Meridian Clinical Suite

Facility

Department

Encounter context

Service period

Interface UP Queue 0 Build 7.4.221

Unsigned encounters 7

Results to review 12

Refill requests 8

Coding queue 9

Denials worklist 4

Prior auth pending 3

Unindexed documents 5

Blackwood, Marguerite

Pemberton, Thaddeus

Vandermeer, Rosalind

Hollingsworth, Ignatius

Castellano, Winifred

Northgate Medical Group

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Action Items

Sign	Unsigned progress notes	7
Cosign	Resident notes awaiting attending cosignature	3
Review	Abnormal results pending acknowledgement	12
Code	Encounters awaiting E/M level assignment	9
Rebill	Claims returned by the clearinghouse	4
Reconcile	Medication reconciliation not completed	6

System Alerts

Care gap	3 patients overdue for HbA1c per HEDIS CDC-HbA1c measure
Chart deficiency	7 unsigned encounters exceed the 72-hour HIM policy
Eligibility	2 x12 271 responses returned inactive coverage
Interface	ADT feed NGMG-ADT-01 lagging 4 minutes behind source
Formulary	RxNorm catalog refresh pending since 11/18/2026
Credentialing	1 rendering provider NPI expires within 30 days

Clinic Census

Scheduled today		68
Arrived		41
In room		9
Ready for provider		5
Checkout pending		7
No-show rate (30d)		6.2%

Revenue Cycle

Days in A/R		38.4
Clean claim rate		91.7%
Denial rate (30d)		8.3%
Net collection rate		96.1%
Unbilled charges		$412,880
Credit balances		$18,204

Quality Program

MIPS composite		84.2 / 100
Promoting Interoperability		Attested
eCQM submission		In progress
HCC recapture rate		72.5%
Average RAF		1.184
Annual wellness completion		63.9%

Access Audit Trail - Last 7 Events

Timestamp	User	Action	Detail	Reference	Workstation	Purpose of Use
11/21/2026 08:41:02	clinician	VIEW	Patient chart accessed	MRN-100004	NGMG-WS-114	Permitted - treatment
11/21/2026 08:39:55	clinician	SEARCH	Registry query executed	lastName=Blackwood	NGMG-WS-114	Permitted - treatment
11/21/2026 08:38:17	svc_hl7	IMPORT	ADT^A08 processed	MSH-00194821	MRDN-INT-02	Interface account
11/21/2026 08:36:44	clinician	SIGN	Progress note filed	ENC0500012	NGMG-WS-114	Permitted - treatment
11/21/2026 08:34:09	svc_837	EXPORT	837P batch transmitted	BATCH-20261121-03	MRDN-EDI-01	Payment operations
11/21/2026 08:31:52	mnorth	PRINT	Continuity of care document	MRN-100159	NGMG-WS-092	Permitted - ROI
11/21/2026 08:30:11	clinician	LOGIN	Session established	SESS-8842	NGMG-WS-114	Permitted - treatment
11/21/2026 08:28:47	rvasquez	VIEW	Results review opened	LAB-770104	NGMG-WS-088	Permitted - treatment
11/21/2026 08:27:03	svc_eligibility	QUERY	270 eligibility inquiry sent	EV-448210	MRDN-EDI-01	Payment operations
11/21/2026 08:25:39	kpatel	AMEND	Demographics updated	MRN-100287	NGMG-WS-041	Permitted - operations
11/21/2026 08:23:18	clinician	ORDER	CPOE order placed	ORD0900117	NGMG-WS-114	Permitted - treatment
11/21/2026 08:21:55	svc_registry	EXPORT	Immunization registry sync	IZ-BATCH-1121	MRDN-INT-02	Public health
11/21/2026 08:19:42	jokonkwo	BREAKGLASS	Restricted record accessed	MRN-100662	NGMG-WS-114	Emergency treatment
11/21/2026 08:17:20	mnorth	MERGE	Duplicate MPI records merged	MRN-100119/100883	NGMG-WS-092	Permitted - operations

Audit entries are retained for six years under 45 CFR 164.312(b). Break-the-glass access is reviewed daily by the Privacy Office. Purpose of use is recorded per HL7 security label.

Interface Engine Status

Channel	Feed	Standard	Transport	State	Backlog	Last Message
NGMG-ADT-01	ADT inbound	HL7 v2.5.1	MLLP 6661	Connected	4m lag	11/21/2026 08:40
NGMG-ORU-02	Results inbound	HL7 v2.5.1	MLLP 6662	Connected	Current	11/21/2026 08:41
NGMG-ORM-03	Orders outbound	HL7 v2.5.1	MLLP 6663	Connected	Current	11/21/2026 08:41
NGMG-EDI-04	837P claims	X12 5010	SFTP	Idle	Next 17:00	11/20/2026 17:00
NGMG-ERA-05	835 remittance	X12 5010	SFTP	Connected	Current	11/21/2026 06:15
NGMG-CCD-06	C-CDA exchange	HL7 CDA R2	HTTPS	Degraded	Retrying	11/21/2026 07:58
NGMG-RX-07	ePrescribing	NCPDP SCRIPT	Surescripts	Connected	Current	11/21/2026 08:41
NGMG-IZ-08	Immunization registry	HL7 v2.5.1	SOAP	Connected	Current	11/21/2026 08:21
NGMG-SIU-09	Scheduling outbound	HL7 v2.5.1	MLLP 6664	Connected	2m lag	11/21/2026 08:39
NGMG-DFT-10	Charge outbound	HL7 v2.5.1	MLLP 6665	Connected	Current	11/21/2026 08:40
NGMG-MDM-11	Document inbound	HL7 v2.5.1	MLLP 6666	Idle	Next 12:00	11/21/2026 06:00
NGMG-FHIR-12	Patient access API	FHIR R4	HTTPS	Connected	Current	11/21/2026 08:41

Channels are monitored by the Meridian interface engine. Degraded channels retry with exponential backoff before paging the on-call integration analyst.

Coding and Risk Adjustment Reference

Code	Set	Description	Category	RAF Weight
E11.9	ICD-10-CM	Type 2 diabetes mellitus without complications	HCC 19	0.105
N18.32	ICD-10-CM	Chronic kidney disease, stage 3b	HCC 138	0.069
I50.32	ICD-10-CM	Chronic diastolic heart failure	HCC 226	0.331
J44.1	ICD-10-CM	COPD with acute exacerbation	HCC 280	0.335
99214	CPT	Office visit, established, moderate MDM	Work RVU 1.92	-
G0439	HCPCS	Annual wellness visit, subsequent	Work RVU 1.92	-
E66.01	ICD-10-CM	Morbid obesity due to excess calories	HCC 48	0.250
F32.1	ICD-10-CM	Major depressive disorder, moderate	HCC 155	0.309
I25.10	ICD-10-CM	Atherosclerotic heart disease	HCC 224	0.135
Z79.4	ICD-10-CM	Long term use of insulin	Status	-
99457	CPT	Remote physiologic monitoring, 20 min	Work RVU 0.61	-
99490	CPT	Chronic care management, 20 min	Work RVU 0.61	-

Risk adjustment factors reflect the CMS-HCC V28 model. Suspected conditions must be documented and coded in the service year to be recaptured.

Scheduled Jobs and Batch Status

Job	Description	Window	State	Duration	Last Run	Result
JOB-NIGHTLY-01	Clinical data warehouse ETL	02:00 CT	Completed	41m 12s	11/21/2026 02:41	0 errors
JOB-NIGHTLY-02	Risk adjustment recalculation	03:00 CT	Completed	18m 44s	11/21/2026 03:19	0 errors
JOB-NIGHTLY-03	Care gap evaluation	03:30 CT	Completed	26m 03s	11/21/2026 03:56	2 warnings
JOB-NIGHTLY-04	Statement generation	04:00 CT	Completed	9m 51s	11/21/2026 04:10	0 errors
JOB-HOURLY-11	Eligibility refresh	hourly	Running	4m 22s	11/21/2026 08:00	-
JOB-DAILY-21	837P claim batch	17:00 CT	Scheduled	-	11/20/2026 17:00	0 errors
JOB-DAILY-22	835 remittance posting	06:00 CT	Completed	12m 09s	11/21/2026 06:15	3 exceptions
JOB-WEEKLY-31	Index rebuild	Sun 23:00 CT	Scheduled	-	11/17/2026 23:00	0 errors
JOB-DAILY-41	Audit log archival	01:00 CT	Completed	6m 33s	11/21/2026 01:07	0 errors
JOB-DAILY-42	Formulary catalog sync	05:00 CT	Failed	0m 14s	11/21/2026 05:00	RxNorm endpoint 503

Failed jobs retry twice before paging the on-call analyst. The formulary sync failure leaves the RxNorm catalog at the 11/18 snapshot until the next successful run.

Interface engine: 5 of 6 channels connected Eligibility: 270/271 real-time available Clearinghouse: Availity - accepting 837P ePrescribing: Surescripts certified, EPCS enabled Immunization registry: bidirectional Document imaging: NGMG-SCAN-02 online Last backup: 11/21/2026 02:00 CT