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Implementation Contact Homework

1 - Add Logins for all your Users

Hover over over the Admin menu in the top navigation bar, select “Manage…”, then “Users”. Select ‘Add New User or Resource’ then ‘Add New User’.  From here you will set their username, temporary password, along with some additional user settings. You are strongly encouraged to review this article on how to manage the settings for your users.

Once you’ve created the profile for each user, you will need to provide them with their username,  password, and your EHR URL. When they first log in, they should change their password by hovering over their initials in the top menu and selecting Change My Password.

Billing for users begins on the first invoice after they are added to the system.

*Note on Users vs. Resources: A User profile is set for individuals to have their information, login credentials, and permission levels set within the system. Whereas a Resource is a non-user account that can have tasks and/or a calendar.  A resource may represent a room or chair, for instance. This allows for scheduling and task assignment related to that resource. If you think your clinic could benefit from having a resource, see this article for additional information.

2 - Set Up Your Appointment Types

To begin scheduling appointments, you will first need to set up the list of appointment types that you offer via Admin > Manage > Schedule Types.

  • How to set up your appointment types: video tutorial and online help.
  • Set your preferred overall, and appointment-specific defaults for the Email Notice, Email Reminder, and SMS Reminder. An appointment-specific default message, if set, will appear instead of the background default message when that appointment type is selected.

3 - Set Up Your Charge List/ Fee Schedule

Before you can add charges to patients’ accounts, you need to set up your Charge List/ fee schedule. This may include charges for services, as well as products that you sell. You can manage and add to your Charge List under Admin > Manage > Charge List.

  • How to set up your Charge List: video tutorial and online help.
  • How to set up your inventory for items that you sell out of the office: online help.
  • Set up your Discounts that you want to have available to apply to charges as needed.

If you already have a charge list and/or inventory in spreadsheet format, we can import that for you.

4 - Initiate Lab Integrations & Set Up Specialty Labs in Orderable Labs Database

To initiate electronic integrations with the labs that you work with, send your implementation manager a list of the labs that integrate with Cerbo that you work with, and your account numbers with those labs. Some must be requested directly from your lab reps, others we can request for you, and some require a specific request form. Once we receive your list, we will provide specific guidance on how to initiate each integration.

Adding specialty tests to the orderable labs database can be done manually, or we can import from a spreadsheet “utilization report” provided by your lab rep at a specific lab. That utilization report should list the labs that you have ordered from that laboratory in the past year (or possibly more, depending on the lab), along with the laboratory’s codes for those orders.

If there are lab panels that you order, which you would like to formally group together in the EHR, you can do that:

5 - Set up Specialty Supplements/ Custom Prescribable Items/ Recommendations *Optional

Do you commonly recommend dietary, lifestyle, movement, or follow up recommendations? Do you use IV therapy or injections? You can set up the specific recommendations and custom “prescriptions” that you use as custom prescribable plan items under Admin > Manage > Alternate Plan Options. Once those are added, you can prescribe/ order them just as you would a standard medication, supplement, lab order, etc.

6 - Review Patient Portal and Request Edits

Review the new patient registration form at https://[YOURPORTALURL].md-hq.com/registration. Let us know if you want to remove specific sections, or have additional information that you hope to capture in that form. Detailed intake information would generally be collected via the intake questionnaires that a patient will complete after they have registered.

To review what is inside the Patient Portal itself, you will need to log into the Patient Portal as a patient, either by registering yourself as a test patient, or by going into the EHR and to John Doe’s chart, then to the Pt Portal menu, and Log into Portal as Pt.

Review instructions on the Patient Portal pages, and let us know if you want to disable specific Patient Portal pages or functionality and/ or edit the instructions that appear at the top of each page. If you would like, we can have specific instructions/information posted for patients on the Logged In screen that they see when they first log in. So, for example, send to your implementation manager the specific instructions that you want to appear for patients when they first log into the Patient Portal.

Select the forms and questionnaires that you want to have available on the Questionnaires page of the Patient Portal. You can choose from our existing forms and questionnaires library and send any consent forms needed to your implementation manager to convert.

Once your requested forms are added, you’ll need to use the Questionnaire Manager in Cerbo to manage how the forms appear on your portal.

*FORMS TIP – Be selective in the forms you request, it can be overwhelming to manage too many forms at once. You can always request more forms if you find you need them!

Config question: ALL new patient registrations and items edited or submitted via the Patient Portal come into the EHR for your review and acceptance. Let your implementation manager know if you would also like to receive email notifications (not containing PHI) when (1) a new patient registers, (2) a secure message is sent to the practice, and/ or (2) an appointment is requested.

7 - Setup eRx

All prescribing providers will want to set up e-prescribing so that they can send electronic prescriptions (including of controlled substances) to pharmacies. Help with setting up eRx is here. Please review the help closely and refer back to it as you move through the setup process. If everything goes smoothly, the setup process can be completed in 20 minutes. For help, please reach out to your implementation manager or to our main support email at support@cer.bo.

If you previously used (or currently use) eRx in another system, you will need to turn off eRx refills in the other system to be able to receive refills electronically in Cerbo.

8 - Providers Add Their Signatures

Providers should add their signatures to Cerbo as an early set up step. Once it is added, a provider’s signature can be applied to e-faxable prescription forms, lab or imaging requisitions, invoices, and other forms generated in the EHR.

Any user can add a signature by hovering over their initials in the top menu, and clicking on Change My Signature. This brings up a signature pad, where the signature can be drawn with the mouse, touchpad or on a touchscreen. Using a touchscreen for this step, and a stylus if desired, will yield the best results.

If the signature is complex or good results cannot be obtained using the signature pad, you can email a scan of the signature to your implementation contact.

Walk Through Videos

Staff Training Modules

Module 1: Calendar/ Scheduling and Tasks (corresponds to Video Walk Through 1)

This module is primarily for: admins, schedulers, front desk staff. Staff that do not schedule or check in appointments should skip to 1a in this section, below.

Add a Patient manually (versus having them register themselves in the online registration form)

Set and save your preferred default calendar view (in the Calendar Options box).

Add an appointment to the schedule for your test patient.

Block off time on the calendar for an internal meeting. Make this recur weekly for 3 weeks.

Create a Work Schedule.

Add an appointment of type Vacation to the schedule.

Use the appointment Status drop down menu to mark an appointment as Checked In.

  • Look over at the far right at the Tracking Board (three grey boxes) and use the tracking board to mark the appointment/ patient as In Room, assign to yourself as if you were the provider (to see how that looks), and finally mark as ready for Check Out.
  • Use the appointment Status drop down menu to mark the appointment as Checked Out to remove from the Tracking Board.

Use Chart Parts to create a template message to send when patients cancel an appointment to confirm the cancellation.

Use the appointment Status drop down menu to mark the appointment as Cancelled and pull up your cancellation email template you just created to populate the email message.

Create a scheduled task (has a due date) for yourself and check the box for there to be a reminder. Create a standing task (no due date). Create another task with a note in it, and re-assign it to another user. Mark a task as complete.

Use Advanced Patient Search to generate a complete list of all the patients in the system. From that list, output a list of all patient emails.

Module 1a: Calendar and Tasks for Non-Scheduling Staff (corresponds to Video Walk Through 1)

This module is for: staff that do not schedule or check in appointments

Save your preferred default calendar view (in the Calendar Options box).

Find an existing appointment in the calendar for the current day (or add one), and use the appointment Status drop down menu to mark an appointment as Checked In.

  • Look over at the far right at the Tracking Board (three grey boxes) and use the tracking board to mark the appointment/ patient as In Room, assign to yourself as if you were the provider (to see how that looks), and finally mark as ready for Check Out.
  • You can use the appointment Status drop down menu to mark the appointment as Checked Out to remove from the Tracking Board.

Create a scheduled task (has a due date) for yourself and check the box for there to be a reminder. Create a standing task (no due date). Create another task with a note in it, and re-assign it to another user. Mark a task as complete.

Use Advanced Patient Search to generate a complete list of all the patients in the system. From that list, output a list of all patient emails.

Module 2: Patient Portal, Patient Portal Queue (corresponds to Video Walk Through 1)

This module is for: patient coordinators, admins, front desk staff, providers, nurses, MAs – anyone who might be working with patient portal requests, sharing information with patients via the Patient Portal, or helping patients with their Patient Portal access

Log into Portal as Patient (from your test patient’s chart, or the chart of a test patient you created), selecting “Keep me logged into the EMR” when prompted.

Acting As the Patient, do at least 4 of the following:

  • Update contact or insurance information in My Account Details; add a photo
  • Send a secure message
  • Request an appointment (requires that appt types be defined and work schedules be set up first; you may skip this if not ready yet to set up online appt requests)
  • Fill out and submit a questionnaire or consent form (requires that forms/ questionnaires have been requested and uploaded by your implementation manager)
  • Upload a document under Labs & Documents
  • Add a height, weight, or BP reading
  • Add a supplement or medication
  • Add a preferred pharmacy

Close out the Patient Portal tab in your browser and go back to the tab where you have the EHR open

Open the Patient Portal Queue (PPQ) and handle the requests you added as a patient:

  • Click the blue chat bubble to respond to the secure message, selecting the dropdown option to “Close this request” when sending the message in response.
  • Click on the Assign as Task button and assign a request as a task to another user. Go to that user’s task list to see it in their Standing Tasks tab. Note that tasked Patient Portal requests would be handled directly in the PPQ, rather than marked as complete from the task list.
  • Click on the yellow helper button to the right of the request that you assigned as a task to take the requested action. Once that is done, click the green checkmark to the left of the request to mark it as completed. Acknowledge the confirmation box that appears. Notice that marking a tasked item as complete in the PPQ marks the applicable task as complete as well.
  • Click on the reverse clock icon at the top right of the Queue to see your archived/ completed requests. Click on the status at the left of an item, e.g. “Completed” to unarchive it and bring it back into the active queue.

If you submitted an appointment request, working from the main calendar screen, look in the Appointment Requests box below the PPQ box, and click on the date and time in the appointment request to pull up the Add New Event window to add that appointment. Select the appointment type that corresponds to what was requested. Click the green checkmark for that request to mark it as complete.

Send a test patient for whom you’ve set their email address to be your own (for testing purposes, you can change this back afterwards) a Patient Portal Invite/Password Reset. Look in your email to see how that will look for the patient.

Open the Patient Portal Onboarding Tool to see how that looks. Click on the link to send your test patient or your test patient a Patient Portal Invite/ Password Reset email.

From your test patient’s chart, hover over the Pt Portal menu and click on View Patient Portal History. This will show ALL requests that have come in from the Patient Portal for this patient. Click on the View Reset Attempts button in the upper right corner to see all of the password reset attempts initiated by the patient (OR invitation/ reset links sent by the practice, which will register as a successful reset attempt as well), as well as the information mismatch, if any, between what the patient entered in the reset request form and the information you have on file for the patient.

Module 3 - Working in the Patient Chart Overview (corresponds to Video Walk Through 2)

This module is for: all except billing only staff

Add a relationship between your test patient and another patient.

Add a specialist to your database (Admin > Manage > Specialists/ Other Listings), then add that person to your test patient’s list of preferred specialists. Add a preferred pharmacy for the patient.

Edit the patient’s contact information or address.

Add a Notice to your test patient’s chart, for example: Patient chronically late.

Add something to one of the free text notes fields on the patient’s chart: Need to Know, Social/ Family Notes, Admin Notes, and click save.

Add Sulfa allergy with a note about the patient’s reaction. Add an intolerance to Gluten. Delete the Sulfa allergy by clicking on it, clicking on Delete, and providing a reason to confirm.

Enter vitals for patient by clicking on the vital(s) in their Vitals block.

Upload a Document to patient’s chart and mark it as needing review by you. Click Save Unreviewed. Notice how that shows up in your For Review task tab. Open it from your tasks, and click the Secure Message option under NOTIFY PATIENT. Add a brief message, then click on SAVE Changes to file the document, send the secure message as well as a generic email notification, and remove the document from your task list.

Add a diagnosis to the patient’s Past Medical Hx block. Add some information to the free text area in their Past Medical Hx block and save.

Send your test patient’s records to your own fax number (use the Fax Entire Patient Chart option, and remove sections so that the resulting fax is short).

Module 4 - Charting Patient Visits (corresponds to Video Walk Through 3)

This module is for: providers, MAs, nurses

Add a new Encounter Note, give it a title, and set the encounter note type. Double click on the colored header bar the Medications/ Supplements block at the right of the note area to expand that block. Expand a couple of other blocks that you will frequently want to refer back to when charting. Go to Preferences > Save Layout as Default to save the current layout as the default encounter view (this is per user, and will apply across all patient charts).

Add a diagnosis to the Assessment box.

Add a prescription rx to the Plan. In the Complete and Add Rx window, modify the dosing information and Patient Instructions to reflect how you would commonly prescribe this particular medication. Use the PROFILE drop down menu to save the current settings as a new dosing profile for that medication. Once you add the medication, generate a faxable/ printable/ saveable prescription form.

Add an order for a lab test or scan/ imaging to the Plan box. Add a specialty test that you use to the Orderable Labs Database and then add that to the Plan box. Generate a lab order form for both together and save it to the patient’s chart.

Add a custom referral option that you would use to the Orderable Labs Database.

  • Add your “referral order” under Plan > Add/ Schedule Orders, making sure to modify the Notes to Lab as appropriate, and clicking Add and Create Fax to add it to the Plan and generate a faxable, printable, saveable form.
  • In the resulting form, select Search for Additional Specialists to search/ pull up the information for the specialist you added in Module 3.
  • Click the Save Form button to save it to the patient’s chart.

Add a NEW prescribable “alternate plan option” to your database (like a dietary/ nutritional, lifestyle, or movement recommendation that you would want to be able to easily recommend to patients) under Admin > Manage > Alternate Plan Options. If an applicable Type doesn’t exist for the item you want to add, create a new Type/ Category using the drop down menu in the Add New window.

  • Once that is added, exit out of the Manage Alternate Plan Options window.
  • If you created a whole new type of prescribable item, click the green Save icon on the note, and then hit Ctrl + F5 to reload your screen.
  • Hover over the Plan box and add your custom recommendation to the Plan.

Use Chart Parts to create an outline for a particular type of visit (a New Patient Intake, for example, or a Follow Up Visit). Make sure that you use both static text (appears exactly how you type it) and Text Variables (insert context-specific information from the patient’s chart when used) in your outline.

  • Populate the outline into the main text area of your note by typing the name or nickname and selecting from the suggested matches that appear.

Use Chart Parts to create a lab panel that includes a group of labs you would like to be able to quickly order all together.

Use Chart Parts to create a template message that you would want to send to patients from the system (for example, notifying them that their lab results have come in and they should call to schedule an appointment).

  • Open the secure message to the patient, and populate your template message in by typing the name or nickname and selecting from the suggested matches that appear.

Click on Autodraft last Saved below the Save/ Save and Sign buttons to see the minute-by-minute autosaved log of the text of the Encounter note. Note that if you lose your work on an Encounter Note text area for any reason, the autosaved text will not autopopulate when you next open the note BUT will be available via this link to copy/paste back into the text area.

Click Save and Sign to sign/ finalize the Encounter Note.

  • Uncheck the “Send a note to” option if you do not want to send a generic notification email to the test patient email on file.
  • This automatically generates a Visit Summary that is shared with the patient on the Patient Portal, which includes whatever is in the Assessment box (unlesss this has been specifically disabled for you), and the Plan box. Under “Should the patient be able to view the full content…” at the bottom, select Custom to share some of the text of your note with the patient in their Encounter Summary as well. In the text area that appears, delete most of your notes, then click the button to sign.
  • Go to Pt Portal > Log into Portal as Patient, and then to My Visit Summaries and click on the resulting summary to see how it appears to the patient.

Prepare to send the encounter note along with the patient’s recent test results to another provider. Click on the Attach Document Attach Document or Image link at the bottom right of the encounter note, then on Select Existing Pt Document. Select from the patient’s documents to attach one to your encounter note.

  • Go to Reports > Fax/ Print Encounter Note. Check the box at the top to include your attached file.
  • Check the box at the top to Add Cover Page. Click in the cover page message area to add a custom message, then on Apply to save your changes.
  • Check the box at the top for Add H&P to add information about the patient from their chart. Click on the Remove link for certain sections to remove them.
  • You could now enter the fax number and click on Send as Fax to send via efax. Close the tab to exit this view/ form (without sending).

Return to your test patient’s main chart view.

Go to Reports > Manage Wellness Plan to view your test patient’s Wellness Plan. This includes any items that have been added to the Plan of an encounter note for this patient. Uncheck the box for Open Orders to exclude those as a category from the Wellness Plan. Add a Header and a TextBlock by clicking on the applicable buttons at the bottom. Use your mouse to click and drag to move the header, textblock, or any items within the Wellness Plan to reorder them. Click the Save Updated Plan button to save your changes and create a document for the patient that is shared with them via the Patient Portal Labs & Documents tab.

Right click on the title of an existing encounter note and select the option to Clone this Note. Notice that you can select/ deselect the parts of the note you want to clone forward to create a new encounter note with information from the previous note in it. X out of this window without creating the cloned note.

Module 5 - Checkout/ Billing

This module is for: admins, front desk, anyone handling checkout/ billing

Note that this section is pretty basic/ minimal, because practices vary considerably in terms of their specific billing setup and needs. This does not cover: memberships, insurance billing, prepaid packages, or other special billing situations and setups that differ from practice to practice. Your implementation manager can review/ train on your specific billing circumstances.

Add a two charges to the Charges/ Payments box at the right of an encounter note in your test patient’s Chart – ideally with one being a visit charge and one being a charge for a supplement, supply, or product (if applicable). Add a payment, selecting Check for the payment type.

Create an Insurance Invoice/ Superbill for the visit. Click the Save button to save it to the patient’s chart and share it with them on the Patient Portal. This is what patients would be able to submit for reinbursement from their insurance for covered services. Create a Service Receipt for the visit. Notice that the Service Receipt differs from the Insurance Invoice in that it includes a separate line item for the payment, and has no option to exclude non-insurance reimbursable charges.

Patient returns a supplement – right click on one of the charge names, and select “Mark as voided/ refunded.” If they want to leave that as a credit in their account, you could stop here. To refund that amount to them, additionally right click on the Credit/ Payment and select “Refund Options,” and then “Partial Refund.” Enter the charge amount as the amount to refund and click the button to refund that. If this were a credit card payment and you have integrated merchant services through Cerbo, then doing this will refund the money to the patient’s card. For any other payment method, you would return the money to the patient separately – for example, by check or via your external merchant services platform, if applicable.