Chapter 1 — End-to-End Journey (how everything connects)

Practice setup ─► Staff & roles ─► Payers & service codes
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 1 Add patient ─► 2 Insurance + consent ─► 3 Assign clinician ─► 4 Portal invite + intake forms
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 5 Schedule intake (type → codes → note template) ─► reminders
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 6 Session (in person / telehealth, optional AI scribe)
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 7 Intake note ─► 8 Treatment plan ─► 9 Progress notes (+ outcome measures) ... ─► Termination note
        │ sign (supervisor co-sign if required)
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10 Charge ready ─► eligibility ─► claim (electronic / paper / external) ─► clearinghouse ─► payer
        │                                                   │ rejected → fix → resubmit
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11 ERA / insurance payment posted ─► secondary claim ─► patient balance ─► statement / portal pay / card
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12 Reports, Insights, To-Do counters, Activity Log

Step by step

1. Add patient — Patients > + New Patient (or + New inside the appointment dialog). Only last name is required, but claims also need DOB, address, sex and HIPAA acknowledgment; the portal needs DOB and email. → Ch 2.5
2. Insurance — Billing Settings > + Add Insurance Policy (primary through quaternary): member ID, group, coverage dates, copay and deductible, signature on file, prior authorizations; upload the card image (AI can read it). Run Verify Eligibility. → Ch 4.5
3. Assign clinician — Clinicians tab (also automatic on the first appointment). This decides who sees clinical records. → Ch 2.5
4. Portal — Portal tab > Grant Access, then Share Documents (consent, privacy notice, intake forms, PHQ-9 and similar). Responses show up on To-Do for processing. → Ch 3.8
5. Schedule — the appointment type controls which clinicians, service codes and note template are allowed. Recurring sessions, telehealth flag, alert, reminders. → Ch 3.1
6. Session — check in via the alert; telehealth opens 5 hours before; Scribe optional.
7. Intake note → 8 Treatment plan (goals, objectives, interventions) → 9 Progress notes each session (diagnosis, mental status, risk, interventions, measures). Missed session → Missed Appointment Note and optional fee. → Ch 3.2
8. Bill — signing makes the claim ready. Submit electronically (up to 4 diagnoses), on paper (CMS-1500) or mark external. Track statuses and fix rejections (New / Amended (7) / Void). → Ch 4.4
9. Get paid — post the ERA (match, allocate, adjust) → submit the secondary claim → the patient's share moves to their balance → card payment, statement, portal payment, refund or write-off. → Ch 4.3, 4.6
10. Close — Termination note; the patient goes inactive automatically after 4 months without appointments.

Screen connection map

| From | Leads to | |---|---| | Home | Upcoming appointments, To-Do summary, + New appointment | | To-Do | Notes to sign, patient records missing info, portal requests, ERAs, claims, rejections | | Patient chart tabs | Info, To-Do, Schedule, Documents, Billing, Billing Settings, Clinicians, Portal, Messages, Insights | | Appointment dialog | Patient, Notes tab (note), Billing tab (rate, method, modifiers), History | | Note | Appointment, diagnosis codes, treatment plan, outcome measures, billing line | | Billing hub | Payments, claims, ERA, reports, transaction search | | Payer | Info (enrollment, telehealth overrides), Billing, Clinicians, Patients | | Staff | Info, Billing (payer overrides), Patients, To-Do, Work Schedule | | Messages | Patient chart, Generate Contact Note | | Library | Portal forms, note templates, outcome measures → patient Portal sharing | | Settings | Every rule above (billing, notes, codes, security, portal, reminders, telehealth, AI) |

To-Do generators (what puts items on To-Do)

• An appointment occurring → note to complete; a draft note → sign; supervision → review or co-sign.
• Missing patient info (HIPAA, contact, billing) → Patient Records item.
• Portal document responses or appointment requests → Portal items.
• Signed billable notes → Submit claims; new rejections → Review; new ERAs → Process; eligibility results → Review.
• Account setup reminders (work schedule, phone, 2FA).