This feature allows you to be precise with your billing procedures. PRN billing can be a very useful tool, particularly if you want to be able to titrate treatments within a dose range for your patients. It allows the medical record to be accurate and the bill to be adjusted automatically with no additional effort from the technician. It does, however, require those executing treatments to understand that their entry into the cell must correlate with how the medication is displayed on the flowsheet. Here are some details on how it works:


PRN For Activity/Monitoring/Procedure parameters

If you create a parameter under the Activity/Monitoring/Procedure sectionsthe PRN Billing Feature will only work if the Picker type is set to Initials. If Picker type is set to Numeric, you will only see one unit on the Billing Report PDF (and sent to your EMR, if you're integrated) regardless of what you entered in that cell.


For example, if we have created two Anesthetic Time parameters with different Picker types - Initials and Numeric:


Then add them to the flowsheet under the Procedure section, and execute them: 


When entering numbers or initials in a cell, the behavior will be different on the Billing Report:


When the initials are entered in the cell, parameters will always be billed as a single use (except in the case of Group parameters, where the quantity for the particular item can be changed and, thus, will be billed accordingly). However, if a number is entered on the flowsheet, the billing will be different depending on the parameters Picker typeIn case of Initials picker type, the Anesthetic Time will show the precise billing quantity entered in the cell, while for the the same parameter with Numeric type, it will always show billed as unit, regardless of the value entered in the cell (for both initials and numbers). 


NOTE: The PRN Billing is not applicable to the Fluids section. They will always be billed as one unit.


PRN For Medication parameters

If you create a Medication parameter, it will use the PRN Billing feature regardless of Picker type (Numeric, Initial). This means that all the numeric input to the cell will affect the quantity of the medication indicated in the Billing report.


In the example below, we have created two 2 Hydromorphone parameters with different Picker types - Initials and Numeric:


After adding them to the flowsheet and executing them:


The Billing Report will reflect the below readings:


Thus the total volume of drugs used (with both Initials and Numeric Picker typewill appear in the Billing Report identically. For both cases when the initials entered in the cell, medication is billed per total dose calculated (one unit). However, if the precise total dose is entered to the cell (0.2 ml as in example below), the medication will be billed accordingly.


NOTE: When the PRN billing feature in Smart Flow is used for Medications, it matters how the medication is chosen to be displayed on the patient’s flowsheet. Simply putting a numeric value in the flowsheet cell does not necessarily result in an equal dose being billed to the client, since it all depends on how the medication is displayed (please find more details HERE). 


You can also have a look at the video for this feature: