Patient Approvals

Work that is completed in axiUm by student providers often requires approval from a faculty member or instructor.

If you select a patient in axiUm and an item is present on the patient’s record that you require approval for, the patient’s chart number displays in teal on the status bar to indicate that an item on the patient record requires approval.

Note: This includes any items that were done on behalf of the provider.

Depending on how a provider is configured, many items may require approval in axiUm:

  • Treatments and treatment plans
  • Conditions and problems
  • Forms, letters, and notes
  • Findings and problems
  • Perio exams, ortho visits, and lab orders
  • Surgery and drug waste

When completing approvals, a variety of warnings/errors may display when applicable to the item type.

Examples: “Cannot approve treatments for multiple providers” or “Treatment was not start checked” can display only for treatments.

If you review an item that you do not want to approve because it requires more work, you can leave the item unapproved. It remains in the Patient Approvals window because it has not been approved, and the student provider should make the necessary edits to the item so you may approve it.

Tip: If the student provider must make extensive changes to the item and they use approval requests, they can retract the requested item, finish the necessary work, and request approval again.

Some institutions may use an optional request-based workflow to complete patient approvals. If enabled, student providers can request approval for items when they finish them during an appointment, then prompt faculty members to approve the items. It makes use of an Approval Request window, the Review Billing Information window, clinical notification states, and if configured, a controllable intervention event.

Financial warnings can be suppressed during the patient approvals process.

After the approvals process if over, staff can review financial warnings for specific procedures that may have occurred during the approvals process and address the issues. These can be reviewed from several places in axiUm:

  • The Transactions module > Treatment tab
  • The EDI Claims window > Unsubmitted tab
  • The Edit Held Paper Claims window

Patient approvals includes several parts: 

  • The Patient Approvals window: This allows faculty members to review and approve all record type items. Depending on your institution's workflow, this may include only requested items or all unapproved items. The window contains Criteria filter fields that can be modified as necessary to narrow the list of items before faculty members begin to review and approve. Additionally, it has User and Audit Date columns that provide more information to users.

    • The Criteria filters default differently depending how the student provider is configured.

    • If the student provider does not use requests, the Requested Items and All Unapproved Items radio buttons are disabled, and the Current User / All Users and Current Date / All Dates radio buttons are enabled.

      • Tip: You can specify workstation defaults for the user and date radio buttons when the Patient Approvals window is accessed from the status bar. These defaults are set from the Patients module > Patient Options window > Default Criteria for Date and Default Criteria for User fields.

    • If the student provider is required to use requests, the Requested Items radio button is selected by default and the Current User / All Users and Current Date / All Dates radio buttons are disabled.

      • Note: If you select the All Unapproved Items radio button, the other radio buttons are enabled, but the Approve button is disabled and you cannot approve other items. However, if you have the correct permissions, you can click an Unlock button to authenticate and re-enable the Approve button.

    • If the student provider uses requests optionally, the All Unapproved Items radio button is selected by default and the Current User / All Users and Current Date / All Dates radio buttons are enabled.

  • The Review Billing Information window: When approving P/I/C treatment items from the Patient Approvals window, the Review Billing Information window may display. This holds the billing information related to the selected treatment(s).

  • The Approval Request window: If a student provider uses the request-based workflow and is ready to have work that was done during an appointment approved by a faculty member, they can use a specific clinical notification state to display the Approval Request window and request approval for the item(s).