Instinct and AVImark will work closely together to help simplify the check in/out process as well as help to easily audit charges.
Table of Contents
✅ Checking Patients In/Out
The check-in/out process for patients in Instinct is driven by AVImark.
Check-In Through AVImark
Once a patient has been checked in to AVImark, they will automatically appear on the Instinct OP Board within 1-4 minutes. The grey arrows under the ‘In/Out’ column on the Status Board lets you know they were checked in via AVImark as opposed to a manual check in via Instinct (manual check ins will not have the sync icon).

During the Check-In process, the following information will NOT transfer from AVImark to Instinct and will need to be manually entered into Instinct:
- Provider
- Reason for Visit
- Patient Colors/Markings
💡Please Note: The first time a patient is checked into Instinct, the user will need to add the patient’s colors/markings manually; however, subsequent visits will have this information present.
To maintain a consistent workflow, it is ideal for the front desk team to complete as much information on the Instinct Status Board as they can after checking a patient into AVImark. This helps the medical team know who is checked in, why they are here, which doctor they are assigned to, any specific alerts, and more!
Check-Out Through AVImark
If a patient was checked in via AVImark, the only way to remove them from Instinct is to check them out in AVImark.
Force Check Out
This feature can help to “Force Check Out” a patient who is no longer checked in to AVImark, but is still appearing on Instinct boards due to a lag in your internet connection. Please note that this should only be used if the patient has been checked out of AVImark completely, but is not being removed from Instinct. If you click ‘Force Check Out’ for a patient who is still checked in to AVImark, they will reappear in Instinct after a few minutes because Instinct is still identifying them as being checked in.
To Force Check Out a patient, click the 3-dot menu next to the patient’s name on the Status Board and select “Force Check Out”.

If a patient is being force checked out and has a similar name as another patient, Instinct will suggest merging the patient records. Please ensure that the suggested patient is indeed a duplicate before merging, as merges cannot be undone!

💸 Invoice
The Instinct invoice works like an ‘audit checklist’ to confirm all charges that originated in Instinct have been entered into the AVImark invoice.
As billable treatments in Instinct are completed, they will automatically generate on the Instinct invoice with an orange flag. The current Total Missed charges and Invoice Total will display in the lower right corner of the screen.

These flagged items will have to be manually entered onto the AVImark invoice. Once entered, confirmed that they have been entered by clicking on the orange flag icon on the Instinct invoice so it is checked off. When hovering over the checkmark icon a tooltip will appear indicating that the item was confirmed to be in the patient’s invoice and the date and time a user cleared the item. As items are marked off, the Total Missed charges will also update.

🚨 Please note: Due to the AVImark and Instinct invoices not syncing, the Predicted Billing feature will only encompass billable treatment items that are scheduled on the Tx sheet as well as charges on the Instinct invoice, and will not reflect any charges that have been entered on the AVImark invoice.
To hide any cleared charges and only show missed charges, toggle the “Only Show Missed Charges” button.

If an item on the Instinct invoice will not be entered on the AVImark invoice, simply void the line item by clicking on the 3-dot menu next to it and selecting ‘Void’.

To undo a Void, click on the 3-dot menu next to the voided item and select ‘Undo Void’

👩⚕️Workflow at Discharge
Before checking out the patient, resolve any missed charges with your medical team. If no missed charges exist, you will see a Piggy Bank and you can proceed to check out the patient through AVImark.

Suggested Workflow:
- Confirm there are no ‘Missed Charges’ and address if so (the piggy bank will indicate all charges have been cleared)
- Apply the ‘Ready To Go’ icon (this can be used to show no further charges are to be applied and the invoice audit is complete)
- Process the AVImark invoice with the client
- Check the patient out of AVImark to close the Instinct visit
🔍 Troubleshooting and AVImark Settings
- If AVImark is down:
- You can always manually check in a patient in Instinct to get a treatment sheet built. Once AVImark is working again and the patient is checked into AVImark, the check in/out process will sync up.
- If a new patient arrives when AVImark is down you can create a new patient in Instinct with a temporary patient/account ID. When AVImark is back online you would then check them in as you normally would. After doing this, you would have two of the same patients in Instinct: 1 with the temporary ID created in Instinct and 1 with the actual ID checked in via AVImark. To resolve this, you’d merge these two patients together and reopen the treatment sheet from the temporary ID so you don’t have to create it again.
- Ensure that AVImark settings are configured appropriately for the Integration
- Go to the wrench icon in AVImark
- In the search field type ‘post history’
- Click on Post History to whiteboard and either set it to prompt or set it to yes
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