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This guide explains how AIR keeps your patient records, appointments, and billing encounters synchronized. These automated processes reduce manual data entry and ensure that administrative changes are reflected in your billing records (and vice versa).
This guide covers three synchronization flows that maintain data accuracy between AIR and your encounter records.

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Overview

Three automated synchronization flows keep your data consistent across AIR and your billing system:
  • Flow 1: Administrative Updates - Changes in AIR automatically update billing encounters
  • Flow 2: Billing Addendums - Compliant way to edit chart notes after submission
  • Flow 3: Billing Corrections - Changes in billing flow back to AIR to keep records accurate

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Flow 1: Administrative Updates (AIR ➔ Encounter)

Purpose: Automatically updates billing encounters when you change administrative details in AIR. When it happens: When you update an appointment or case (e.g., changing a provider, updating insurance, or adding a prior authorization) after a chart note has already been submitted. The benefit: Your billing records stay current even if insurance information is discovered or corrected after the visit.

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How It Works

Edit Case Drawer showing selection of past completed appointments
  1. You make changes to an appointment or case in AIR.
  2. If the chart note(s) are already submitted, the system:
    • Checks for any active addendums (see Flow 2).
    • Automatically updates the linked encounter.

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What Data Syncs

From Appointments:
  • Provider, patient, site, facility
  • Appointment dates and time spent
  • Accident dates
  • Workers comp information
  • Prior authorizations
From Cases:
  • Insurance information (primary/secondary/tertiary)
  • Referring provider
  • Supervising provider
Administrative updates will not overwrite any clinical data (notes, diagnoses, etc.) entered by a provider in the chart note.

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Flow 2: Post-Submission Corrections (Billing Addendums)

Purpose: Provides a compliant way to edit chart notes after they have been signed and submitted for billing. When to use: Use this when a provider needs to correct clinical documentation or when billing needs to update coding on a finalized note.

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How It Works

Creating and managing billing addendums To create and finalize an addendum:
  1. Create an Addendum: After submission, you can create an Addendum and specify a Reason.
  2. Make Changes: While an addendum is active (not finalized), the chart note is fully editable.
  3. Finalize (Provider Only): To maintain compliance, only providers can finalize an addendum. This:
    • Validates all clinical documentation
    • Updates the encounter with all relevant changes
    • Re-locks the chart note
Note: You can create as many addendums as needed for a single note, but only one addendum can be active at a time per chart note.

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User Impact

  • Audit Trail: Enables corrections after submission without losing the legal record
  • One-at-a-Time: Only one addendum can be active at a time per chart note
  • Provider Signature Required: The provider must sign/finalize the addendum to trigger the resubmission to billing
Once an addendum is created, there is currently no “cancel” action. Ensure you are ready to make a correction before initiating an addendum to avoid leaving a chart note in an “unlocked” state.
If you only need to view data in a submitted note, use the Open All Sections view rather than creating an addendum just to read the contents.

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Flow 3: Billing Corrections (Encounter ➔ AIR)

Purpose: Ensures that changes made by the billing team flow backward to keep AIR records accurate. When it happens: When you update encounter information from the Encounter Details page (manually or via bulk updates).

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How It Works

Updating encounter information and syncing to AIR
  1. You update encounter information in the EHR system.
    • IMPORTANT: You must filter for an individual patient to perform bulk actions.
  2. The system detects if the encounter is linked to an AIR appointment.
  3. If yes, the system:
    • Identifies which fields changed and determines if they are “significant”
    • Queues asynchronous updates to both the appointment and its associated case in AIR

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What Data Syncs

  • Insurance information (primary/secondary/tertiary)
  • Prior Authorizations (primary/secondary/tertiary)
  • Referring provider
  • Supervising provider

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Bulk Updates

When updating multiple encounters at once (e.g., changing billing type for 10 encounters), the system processes them in a batch and queues updates to AIR to maintain a single source of truth across the patient’s history.
Because Flow 3 updates the “Source of Truth” in AIR based on EHR changes, ensure encounter edits are accurate before saving.

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Key Points for Users

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For Providers

  • Flow 2 (Addendums) is your main tool for fixing submitted chart notes
  • Clinical changes sync to billing automatically once you finalize the addendum
  • Only providers can finalize addendums to maintain compliance

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For Billing Staff

  • Flow 1 keeps billing records current when admin data changes
  • Flow 3 ensures AIR stays accurate when you make billing corrections
  • Administrative Changes: You may initiate addendums for administrative fixes, but a provider must sign to finalize clinical documents

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Best Practices

  • Addendum Safety: Ensure you are ready to make a correction before initiating an addendum, as there is currently no “cancel” action
  • Reading Locked Notes: Use the Open All Sections view to view data in submitted notes rather than creating an addendum
  • Claim Resubmission: While the system updates the encounter data automatically, follow your standard protocol for resubmitting claims to the payer after the data has synced
  • Data Accuracy: Double-check encounter edits before saving, as Flow 3 updates AIR based on EHR changes

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FAQ

Currently, there is no “cancel” action for addendums once they are created. To avoid leaving a chart note in an unlocked state, ensure you are ready to make a correction before initiating an addendum. If you only need to view data in a submitted note, use the Open All Sections view instead.
Yes, you can create as many addendums as needed for a single note. However, only one addendum can be active at a time per chart note.
Only providers can finalize an addendum to maintain compliance. This ensures that clinical documentation is properly validated before the encounter is updated and the chart note is re-locked.
From appointments: Provider, patient, site, facility, appointment dates, time spent, accident dates, workers comp info, and prior authorizations. From cases: Insurance information (primary/secondary/tertiary), referring provider, and supervising provider. Note: Administrative updates will not overwrite any clinical data entered by a provider.
Yes, while the system updates the encounter data automatically, you should follow your standard protocol for resubmitting claims to the payer after the data has synced.
Yes, you can update multiple encounters at once. However, you must filter for an individual patient to perform bulk actions. The system processes them in a batch and queues updates to AIR to maintain a single source of truth.