Complete a visit — the charting modal
The visit charting workspace: its four steps, every control in each one, what blocks the decision, and exactly which click finishes an async visit and a sync visit.
The visit charting workspace is the full-screen window you complete a visit in — four steps, one patient, one decision — and the same window serves async chart reviews and live video visits.
Questions people ask about this page
What are the four steps?
Clinical Review → Evaluation → Attestation/Decision → Write a Prescription. They are pills along the bottom right. On a narrow screen they shorten to Review, Evaluate, Decision, Prescribe.
Where is the "Complete visit" button?
There isn't one, and no Sign or Finish either. For an async visit the Step 3 decision is the completion. For a sync visit that decision records the clinical outcome and End Call completes the visit. The last button on the last step is Done, which only closes the window.
Why is "Write a Prescription" greyed out, with no message?
Because no decision exists yet, and the product does not say so. The pill is disabled and its only clue is the accessible label Write a Prescription, unavailable. Record Approve on Attestation/Decision and the workspace jumps you onto the step automatically. It also unlocks early if your network turned on Sign and prescribe together or marked the Prescription section Always visible.
Why is every decision button dead?
All five — Deny, Defer, Approve, Escalate to MD, Request Sync Visit — stay disabled until all three attestation boxes are ticked. The only hint on screen is one line of small text: Approval stays disabled until all required attestations are completed. It says "Approval", but it gates the other four too.
Does editing the SOAP note after I decide reset my attestations?
If the change came from the Ask AI panel, yes — all three boxes clear and you tick them again. Typing in a SOAP editor yourself does not clear them.
When do I Defer, and when do I escalate to an MD?
Defer when you cannot decide yet and the patient has to do something: it is a decision and it ends the review. Escalate to MD when a different, MD-licensed provider should finish it — escalation reassigns the chart, records no decision, and leaves the review open in their queue.
Why does the chart say "prescriptions unavailable"?
It is an approval-only review. The banner reads Approval-only review — prescriptions unavailable (or Good Faith Exam — prescriptions unavailable). Approving records the decision only — no order, payment or prescription is created.
I opened a chart and everything is read-only. Why?
The banner names the reason. Only the provider who completed this review can edit it. — someone else owns it. Provider delegates can view this chart review. Approved reviews unlock prescribing only. — you are a delegate. The decision on this chart belongs to the provider who claimed it. You can still write a prescription. — the decision is already recorded; you see this even on your own finished review.
Where to find it
You do not navigate to it. It opens over Left menu → ASYNC Visits (/async-visits) the moment you click Claim, and again from Start, Continue or View Summary; or over Left menu → SYNC Visits (/sync-visits) from Start Visit or Continue Visit. The window adds ?visit=<id> to the address bar, so a chart is linkable. Usable by: Provider, Provider Delegate (view, and prescribe on approved reviews), Provider Network Admin.
If you cannot get this far because Claim is greyed out, the usual cause is Preferred Protocols. Fix it at left menu → My schedule → Capabilities → tick the protocol under Preferred Protocols → Save Preferred Protocols. See Async visits queue.
The same four steps have three sets of names
| Step pill | Narrow screen | Settings → Operations |
|---|---|---|
| Clinical Review | Review | Clinical review (plus Progress notes) |
| Evaluation | Evaluate | Evaluation (SOAP) |
| Attestation/Decision | Decision | Attestation / decision |
| Write a Prescription | Prescribe | Prescription |
Your network admin can switch any of them off or reorder them, so your window may show fewer than four.
What is on screen
| What you see | What it does |
|---|---|
| Left column, Patient data | Sections Patient profile, ID & Selfie, Prior order history, Recent prescriptions, Forms and consents, Documents, Notes, Lab results. Only Patient profile is open at first; the rest load when expanded. The patient's name opens their full record over the chart. |
| Save & Exit | Top right. It asks first: the dialog Save and exit chart? reads Your chart edits will be saved and you can return to this chart later. with Keep Chart Open and a second Save & Exit. Confirming saves every step, closes the window, and fires the toast Progress saved. You can return to this chart later. It is not on the last step — that step has Back and Done only. |
| Footer Chat · Ask AI · Need Clarification | Message panel (with unread badge), chart assistant, and the async-only "ask the patient and move on" action. |
How to complete an async visit
Open the chart
On ASYNC Visits → To Do, click Claim. The workspace opens straight away — claiming and opening are one click, not two, and the address bar gains ?visit=<id>. If you closed it, the row is waiting on In Progress: the button says Start the first time and Continue once you have opened it.
Step 1 — Clinical Review
The left column opens on Patient profile with the fixed fields, plus collapsed sections for Forms and consents, Lab results and the rest. In the centre, heading Clinical Review: Showing intake responses submitted for this order or review. Consents and other patient forms are available in the left panel. Intake answers render as read-only cards. At the bottom is Progress Note — Capture your clinical reasoning, notable findings, and any notes added from patient responses. Type into Add the progress note... and click Save Progress Note.
Step 2 — Evaluation
Click Next. Heading Evaluation: Document the encounter across subjective, objective, assessment, and plan. Four editors — Subjective, Objective, Assessment, Plan — each with Regenerate section. Generate Notes drafts all four with AI. View transcript appears only when a transcript exists. SOAP autosaves. AI output is a draft — edit every section until it is your own reasoning, because you are about to attest that you did exactly that.
Step 3 — Attestation/Decision
Click Next. Heading Attestation/Decision: Review the compiled documentation, complete attestations, and record the chart decision. A read-only card shows your notes and all four SOAP sections together.
Tick all three attestations
Under Required Attestations, each ending in a red asterisk: I have conducted a good faith examination and believe the patient is an appropriate candidate. · Informed consent was obtained and documented in the record. · I reviewed all AI-assisted output, verified its accuracy, and exercised independent clinical judgment as the provider of record. Every decision button is dead until all three are ticked.
Record the decision
Under Visit Decision — Complete the required attestations, then record the outcome for this review. — five buttons wake up: Deny, Defer, Approve, Escalate to MD, Request Sync Visit. Four of them finish the visit. Escalate to MD does not. On an approval-only review only the first three are rendered; escalation is still reachable inside Defer.
That was the completion
The review is finished; the row moves to Done. Approving jumps you straight onto Write a Prescription. There is no Complete, Sign or Finish button anywhere — the last control on the last step is Done, and all it does is close the window.
Next on the decision step does not navigate. It walks you through the attestations one at a time, ringing each in blue, then focuses Approve and fires it. To deny or defer, click that button yourself.
Every decision control on Step 3
| Button | What happens | Finishes the visit? |
|---|---|---|
| Approve | Records approval, then jumps you onto Write a Prescription. Toast Visit approved (approval-only reviews: Approval recorded). Your network can rename this button. | Yes — Done / Approved |
| Deny | Opens Confirm denial: This will set the review status to Denied and move the entry to Completed. Provide a reason and type DENY to confirm. Write the reason under Denial reason (required) (Explain why this intake is being denied...), then type DENY under Type DENY to confirm. Confirm denial stays disabled until both are filled; Cancel backs out. Toast Intake denied (approval-only reviews: Denial recorded). | Yes — Done / Denied |
| Defer | The row swaps for two buttons: Defer with reason and Escalate to MD. Defer with reason reveals Reason for deferral (required) and Submit deferred decision, which stays disabled until you type something. Back to defer options returns. Toast Status set to Deferred. | Yes — Done / Deferred |
| Escalate to MD | A two-page popover headed Escalate to MD — Pick an MD-licensed provider to finish this review. Page one lists eligible providers with an MD badge, filtered by Search providers…. Picking one turns the page into Note for <name>, with Change to go back. The Note is required — Escalate visit stays dead until you write one (e.g. Patient's BMI and history need MD review before prescribing…). Save this note as a template keeps it for next time; a Template picker reading Start from a template appears only once your network has saved one. Toast Escalated to <name>. Reachable from this button or from inside Defer. If your network does not enforce state licensure the button and the popover both read Escalate, and the subtitle becomes Pick an eligible in-network provider to finish this review. | No — it reassigns the chart and records no decision. The visit stays open under the new provider. |
| Request Sync Visit | Confirm modal Request Sync Visit? — The patient will be emailed to schedule this visit with any eligible provider. They will not be asked to pay again for an already-paid product. Reason for deferral is optional; leave it blank and the recorded reason becomes Patient needs to schedule a sync visit for approval. Buttons are Cancel and Request Sync Visit. Toast Sync visit requested - Patient will be notified, and the window closes on its own. | Yes — it records a deferred decision that also asks for a live visit, and lands in Done / Deferred. |
What blocks the decision
| Hint under the buttons | What is missing |
|---|---|
Approval stays disabled until all required attestations are completed. | An attestation box is unticked. |
Complete all required decision questions before recording a decision. | Your network added custom decision questions in Settings → Operations. |
Approval stays disabled until required attestations and decision questions are completed. | Both. |
Toast Please complete required attestations. or Please answer all required decision questions. | You clicked a decision button anyway. |
If your network turned on Combine attestations, the three checkboxes become one statement inside the decision card headed Attestation, and clicking the decision button is the attestation.
Step 4 — Write a Prescription
Header shows an autosave stamp reading Saved <time>, and the forward button here is Done, not Next. Description: Finalize the primary prescription, add-ons, recommendations, and internal note for this encounter.
| Section | What is in it |
|---|---|
| Purchased product | What the patient bought, under the eyebrow PRODUCT PURCHASED. |
| Prescription(s) | Select medications from the client formulary, confirm directions and quantities, and send each line to its pharmacy. Under Prescription 1: a MEDICATION picker (Select medication → Search medications..., plus a Manual entry option), Add another, and the action button Prescribe, which is dead until a medication is chosen. On an assessment-first order that same button reads Queue payment instead (Hold prescription when the client pays externally), and with Sign and prescribe together on it is prefixed Sign & …. The card is headed Primary Prescription on networks that do not use per-line fulfilment. |
| Manual entry | Chosen inside the picker. Reveals PHARMACY NAME, MEDICATION NAME, DOSAGE, DIRECTIONS FOR USE (Sig / patient directions), QUANTITY, DAYS SUPPLY, TOTAL REFILLS. It writes a record and sends nothing. |
| Prescription add-ons | Collapsed. Write additional prescriptions for this visit. Each add-on is queued for the patient to review, accept, and pay before it is sent to the pharmacy. Its action is Send to patient for payment. |
| Recommendations and Internal note | Collapsed. Add informational recommendations with a title and rich description for the patient record. Recommendations take a TITLE and DESCRIPTION and are saved with Save recommendations. The internal note is Save a private note tied to this review. — never shown to the patient. |
Sending takes two presses. Prescribe does not transmit. The section retitles itself Review prescription(s) — Confirm the medication, pharmacy, quantity, supply, and refills before submitting. — and the form becomes a read-only card listing MEDICATION, PHARMACY, QTY, SUPPLY, REFILLS and DIRECTIONS, with Back and one confirm button. That confirm is the point of no return. Its wording varies by route — Send prescription, Send N prescriptions, Send primary prescription, Save prescription, Save N prescriptions, Save primary prescription, Open ScriptSure, Prescribe via ScriptSure, Queue prescription payment, Sign and hold prescription, Queue prescription, Retry N prescriptions, Save changes. Prescriptions has the full matrix.
Before it renders any control the step resolves payment and pharmacy context — card Preparing prescription queue, Loading pharmacies and formulary options for this order. If that fails you get Couldn't prepare the prescription queue and a Retry button, and prescribing stays locked until it loads.
The three panels
- Ask AI — a floating panel headed Ask AI, subtitle Patient chart assistant. Its opening line names the patient and the product:
Ask about <Patient>'s chart, intake and <Product>, history, orders, forms, transcript, or demographic details. I’ll pull the relevant chart context before answering.Ask inAsk about this patient’s intake, history, orders, or transcript...or dictate with Start dictation; send with Send Ask AI prompt, close with Close Ask AI. Drag it by its header. History is kept per visit. Remember that an Ask AI edit to the SOAP note clears all three attestations. - Chat — the same conversation as the Messages page, opened with this encounter's context so you keep the chart.
- Video overlay — sync visits only: mute and camera controls, a timer, and the states
Reconnecting...,Patient has left the call,Not Connected.
Need Clarification — parking a chart on the patient
Async only, and only before you record a decision — once a decision exists the chart goes read-only apart from prescribing and the footer button disappears. Click Need Clarification in the footer. The dialog reads Ask the patient for more information and move on to your next visit. The patient will see this on their dashboard. Fill in What information do you need? (Describe what you need from the patient...) and click Request information — that also emails the patient and points them at their dashboard. Toast Clarification requested; the window closes. The row moves to the Pending Patient Response table inside In Progress, keeps your name on it, and shows one action, Move to In Progress (toast Visit moved back to In Progress). A patient reply moves it back on its own. Already messaged parks the row with no email at all; Cancel backs out.
Sync visits: what is different
| Async chart review | Sync video visit | |
|---|---|---|
| Need Clarification | Available | Not available |
| Cancel Visit | Not available | Available; requires Cancellation Reason * |
| What completes it | The Step 3 decision | End Call — This will disconnect the video call. You can continue charting afterwards., buttons Keep Call / End Call |
Statuses you will see here
| Badge | What it means | What to do |
|---|---|---|
| Under Review | The chart is open with a provider; no decision yet. | Finish the steps. |
| Has SOAP | SOAP documentation exists. Shown next to Under Review. | Nothing; a progress marker. |
| Pending Patient Response | You used Need Clarification. | Wait, or Move to In Progress from the queue. |
| Approved | You approved. The patient record calls the same visit Completed. | Prescribe if the workflow prescribes. |
| Denied | Terminal. The patient is not automatically refunded. | Nothing. |
| Deferred | You deferred, or you requested a sync visit. | Hovering the badge shows your reason. |
| Sent to pharmacy / Prescription saved | A prescription was transmitted, or written without transmitting. | Track it on Prescriptions. |
| Voided / Cancelled | The row was killed before any decision. Hides every other badge. | Nothing. |
What can go wrong
| What you see | Why | Fix |
|---|---|---|
Only the provider who completed this review can edit it. | Another provider owns the chart. | Ask a Provider Network Admin to reassign it from ASYNC Visits. |
The decision on this chart belongs to the provider who claimed it. You can still write a prescription. | You are covering for the assigned provider. | Prescribe if that is what was asked. Do not expect decision buttons. |
Record a decision before prescribing. | Step 4 is locked. | Finish Step 3. |
Couldn't prepare the prescription queue | Payment context or the pharmacy list did not load. | Click Retry. The lock is deliberate: without payment details every payment gate would read as "nothing to collect". |
This encounter is missing linked order or clinical context, so the clinical workflow could not be assembled. | The visit is not linked to its order or chart review. | Click Close and report the row. You cannot fix it from here. |
| Your attestations cleared themselves | Ask AI changed the SOAP note. | Re-read the note, then tick all three again. |
| The window jumped back to Clinical Review on its own | The workspace remounts on some data refreshes, and a deep link always reopens on step 1. | Nothing is lost — only your position. Click the step pill to go back. |
| The window closed mid-chart | Esc, or a click on the dark margin outside the window, closes it immediately — no confirmation, no save prompt. Only the Save & Exit button asks. | Reopen from the queue. Autosaved work (SOAP, drafts) is intact; use Save & Exit deliberately instead. |
| The queue says Approved but the patient record says Completed | Three surfaces use three vocabularies for one visit. | They agree. Approved in the queue, Completed in the patient record's Visits tab, Approved on the order. |
| You reopen your own finished review and it says the decision belongs to someone else | Product copy defect — the banner shows even to the provider who claimed it. | Ignore it. View Summary is read-only for everyone; you can still write a prescription. |
| There is no Evaluation step | Your network disabled Evaluation (SOAP). | Nothing — a network setting, not a fault. |
Next
Was this helpful?