Encounter Oversight Setup

athenaClinicals

This page allows you to specify the criteria for encounter oversight review, including the rendering provider, the percentage of encounters to be reviewed, and diagnoses to exclude.

With the Encounter Oversight feature, athenaClinicals supports physician oversight of encounters rendered by midlevel providers, including reports for oversight providers and high-level administrators who review the work of rendering providers.

To configure which encounters oversight providers should review

Encounters that are marked for review based on the configurations on this page are marked as "Auto-generated" on the encounter review document and in reports.

Note: A rendering provider can be set up only once. If the rendering provider is not set up on the Encounter Oversight Setup page, the encounters for that rendering provider will not be automatically marked for review.

Display the Encounter Oversight Setup page: On the Main Menu, click Settings > Clinicals. In the left menu, under Practice Links — Encounter Oversight, click Encounter Oversight Setup.
Click Add new.
Additional fields appear.
Note: Click edit or delete to update existing encounter oversight setups.
Rendering providers — Click All, or click Selected to select the midlevel providers who will have the same percentage of encounters reviewed and the same diagnoses excluded.
% of encounters to be reviewed — Enter an integer from 0 to 100.
Note: This percentage is calculated based on the number of reviews performed in the configured time period, or 30 day default. If the percentage of encounters sent for review over the past 30 days is less than the percentage set in this field, the next encounter closed by the rendering provider is flagged for review. If this percentage was edited less than 30 days ago, the calculation is based on that number of days.
Diagnoses to exclude — Search for a SNOMED term to indicate which diagnosis to exclude from provider oversight. athenaOne will not generate encounter review documents for encounters with matching diagnoses.
You can enter ranges and wildcards to describe a large number of related diagnoses. For example, V03-V06 excludes a range of vaccines, indicating that encounters with these diagnoses do not require review.
Note: If an encounter has multiple diagnoses and only one of them is excluded, the encounter may still be selected for review.
Click Save.

Field Reference

Rendering providers	Click All, or click Selected to select the midlevel providers who will have the same percentage of encounters reviewed and have the same diagnoses excluded.
% of encounters to be reviewed	Enter an integer from 0 to 100.
Diagnoses to exclude	Search for a SNOMED term to indicate which diagnosis to exclude from provider oversight. athenaOne will not generate encounter review documents for encounters with matching diagnoses. You can enter ranges and wildcards to describe a large number of related diagnoses. For example, V03-V06 excludes a range of vaccines, indicating that encounters with these diagnoses do not require review. Note: If an encounter has multiple diagnoses and only one of them is excluded, the encounter may still be selected for review.

Rendering providers

Click All, or click Selected to select the midlevel providers who will have the same percentage of encounters reviewed and have the same diagnoses excluded.

% of encounters to be reviewed

Enter an integer from 0 to 100.

Diagnoses to exclude

Search for a SNOMED term to indicate which diagnosis to exclude from provider oversight. athenaOne will not generate encounter review documents for encounters with matching diagnoses.

You can enter ranges and wildcards to describe a large number of related diagnoses. For example, V03-V06 excludes a range of vaccines, indicating that encounters with these diagnoses do not require review.

Note: If an encounter has multiple diagnoses and only one of them is excluded, the encounter may still be selected for review.