Understanding the Contracted Telehealth Provider Exam Workflow

1. The patient schedules an appointment by calling the office or scheduling online if available.
2. The front desk staff confirms the appointment and insurance information and asks the patient to complete intake forms prior to arriving.

1. The patient arrives and checks in.
2. The patient completes any intake forms (e.g., medical and ocular history, consent forms) they did not complete before arriving.
3. The front desk staff checks in patient.

1. The technician creates a nonvisit order in Encompass.

   To learn how to create a nonvisit order in Encompass, go to To use the Nonvisit Order feature.

2. The technician takes the patient to the pretesting room.
3. The technician reviews medical history with the patient.

   Because the nonvisit order does not include CC The main reason for the patient’s visit to the doctor., HPI History of Present Illness. A detailed account of a patient's current health issue, including when it started and how it has changed over time. , and ROS Review of Systems. An ROS is an inventory of the body systems obtained through a series of questions seeking to identify signs or symptoms that the patient may be experiencing or has experienced. sections, you'll need to enter any relevant history in Additional Visit Notes.

4. The technician performs pretesting.

   For any equipment that does not integrate with the doctor-remote exam software, enter the data in Encompass just as you would for an in-person visit. The contracted telehealth provider will have access to the data when the nonvisit order is finalized. To learn how to enter pretesting information, go to Documenting Pretesting Information in the Vision Exam Screen in the iPad App.

   For any equipment that does integrate with the doctor-remote exam, software do not enter the data in Encompass; otherwise, the information will be duplicated when the contracted telehealth provider finalizes the exam in the doctor-remote exam software.

5. The technician enters any pretesting information that is not device-driven (e.g., visual acuities using a Snellen chart) manually into Encompass.

6. The technician must also enter this data into the doctor-remote exam software. For more information, refer to the documentation provided by your doctor-remote exam software vendor.

7. The technician finalizes the nonvisit order.

   The nonvisit order must be finalized before Encompass can send the pretesting data to the contracted telehealth provider.

8. The technician takes the patient to the exam room.
9. The technician performs the video slit-lamp A specialized microscope used by eye care specialists to examine the structures of the eye in detail. Used in a slit lamp exam, also known as biomicroscopy. examination.
10. The video slit-lamp data is pushed to the doctor-remote exam software. This data is not pushed directly to Encompass.
11. The technician signals that the patient is ready for refraction in the doctor-remote exam software. For more information, refer to the documentation provided by your doctor-remote exam software vendor.
12. The technician initiates the video with the remote refractionist or contracted telehealth provider.

The refraction portion of the exam may be performed by a remote refractionist or the contracted telehealth provider.

1. The remote refractionist joins the video call with the technician and patient.
2. The remote refractionist captures the patient's manifest refraction with the digital phoropter and pulls the measurements into the doctor-remote exam software.
3. The remote refractionist signs off of the video call.
4. The technician signals that patient is ready for the eye exam in the doctor-remote exam software. For more information, refer to the documentation provided by your doctor-remote exam software vendor.

1. The contracted telehealth provider reviews the refractive data in the doctor-remote exam software.
2. The contracted telehealth provider joins the video call with the technician and patient.
3. The contracted telehealth provider uses screen sharing to review the slit-lamp A specialized microscope used by eye care specialists to examine the structures of the eye in detail. Used in a slit lamp exam, also known as biomicroscopy. video with the patient.
4. The contracted telehealth provider reviews the manifest refraction and creates final prescriptions for the patient.
5. The contracted telehealth provider performs the exam and documents the findings in the doctor-remote exam software.
6. The contracted telehealth provider finalizes the exam in the doctor-remote exam software.

   The finalized exam in the doctor-remote exam software triggers the following events:

   • The finalized exam is pushed from the doctor-remote exam software to Encompass and appears as a PDF alongside any previous exams listed in the patient's activity. The PDF generated by the doctor-remote exam software is visually different and organized differently than the PDFs generated by Encompass.
   • The final contact lens or eyewear prescriptions are saved as a PDF within the Attachments section of the Patient Overview. The final prescription generated by the doctor-remote exam software is visually different than those generated by Encompass. If your state requires the provider's signature on printed prescriptions, print this PDF for the patient.
   • The final contact lens or eyewear prescriptions are also sent to the practice management system for lab orders.
   • Billing codes are sent to the practice management system. The biller will need to review these codes to ensure they conform to the the patient's insurance requirements.

The workflow from this point is the same as if the patient saw a doctor in-person.

1. The technician takes patient to the optical station.
2. The optician pulls the contact lens and eyewear prescriptions and exam charges from Encompass.
3. The optician helps patient select frames.
4. The optician reviews all products the patient wishes to purchase.
5. The optician creates a materials order.
6. The optician collects any copays or out-of-pocket expenses.
7. The optician prints any receipts and prescriptions.

The biller reviews, adjusts, and submits the claim to the patient's insurance through the practice management system.