Module 1 - Basic Setup

Please note: The outlines below are intended to supplement the linked videos and are not standalone documentation.

1.0 System Overview (2:09)

System Overview

1.1 - Time Zone (0:34)

Setting Your Time Zone

Overview

Before configuring anything else in your database, you must ensure your time zone is correct.

This ensures accurate appointment scheduling and proper online booking functionality.

Navigate to Time Zone Settings

1. Go to Practice→ Settings→ General
2. At the top of the page, locate the General Settings section.
3. You will see:
   • Your Practice ID
   • The Time Zone your database is currently using

Confirm and Save Your Time Zone

1. Verify that the time zone displayed matches your actual practice location.
2. If it is correct, scroll to the bottom of the page and select Save.

1.2 - Office Locations and Logos (3:41)

Office and Facility Locations and Logos

Overview

In this section, you will set up your office location details and upload your practice logo.

These settings help ensure your information appears correctly throughout the system.

Setup your Business Information

1. Go to Practice→ Admin→ Facilities
2. In the Offices section under Business Name, your database should already list your business name, but without details.
3. Select your business name to open Office Details in a new window.
4. Add Business Details
   • You may enter:
     • Website
     • Checks should be payable to
     • NPI or EIN
     • These fields are optional, but we recommend entering at least your website.

Configure Your Main Office Location

1. In the Office Details window from above, your database should list an office under the Office Locations section.
2.   Select Main Office to open its details window.
3.  If you have multiple locations, update the nickname to differentiate them.
4. Enter your:
   • Office address
   • Phone number
   • Fax number (optional)
   • Email address (optional)
5. If you want staff to log in only from the office, enter your office IP address.
6. You may need assistance from:
   • Your IT team, or
   • Your Internet service provider
   • This feature will be covered further in the Staff Permissions module.
7.  Configure other office settings
   • Tax Rates
     • If your facility needs to apply tax when selling products, you can use the two tax rate fields provided.
   • Clinical and Quote Facility Options
     • If this location is used for non‑surgical appointments, toggle Clinical ON (most practices enable this).
     • If you perform procedures at this location and want it available when creating quotes, toggle Quote Facility ON.
   • Fee Schedule Priority
     • Toggle ON if this facility uses procedure based fees rather than time base fees.
   • Surcharge Field
     • This setting is intended for HCRA taxes in New York.  Review with your onboarding project manager before setting this value.
   • Paid Separately
     • If you want to separate facility fees when quoting, toggle this option ON.
   • Separate Accounting
     • Review with your onboarding project manager before setting this value.
   • Bill Insurance Separately
     • Review with your onboarding project manager before setting this value Bill Insurance Separately.
   • Rooms for Scheduling
     • If your facility has multiple rooms you want to use on the scheduler:
       •   Select the Plus (New) icon under Rooms.
       • Enter the room name.
       • Select the blue checkbox to save.
8. After completing all fields and settings, click Save at the bottom of the window.

Upload Your Practice Logo

1. Scroll to the bottom of the Office Details page and locate the Logo section
2. Select the Select Picture icon.
   •  Upload from your computer, or import from a website
3. If needed, select the image to resize adjust alignment or layout.

1.3 Surgery Centers and Hospitals (1:33)

Hospital and Surgery Center (ASC)  Setup

Overview

You may need to add additional hospitals or surgery centers (ASCs) where you perform procedures.

Fee schedule setup for these facilities will be covered in a later module.

Navigate to Facility Settings

1. Navigate to Practice → Admin → Facilities 
2. Scroll to the bottom of the page to find:
• Hospital Locations
• Additional Surgery Center (ASC) Locations

Adding a New Hospital

1. Start a New Hospital Entry
   • To the right of Hospitals section, select the +New icon.
     • Enter Hospital Information
       • Provide the hospital name.
       • Enter the address.
       • Enter the phone number.
       • Optional fields:
         • Fax number
         • Facility NPI
2. Configure Hospital Options
   • Clinical and Quote Facility Options
     • If this location is used for non‑surgical appointments, toggle Clinical ON (most practices enable this).
     • If you perform procedures at this location and want it available when creating quotes, toggle Quote Facility ON.
   • Paid Separately
     • If you want to separate facility fees when quoting, toggle this option ON.
   • Fee Schedule Priority
     • Toggle ON if this facility uses procedure based fees rather than time base fees.
   • Surcharge Field
     • This setting is intended for HCRA taxes in New York.  Review with your onboarding project manager before setting this value.
   • Has a Calendar
     • If this hospital should appear as a clinical location on the schedule, toggle Clinical ON.
3. Once all required information is entered, select Save.

Adding a Surgery Center (ASC)

1. Start a New ASC Entry
   • To the right of Surgery Center section, select the +New icon 
     • Enter ASC Information
       • Provide the ASC name.
       • Enter the address.
       • Enter the phone number.
       • Optional fields:
         • Fax number
         • Facility NPI
         • Has a Calendar
2. Once all required information is entered, select Save.

1.4 Users and Permissions (4:58)

Managing Providers (Doctors), Staff, and Permissions

Overview

Throughout onboarding, you may need to  add users or refine user permissions as workflows become clearer.

You can return to this section anytime, especially as you get closer to going live.

 Navigate to User Management

1. Go to Practice→ Admin→ Doctors and Staff.
   • 4D EMR Staff/User User Types
     • Doctors as Providers
     • Everyone else as Staff

Add/Edit a Staff Member

1. Select the +New icon to the right of the Staff section (or click on existing staff member name to edit).
   • Basic Information
     • First and last name
     • Optional: staff license or title
     • Display name (how the staff member’s name appears to patients)
   • Login Credentials
     • Email address (used for login)
     • Temporary password
     • The system will prompt the user to create a new password at first login.
   • Security Options
     • Enable Two-Factor Authentication if required
       (Setup instructions are covered in another module.)
   • Optional Contact Information
     • Staff address
     • Personal or home phone number, etc.
   • Default Facility Location
     • Assign the location where the staff member primarily works or provides services.
   • ePrescribe Access
     • ePrescribe setup is covered in a separate module. If this user needs access, notify your onboarding project manager.

Add/Edit a Provider

1. Providers and subject to additional subscription fees. If you need to add another provider, contact your implementation specialist or 4D EMR Support.
2. Click on the Provider name to edit existing setup.
   • See above for editing Provider information

Configure Provider/Staff Options

1. Insta Announce
   • Enables 4D’s internal instant messenger. We recommend enabling this for all users.
2. Role & Workflow Options
   • Has a Calendar — Enable if the staff member needs their own schedule.
   • 4D Health Info Form — Review with 4D onboarding project manager
   • Provider for Quotes — Enable if they generate quotes.
   • Commissions / Gratuity — Toggle one or both if applicable.
     (Commission structures are covered later.)
3. Clinical & Documentation Options
   • Prominent Alerts — Requires staff to manually close patient alerts.
   • Can Cosign Chart Notes — (Staff setting only) only enable after completing the Charting module.
   • Scribe Only — (Staff setting only) allows the user to scribe for a provider.
4. Communication Options
   • Global Text Recipient — Allows the user to receive all patient text message alerts.
5. Once all information and settings are complete, select Save.

Managing Permissions

1. Open Permission Settings
   • To the left of the staff member’s name, you’ll see three icons, select the Key icon to manage permissions.
     • Super User Access
       • You can make a staff member a Super User by selecting Change to Super User.
       • Super Users have full access to all areas of 4D EMR.
   • Granular Permission Controls
     • If you prefer to control access manually, toggle permissions for each area.
     • Permissions are grouped by:
       • Security Settings
       • Main EMR Sections (top-right navigation)
   • Login Restrictions
     • To restrict login to the office only, ensure the office IP address is set up in your facility settings and leave Allow Login Outside of Office unchecked.
     • Leave Ignore Automatic Logout unchecked to maintain HIPAA compliance.
     • As roles evolve or responsibilities shift, update access levels to match your practice’s needs.

1.5 Schedule Configuration (4:41)

Configuring Schedule Settings

Overview

Every option in this section directly impacts how your Schedule page behaves and displays information.

 Navigate to Schedule Settings

1. Go to Practice Settings → Schedule → Schedule Settings.

Configuring Schedule Display and Timing

1. Time Slot Duration
   • The Schedule page defaults to 15‑minute intervals, shown as light gray lines between each hour.
     • You can change the interval to 10, 15, 20, 30, or 60 minutes.
     • Most practices keep the default 15‑minute setting.
2. Office Opening Time
   • Must be entered as a whole number.
     • Example: If your office opens at 8:30 AM, enter 8.
   • If you schedule internal meetings before patient hours, set the opening time earlier so those events appear on the calendar.
3. Office Closing Time
   • Uses a 24‑hour clock.
     • Example: If your office closes at 5:00 PM, enter 17.

Appointment Display Options

1. Appointment Patient Name Sequence
   
   • Choose how patient names appear on appointments
2. Appointment Cancellation & Rescheduling
   • This requires staff to enter a reason when canceling or rescheduling, which is stored in the patient’s history.
3. Hide appointment surgery price
   
   • When scheduling surgeries, the appointment will display the surgery price.
     If you prefer not to show this, enable Hide Appointment Surgery Price.
4. Appointment consult reasons
   • You can enable a Consult Reason dropdown when creating consult appointments.
     This list is configurable and covered in a later module.
5. Include Insurance on Appointment
   • If your practice accepts insurance and you want it displayed on appointments, toggle on Include Insurance on Appointment.
6. Print Superbill when patient arrives
   • Enable Print Superbill When a Patient Arrives if you want a superbill automatically printed at check‑in.
7. Add post-op interval to new appointment
   • This displays how many post‑op days the patient is on their follow‑up appointment.
8. Show Patient Photo
   • Enable Show Patient Photo to display the patient’s profile photo when hovering over their appointment.
     Photo setup is covered in another module.
9. Display US Holidays
   • Holidays will appear on the calendar as visual reminders but will not block scheduling.
10. Require Appointment Subtype
    • You can create appointment subtypes (covered in demos).
      If you use them, you can require subtype selection when creating appointments.
11. Unread Text Message Indicator
12. Unread Text Message
    • When a patient texts your practice, their appointment will show a pinstripe pattern to alert staff.
13. Appointment Color Opacity
    • You can adjust appointment color opacity.
14. Show Appointment Type
    • Displays the appointment type textdirectly on the appointment block.
15. Display Count of Appointments
    • Shows daily appointment count next to each provider’s name.
16. Hide appointment overflow space
    • By default, 4D leaves extra space to the right of appointment blocks to allow overlapping appointments.

1.6 Scheduling Basics (10:29)

Scheduling Basics

Overview

Upon logging in to 4D, you will always start on the Schedule page. Your schedule reflects the office hours and settings you configured earlier.

Below is a step‑by‑step guide moving from left to right across the Schedule page, then into appointment scheduling and appointment options.

Using the left‑hand calendar panel

1. Locate the calendar on the left side of the Schedule page.
   • Click a date to view the schedule for that day.
2. Use the calendar controls (arrows or month/year selector) to move backward or forward in time.
   • This lets you view and schedule appointments in different months or years.
3.  Return to today
   • Beneath the calendar, select the blue “Today” text.
     • The schedule will jump back to the current date.
4. Jump ahead by weeks.months
   • Look for options that show blocks of weeks (for example, “3”).
     • Select the “3” block to jump exactly three weeks from today on the schedule.

 Managing calendars (Calendars tab)

Show or hide calendars

1. Select the Calendars tab on the left side.
   • You will see a list of calendars (for example, providers, rooms, or other resources).
2. To turn a calendar on or off, click the eye icon to the left of its name:
   • Eye on: calendar is visible.
   • Eye off: calendar is hidden.

 Find Openings

1. Select Find Openings in the left panel.
2. Choose:
   • Which schedule you want to search (e.g., provider).
   • Appointment duration (how long the appointment should be).
   • How far out you want to look on the schedule.
3. Review the results and slot in the appointment where it fits best.

Collapse the left-hand panel

1. Locate the three lines (hamburger) icon near the top of the page, above the left panel.
2. Select it to collapse the left side if you don’t need those features.
3. Select it again to expand the panel when needed.

Change from Day to Work Week view

1. Locate the view options near the top of the schedule (e.g., Day, Work Week, Week).
2. Select Work Week.
3. You will now see the provider’s schedule for the full work week.

Icons and buttons at the top of Schedule view

1. Move Up List
• Patients who want to be moved up when spots open can be managed here.
• You’ll use this after marking an appointment to be on the Move Up List.
2. Refresh
• 4D auto‑refreshes every few minutes.
• To force an immediate refresh, select the Refresh icon.
3. Reports
• Select Reports to go directly to the reporting module.
• Reporting will be covered in its own training module.
4. Prices
• After your products, services, and procedures are configured, select Prices to view a list of prices.
• Use this when someone calls asking about the cost of a service.
5. Pre ops
• Select Preops to view upcoming pre‑operative items that need to be completed before a patient is cleared for surgery.
• Configuration of this list will be covered in the Quoting module.
6. Online booking

• If you use 4D’s online booking feature, an icon will appear at the top.
• Select it to review pending online bookings.
• Online booking setup is covered in a separate module.

Scheduling a new appointment

1. In the schedule grid, find the date and time you want.
2. Right‑click on that time slot.
   • On a tablet, long press instead of right‑click.
3. Choose one of the three options:
   • New Patient – for a patient who is not yet in your database.
   • Existing Patient – for a patient who already exists in your system.
   • Happening – for non‑patient events (e.g., lunch, meetings, vacations).

 Create a new patient appointment

1. Select New Patient from Item 3 in above Scheduling a new appointment section
   • Enter a name for your test patient and click Next
   • Under “Has this patient been seen before?”, choose Never before seen.
2. When the window expands, enter patient details:
   • Birthday (choose one you’ll remember for testing).
   • Phone number (use a number you can receive texts on for testing).
   • Email address (use one you can access to test the portal).
   • Referral source (how the patient was referred).
3. Select Save and Send portal invitation (recommended)
   • This sends the patient an invitation to the Patient Portal.
   • Patients can complete health information and additional forms before their appointment.

Choose appointment type

1. After saving a new patient, a window appears asking for the type of appointment.
   1. Select the appropriate appointment type (for example, Injectable).
   2. If applicable, select a Subtype (such as Neurotoxin or Filler).
   3. These options are customizable in the Appointments module.
   4. Add any comments in the comments field if needed.
   5. If your practice has multiple locations, select the correct Facility/Location.
   6. Confirm the Start Time and Duration are correct.
2. If you want this patient on the Move Up List, toggle the Move Up List option ON.
   • This will allow you to move them into earlier openings if a spot becomes available.
3. Select Save.
4. The patient’s appointment will now appear on the schedule grid.

Understanding Privacy Mode

If this is your first time logging into 4D, your appointment block may show “Privacy Mode On” instead of patient details.

This protects patient information from being seen by non‑staff and is especially useful on portable devices.arrivesl

Turning Privacy Mode ON/Off

1. Click the Options gear icon near the top right of the page.
2. Choose Privacy Mode Off/On.
3. You will now see the full appointment information on the schedule.

 Move Up List

1. At the top of the page, select the Move Up List icon.
   • You will see a list of patients who have Move Up toggled on, including the patient you just scheduled.
2. Select the clock icon next to the patient you want to move up.
3. Navigate to the new desired time on the schedule.
4. Right‑click (or long press on tablet) and select Paste.
5. The appointment will move into the new time slot.

Status colors and legend

1. The current status of an appointment can be viewed by right-clicking on the appointment and then clicking Status.
2. The Status is also indicated by in the color of the bar on the left side of each appointment. There is a legend in the Knowledge Base you can reference.

 Chart note indicator (pinstripes)

1. The pinstripes that appear in the status bar of an appointment indicate that a chart note has not yet been completed.
2. Once you sign and complete the chart for that appointment, the pinstripes disappear.

 Basic appointment (right-click) actions

1. Edit
   • Change appointment details such as type, time, location, or comments.
2. Copy
   • Copy the appointment and paste it to another day/time.
   • This works only for established patients (patients who have been seen before).
   • New patients who have never been seen cannot have their appointments copied.
3. Reschedule
   • Select Reschedule, then right‑click on the new date/time and select Paste.
   • You can also drag and drop the appointment block to a new time.
4. Cancel
   • Choose whether the cancellation is by the office or by the patient.

Appointment-Patient (right-click) actions

From the right‑click menu, the Patient section lets you jump to various areas of the patient’s record:

1. Summary
   • Opens the Patient Summary page with key information at a glance.
2. Photos
   • Opens the Photos tab to view or upload patient photos.
3. Profile
   • Opens the Profile page to view or update demographics and other details.
4. Quotes
   • Opens the Quotes section to begin or review quotes for procedures.
5. Read All Notes
   • Shows all of the patient’s chart notes from the schedule.
6. Write Chart Notes
   • Opens a window to start a chart note for this appointment.
   • Charting will be covered in its own module.
7. Internal note
   • Lets you write an internal note directly from the schedule.
   • This is not visible to the patient and is not filed in the official chart.

Other Appointment (right-click) actions

1. Create Invoice
   • Creates an invoice for services directly from the schedule.
2. ePrescribe
   • Opens the Doctor First integration to prescribe medications.
3. E‑Prescribe will be covered in a dedicated module.Phone Call
   • Call the patient directly from 4D using the phone number on file.
4. Text Message
   • Send a text message to the patient.
5. If your phone integration is configured, patients can reply, and you can view messages in 4D.
6. Send Email
   • Send a HIPAA compliant email from 4D.
7. Send Portal Invitation
   • Resend a Patient Portal invitation if the patient still needs to complete forms.
8. Update Appointment Status
   • In the right‑click menu, hover over Status and select the appropriate status (e.g., Arrived, In Room, Checked Out).
   • Assign a room
     • If you created rooms during the Office Details setup, hover over Roomed and select the room the patient is in.
9. View appointment edit history
   • Select History from the appointment right‑click menu.

1.7 Feature/Development Requests (1:25)

4D EMR Feature Upvote Website Link

During onboarding, it’s common to think of features that could improve 4D as you learn the system. While our primary focus during this phase is to train your team on how 4D works today—so your setup can be completed smoothly and without delays—you’re welcome to submit development ideas at any time.

If you have a feature request, please submit it through Feature Upvote, 4D’s official platform for collecting enhancement suggestions. Once posted, your idea becomes visible to the entire 4D community, where other practices can vote on it. The development team reviews submissions based on community interest, feasibility, and overall system priorities. If your idea moves forward, your Feature Upvote post will be updated with an implementation timeline.

You’ll also have regular project review calls with your 4D EMR Onboarding Lead. These conversations are a great opportunity to discuss your ideas, explore existing functionality, and understand how your request fits into future development plans. Keep in mind that software development at 4D is a detailed, multi‑step process—every new feature undergoes extensive testing and quality assurance to ensure reliability before release.

Submitting your ideas through Feature Upvote ensures they reach the development team directly while allowing your onboarding trainer to stay focused on getting your system live. You can continue using Feature Upvote long after onboarding ends, and we always appreciate your feedback.