Understanding the In-house Doctor-remote 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 (medical and ocular history, consent forms, etc) they did not complete before arriving.
3. The front desk staff checks in patient.

1. The technician creates a visit in Encompass as well as in the doctor-remote exam software.

   To learn how to create a visit in Encompass, go to Creating or Opening a Visit in the iPad App.

   For information about creating a new visit in the doctor-remote exam software, refer to the vendor's documentation.

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

   To learn how to document the patient's history, go to Recording the Chief Complaint, HPI and ROS in the iPad App.

4. The technician performs pretesting.

   To learn how to enter pretesting information, go to Performing a Routine Vision Exam from the iPad.

   Data from the diagnostic equipment is pushed into both Encompass and the doctor-remote exam software by the equipment integration software.

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

   If the practice is using a remote refractionist, 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.

6. The technician takes the patient to the exam room.
7. The technician performs the video slit-lamp examination.
8. The video slit-lamp data is pushed to the doctor-remote exam software. This data is not pushed directly to Encompass.
9. 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.
10. The technician initiates the video with the remote refractionist or remote doctor.

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.
3. The technician pulls the manifest refraction into Encompass using the Equipment Interface.
4. The remote refractionist signs off of the video call.
5. 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 remote doctor reviews the data in Encompass.
2. The remote doctor joins the video call with the technician and patient.
3. The remote doctor uses screen sharing to review the slit-lamp video with the patient.
4. If practice is using Image Management, the remote doctor reviews images in Encompass.

   Otherwise, doctor reviews images within the doctor-remote exam software. For more information, refer to the documentation provided by your doctor-remote exam software vendor.

5. The remote doctor reviews the manifest refraction and creates final prescriptions for the patient.
6. The remote doctor performs the exam and documents the findings in Encompass.

   Encompass generates the CPT and ICD-10 codes.

7. The remote doctor sends the prescriptions and fees to the practice management system
8. The remote doctor finalizes the visit in Encompass.

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 submits the claim to the patient's insurance through the practice management system.