Overview
Key benefits of POC Tracking:
- Automated Compliance Tracking: Never miss a certification deadline.
- Risk Mitigation: Reduce claim denials due to missing or late POC signatures.
- Real-time Visibility: See all POC statuses at a glance from a single dashboard.
- Audit Trail: Complete documentation history for compliance audits.
- Workflow Support: Streamlined signature collection and follow-up.
Medicare Compliance Requirements
Initial Certification — 30-Day RuleThe Plan of Care must be signed and dated by the referring or ordering physician within 30 days of the initial evaluation appointment date (date of service).
Example: If a patient’s initial evaluation is on January 15th, the POC must be signed by February 14th.Recertification — 90-Day RulePOCs must be recertified every 90 days. This timeline is calculated from the initial evaluation date of service or the date of the previous recertification.
Example: If the initial evaluation was on January 15th, recertification is due on April 15th.
Dashboard Overview
The POC Tracking dashboard displays all Plans of Care grouped by status. Access it from the Plan of Care Tracking section in Air.
Status Tabs
Filter Options

| Tab | Description |
|---|---|
| All | Every POC currently being tracked |
| Not Sent | POCs created but not yet sent to the physician |
| Awaiting Signature | POCs sent to the physician, waiting to be returned |
| Due Soon | POCs unsigned for 20–30 days (approaching deadline) |
| Overdue | POCs exceeding 30 days without a signature |
| Certified | POCs successfully signed by the physician |
- Patient Filter: Search for a specific patient’s POC.
- Phase Filter: Toggle between Initial Eval Certification and Recertification phases.
- Custom Filters: Filter by referring provider, facility, payer, or patient.
POC Tracking Preferences
Configure how the system handles faxing and tracking from your practice settings.Auto-Faxing Eval NotesDetermines when an evaluative note is automatically faxed to the referring physician:
- Always — Fax every evaluative note automatically.
- POC Updates — Fax only when the POC is created or updated.
- Never — Do not auto-fax; staff sends manually.
- Always — Track all evaluative notes.
- POC Updates — Track only when the POC is created or updated.
Certification Workflow
Initial Certification Process
Recertification Process
Discharge WorkflowWhen a patient is discharged, the system marks the case as closed. No further recertification alerts are generated, and all documentation is retained for audit purposes.
- Case creation (automatic): When an Initial Eval note is signed, POC tracking begins automatically.
- Auto-fax: The system faxes the visit notes to the referring physician based on your preferences. If the fax fails, the case is flagged; if not sent, it moves to Not Sent status.
- Awaiting Signature: The system tracks the number of days elapsed since the date of service. At 20 days, the status changes to Due Soon. At 30 days, it changes to Overdue.
- Attach signed POC: When the signed document is received, staff attaches it and marks the case as signed. Status updates to Certified.
- Signature tracking stops: The system stops reminders and begins tracking toward the next recertification date.
Recertification Process
- Automatic trigger: The system triggers a recertification when the recertification window approaches (near 90 days from the initial eval date of service or last evaluative note), or when a new evaluative note is submitted.
- Follow standard signature process: The same workflow as initial certification applies. The status changes to Due Soon at 75 days and Overdue at 90 days.
Discharge WorkflowWhen a patient is discharged, the system marks the case as closed. No further recertification alerts are generated, and all documentation is retained for audit purposes.
Status Types
| Status | Meaning | Action Required | Risk Level |
|---|---|---|---|
| Not Sent | POC created but not yet sent to the physician | Send POC via fax | Moderate |
| Awaiting Signature | POC sent, waiting to be signed | Monitor; follow up if approaching 20 days | Low |
| Due Soon | Unsigned for 20–30 days | Follow up with physician, confirm receipt, request expedited signature | Moderate |
| Overdue | Not signed within 30 days | Priority follow-up, document all attempts, consider escalation | High — claim denial risk |
| Certified | Signed by physician, compliant | None — system alerts when recertification approaches | None |
Initial Script Exemption
What is the Initial Script Exemption?A Medicare allowance that permits providers to demonstrate a “good faith effort” in obtaining a POC signature for the initial certification only. When this exemption is applied, the system stops alerting for that case and a returned signed POC is not required.Requirements to Use the Exemption
System Behavior When Exemption is Applied
- A written referral (script) from the physician that is signed, dated, and attached to the patient’s medical record.
- Documented proof that the POC was sent within 30 days of the initial evaluation date (fax confirmation or delivery record).
- One send attempt is sufficient — you do not need to receive the POC back signed.
| Standard Path | Script Exemption Path | |
|---|---|---|
| Step 1 | Initial Eval completed | Initial Eval completed |
| Step 2 | Send POC | Confirm signed script is on file |
| Step 3 | Wait for returned signed POC | Send POC once |
| Step 4 | Attach signed POC → Certified | Mark as Script Exempt → No signature required |
- The system stops alerting for that certification.
- A returned signed POC is not required for compliance.
- The system still records that the POC was sent (for audit trail).
- Recertification will still require a signed POC.
- Requires both a signed script and proof that the POC was sent.
- Should only be used when the physician is unresponsive after a documented good faith effort.
- Does not apply to recertifications under any circumstances.
Tracking and Managing POCs

Sending a POC to a PhysicianTo send or resend a POC:
- Navigate to the patient’s case in the dashboard.
- Click Resend Fax or the fax icon.
- The system automatically sends the POC via fax, updates the status to Awaiting Signature, and begins tracking days elapsed.
Marking a POC as SignedTo mark a POC as certified:
- Click the edit (pencil) icon on the patient’s row.
- Click Attach Signed POC.
- Upload the signed document.
Using the Script ExemptionTo apply the Initial Script Exemption:
- Confirm you have a signed, dated referral script on file.
- Confirm the POC was sent to the referring physician at least once.
- Check Script Exempt on the case.
- Attach the signed referral script.
POC Alerts in the Appointment Details ModalThe Plan of Care section within the Appointment Details modal reflects the current POC alert status at the individual appointment level. The alert badge changes color based on urgency.Not Sent — The POC has been created but has not yet been sent to the referring physician. Send the POC via fax to move this case forward.





Best Practices
Front Desk / Care Coordination Staff
Therapists / Providers
Admins / Operations Managers
- Send POCs within 1–2 days of the initial evaluation and confirm fax delivery.
- Check the Due Soon tab every morning and follow up on cases approaching 20 days.
- Call physician offices at 20 days if no response has been received.
- Only apply the Script Exemption when a valid signed script is on file; always document that the POC was sent.
Therapists / Providers
- Finalize initial evaluation documentation within 24–48 hours so the POC is clear and ready to send.
- Review your caseload 2 weeks before a POC expires and decide whether to discharge or recertify.
- Create new POCs in advance if a patient’s condition changes significantly.
- Do not document visits without a valid POC — update or recertify before continuing treatment.
Admins / Operations Managers
- Review the dashboard regularly to identify patterns and problem areas (e.g., a specific referring provider with high overdue rates).
- Streamline the POC sending process and build relationships with high-volume physician offices.
- Train staff on Medicare requirements and the correct handling of Due Soon and Overdue alerts.
FAQ
Why is physician signature required on the Plan of Care?
Why is physician signature required on the Plan of Care?
Medicare requires physician certification to confirm that therapy services are medically necessary and appropriate for the patient’s condition. Without this signature, claims may be denied.
What is the difference between initial certification and recertification?
What is the difference between initial certification and recertification?
- Initial Certification: The first POC signed after the initial evaluation — must be signed within 30 days of the date of service.
- Recertification: Renewal of the POC every 90 days to continue therapy services.
Does the 30-day deadline start from when I finish documenting or when the patient was seen?
Does the 30-day deadline start from when I finish documenting or when the patient was seen?
The 30-day deadline starts from the appointment date of the initial evaluation (the date of service), not when you finish documentation or submit the claim.
What should I do if a physician does not sign within 30 days?
What should I do if a physician does not sign within 30 days?
Claims for dates of service after 30 days are at risk of denial. Document all follow-up attempts, continue pursuing the signature, and consider applying the Initial Script Exemption if you have a valid signed referral on file.
When should I use the Initial Script Exemption?
When should I use the Initial Script Exemption?
Use the Script Exemption when:
- You have a signed, dated referral script attached to the patient’s medical record.
- The POC has been sent to the physician at least once within 30 days.
- The physician is unresponsive despite a good faith effort.
What documentation do I need for an audit if I used the Script Exemption?
What documentation do I need for an audit if I used the Script Exemption?
- Signed, dated referral script attached to the patient’s medical record.
- Proof the POC was sent (fax confirmation or send record).
- The Script Exempt checkbox checked in the tracking system.
- Documentation of the attempt to obtain a signature.
What if the referring provider information on file is incorrect?
What if the referring provider information on file is incorrect?
Update the referring provider in the patient’s chart, then resend the POC to the correct physician using the Resend Fax option and attach the corrected record.
How far back can I view POC history?
How far back can I view POC history?
The system maintains a complete historical record of all POC activity from the release date of the feature. Click the edit icon on any patient row to view the full send and status history for that case.