from creating new notes or charges. Set by administrators in days (0 = no attestation required).

Census
The list of patients assigned to a provider for a specific date of service at a facility.

[Report] Completed Visit
A patient interaction where both a signed note and charge have been submitted.

[Report] Completion Rate
The percentage of patients seen out of total patients assigned, calculated as (Patients Seen ÷ Total Patients) × 100.

[Report] Incomplete Visit
An encounter that has not been completed (missing signed note and/or submitted charge).

[Report] MRN (Medical Record Number)
A unique identifier assigned to each patient.

Not Seen Attestation
A practice feature that requires providers to account for every patient on their census by indicating whether they were seen or not seen, with reasons documented for missed visits.

Not Seen Reason
A predefined explanation selected by providers when marking a patient as not seen. Administrators create and manage the available list of reasons.

Note Restriction
A system-enforced block preventing providers from creating new notes or charges when past attestations remain incomplete beyond the attestation period.

[Report] Projected Completed Visits
The count of patients on a census with status toggled to true (green), representing expected but not yet finalized visits.

Status Toggle
A button providers use to indicate they have seen or intend to see a patient for the corresponding date of service.