Encounters and Episodes of Care (EOC)

Episodes of Care bundle multiple encounters into a structured record of the patient journey. This supports outcome tracking, modern reimbursement models, and interoperability by providing standardized, exportable data. 

EOC Overview

Healthcare is shifting from one-off visits to longitudinal, patient-centered care. To support this, Healthie has introduced Encounters and Episodes of Care as core infrastructure:

• Encounters: Represent a single billable provider–patient interaction.
  • Current state: Encounters are automatically created only when an appointment is marked as occurred.
• Episodes of Care (EOC): Group multiple encounters together, defining a treatment period (e.g. injury recovery, chronic disease management, therapy program).

Together, Encounters and Episodes of Care create a foundation for value-based care, bundled payments, and data exchange aligned with industry standards.

How Episodes of Care Work

1) Automatic Encounter Creation Current Implementation (Available Now)

• When an appointment is marked as "occurred," Healthie automatically generates an Encounter object.
• Encounters can include chart notes, claims, and invoices tied together.
• All encounter objects have been backfilled for appointments since 2025.

Today, encounters remain tightly coupled to appointments in Healthie. Through the Workflows > Appointments feature, you can select View Details to expand an appointment record. This surfaces the Encounter and its associated data (chart notes, claims, invoices) in a consolidated, read-only Appointment Details Page.

Learn more about Appointment Details here. 

2) API Capabilities (Available for API Customers)

Episodes of Care are fully available through Healthie's GraphQL API, enabling API customers to:

Create Episodes of Care

• Required Fields: All episodes require a patient_id, provider_id, diagnosis_id, and start_date
• Date Constraints: Start date must be present or in the past.
• Diagnosis Association: Must link to an existing diagnosis in the system.
• Provider / Client Relationship: The provider must have access to the specified client.

b. Manage Encounters

• Link multiple encounters to an episode
• Unlink encounters when needed
• Bundle related patient interactions under one episode

c. Access Structured Data

• Export episodes in structured formats
• Support Electronic Health Information exchange
• Generate reports for value-based care models

d. Supported GraphQL Operations

• createEpisodeOfCare
• updateEpisodeOfCare
• deleteEpisodeOfCare
• linkEncounterToEpisodeOfCare
• unlinkEncounterFromEpisodeOfCare

📘 Learn more: Healthie API Documentation

Use Cases

For providers, Episodes of Care make it possible to track patient progress across therapy programs, recovery journeys, and other longitudinal treatment plans, while also evaluating the effectiveness of care over time and sharing structured records across teams.

Organizations can leverage this framework to generate reports that align with bundled payments and value-based care models, exchange structured data with third-party systems, and meet compliance requirements.

From a billing and reimbursement perspective, Episodes of Care simplify grouping related encounters for bundled payments, improve insurance reporting accuracy, and help optimize revenue capture for services delivered across the full course of care.

• Track longitudinal progress (e.g., therapy programs, recovery journeys).
• Evaluate treatment effectiveness over time.
• Share structured records across care teams.
• Generate reports for bundled payment and value-based care models.
• Exchange structured data with third-party systems.
• Group related encounters for bundled payment models.
• Improve insurance reporting accuracy.
• Optimize revenue capture for longitudinal care.

Episodes of Care are available immediately via Healthie’s GraphQL API. The functionality is secure, additive, and does not disrupt existing appointment or billing workflows.

• For API Customers: Encounters and Episodes of Care are available; Email hello@gethealthie.com with questions.  
• For UI Customers: Encounter creation is live today; View Appointment Details is available via our Workflows feature. 

Have feedback to share with our team? We’d love to hear from you – submit your feedback to our Product Portal.