LocalChart FAQ

Not as a public download yet. LocalChart is preparing a signed Windows clinic-host installer with guided setup, reliable upgrades and rollback, and release evidence tied to the exact package offered to a clinic. Until that launch gate passes, the website will not present an unfinished build as a public download.

After signing in, use Finish your profile to confirm your name and optionally add a photo. Click your photo bubble beside your name to choose a JPG, PNG or WebP image under 3 MB. My profile in the account menu also lets you edit your clinic display name. Changing your name does not change your login, permissions or previously signed records. You may skip the photo and keep working.

Yes. Open the photo attachment in the conversation to view it in a larger window, zoom, or download a copy. Supported mobile browsers also offer Share / Save photo. Close the viewer to return to the conversation. Downloads leave the clinic-controlled message store, so save them only to an appropriate authorized device or destination.

Choose Set working hours directly above the calendar, or use the working-hours setup task on Today. Save each provider's regular hours and use unusual days for exceptions. The calendar fits selected providers' hours and appointments, including early mornings and evenings; Show full day expands it to all 24 hours. This changes the view, not appointment times or booking permissions.

Messages use one compact time and Read or Unread status. Click or tap that line to reveal exact sent and read timestamps. Incoming messages show their sent time. Older read messages without a recorded read timestamp say the time is unavailable rather than guessing. Messaging is internal staff communication, not patient texting.

A PT selects measures and tests for the patient's specific issue. Evaluation scores establish a baseline; a completed progress note with the selected scores resets the assessment reminder; discharge records final scores against that issue's baseline. The default reminder is ten completed visits or thirty days, whichever comes first, and is clinic-configurable rather than a universal payer rule. Schedulers see when assessment is due. The library provides measure names and result units; licensed questionnaire content and automatic item-level scoring are not bundled.

An administrator can select cash-only work or cash plus local insurance preview. Preview shows authorized clinician-reviewed notes and service evidence without changing the note, converting a cash patient to insurance, creating a claim, posting payment, or contacting Claim.MD. Connected claim submission remains unreleased; preparation permissions and paid entitlements are separate from the preview setting.

The local clinic computer must be running for other devices to reach the workspace. Start or restart LocalChart using the clinic computer's existing tray, then retry. Demo uses a separate local backend and its own data. The application no longer uses an old cached login page as evidence that a clinic is available. Do not clear browser data: it may hold unsynced drafts or recordings. Interface updates notify signed-in staff to save their work before reloading.

The currently qualified clinic host is Windows. Staff can use current browsers on Windows, macOS, and iPadOS through the clinic's approved HTTPS route. Phone layouts support focused mobile work, but long documentation and front-desk scheduling are better suited to a computer or iPad. Every clinic must validate its actual host, browsers, microphones, and network with fictional patients before clinical use.

Start with the interactive guided tour at https://localchart.app/tour, then email support@localchart.app with the clinic type, approximate provider count, devices, and current documentation workflow. Do not include patient information. A pilot-fit conversation reviews workflow and readiness; it is not a promise of immediate installation or clinical use.

LocalChart helps clinics manage daily work, schedule visits and resources, record or paste visit context, review ordered sources, draft documentation, maintain rehab flowsheets, manage patient memory, import reference records, and export reviewed documentation packets from a clinic-controlled local system.

No. LocalChart can serve as an EMR-lite scheduling and documentation workspace for some cash, wellness, performance, or small therapy practices, and it can also sit beside a cloud EMR as a clinic-owned scheduling, documentation, and records layer. It is not a full practice-management, billing, claims, payment, or payer workflow platform.

A clinic can keep the EMR it already uses for claims, payments, eligibility, patient portals, and payer workflows while using LocalChart for clinic-local scheduling context, visit capture, transcription, fact review, draft documentation, records, and clinician-reviewed exports. This avoids a disruptive replacement project, gives clinicians a focused documentation workflow, and keeps the handoff into the official EMR deliberate and reviewable.

Today, the practical handoff is operator-controlled. LocalChart can import supported copies of schedule, patient-demographic, and reference-record files exported by another system. Authorized users can copy or export reviewed LocalChart documentation for the destination system. For a protected WebPT patient-identity review plan, explicitly assigned staff can prepare and review staged rows without applying them to LocalChart patient records. Exact files vary by EMR and must be tested with synthetic data first. An import is a point-in-time copy. An export or review decision does not automatically file, finalize, or update a chart in the other system.

WebPT import review is a staged review lane for a protected, hash-bound WebPT patient-identity plan. An explicitly permitted preparer chooses the plan and assigns a reviewer. Every row starts on Hold, decisions are limited to Create, Link, Skip, or Hold, and the decision set is encrypted and revisioned. The screen is deliberately review-only: it does not connect to WebPT, does not apply rows to LocalChart patient records, and does not merge or overwrite patient identities. A separate future apply review would be required before any patient-store change.

Connected LocalChart browsers share the host's current LocalChart schedule and records. That is LocalChart synchronization, not live EMR synchronization. Current EMR imports and exports are asynchronous, staff-initiated handoffs: a person chooses when to bring in a supported file or transfer reviewed content. LocalChart does not silently overwrite either system or resolve changes made in both places. A future vendor-authorized API connection could synchronize selected appointments, demographics, statuses, or reviewed note fields only after the clinic, vendor, permissions, field mapping, and audit behavior are validated.

Not by default today. The supported path is to review the content in LocalChart, then copy or export it into the clinic's official system. For the photo-observed WebPT 1.0 workflow, Export places populated high-impact fields first, names the matching WebPT destination, and gives each value its own copy action. The billing-review workspace can prepare service concepts, minutes, proposed timed-unit results, authorization or credential holds, and a manual WebPT handoff summary for assigned human review. WebPT import review can stage protected patient-identity decisions for Create, Link, Skip, or Hold review, but it does not connect to WebPT and does not apply anything to the patient store. The clinician or authorized billing staff member pastes, reviews, saves, signs, submits, and verifies acceptance in WebPT; WebPT remains the final authority. Billing codes, minutes and units, payer-conditional values, signatures, certifications, and attestations remain explicit human decisions. The WebPT 1.0 profile remains partial until a genuine fake-patient walkthrough confirms validation and save/sign boundaries; WebPT 2.0 is not yet mapped. Until a specific integration is built and tested, LocalChart should never be represented as automatically writing back to Jane, WebPT, or another EMR.

One clinic computer is LocalChart's home base, or host. It runs the application and local AI, stores the clinic's LocalChart data, and serves the screens that staff open in a browser over the clinic network. The iPads, Macs, and other PCs do not each need the AI model. If the host is turned off or disconnected, those devices cannot reach LocalChart until it returns. The public LocalChart website is for product information, account/address coordination, and support; it is not where the clinic's charts or recordings are stored.

Short answer: one Windows clinic host runs LocalChart for the whole clinic. Staff computers, iPads, and phones are browser clients and do not need their own GPU. • Fit is not speed: VRAM determines whether the selected workload fits. CUDA-core throughput, GPU architecture, memory bandwidth, cooling, and power determine how quickly the queue clears. • One-provider GPU host: 16 GB system RAM can be workable; 32 GB is the normal recommendation. • Entry GPU host: a qualified 16 GB card in roughly the 4,000-6,000 CUDA-core range is a calculated two-to-four-clinician planning tier. Faster 16 GB cards can serve more people than slower cards with the same VRAM. • Typical clinic host: the measured 6,144-core, 20 GB Ada professional GPU averaged about 7 seconds per ordinary draft and supports a five-to-six-clinician planning target on one managed queue. • Faster clinic host: gaming and professional cards in roughly the 8,000-13,000 CUDA-core range, with adequate VRAM and bandwidth, are calculated five-to-eight-clinician tiers. This includes qualified 16 GB high-performance gaming cards, RTX 3090-class cards, Ada professional cards, and Blackwell professional cards. • Maximum practical clinic tier: RTX 4090/5090-class gaming cards and comparable professional hardware have enough compute for eight or more clinicians on the intended single-queue clinic scale. More expensive flagship workstation hardware is not an ordinary LocalChart requirement. • Measured upper anchor: the RTX PRO 6000 Blackwell averaged 2.3 seconds per ordinary draft with a 3.2-second P95 and completed three simultaneous provider-load requests in about 11 seconds. It is shown as measured calibration evidence, not as an ordinary clinic purchase recommendation. • System RAM: 32 GB is normal. Use 64 GB only as optional headroom for a larger clinic around six to eight or more clinicians, larger imports, or extra background work. • CPU-only fallback: use a current high-end desktop processor, 32 GB system RAM, and NVMe storage. This is primarily a one-provider configuration because simultaneous drafts queue for minutes rather than seconds. • Network and devices: connect the host with 1 Gb Ethernet when practical. Wi-Fi 5 is the normal minimum for staff devices; Wi-Fi 6 or 6E is preferred for a busy clinic. Wi-Fi 4 may be adequate for one or two light-use clients but requires an onsite workflow test. Use current browsers and verify every recording device's microphone. Observed planning measurements use the same bounded synthetic drafting workflow. The measured 20 GB professional GPU completed one provider-load request in about 14 seconds and three arriving together in about 43 seconds. Extending that measured queue slope gives roughly 71-86 seconds for five to six simultaneous requests; that extension is calculated rather than directly measured. The measured high-end CPU averaged about 62 seconds per ordinary draft; its provider-load case took about 111 seconds for one request, 239 seconds for two, and 316 seconds for three. In the 100-report synthetic backlog stress test, the RTX PRO 6000 Blackwell completed 100 of 100 standard reports in 4 minutes 22 seconds, or about 22.9 reports per minute. The CPU attempt completed 29 reports in 30 minutes 6 seconds before stopping; projecting its observed 62.3-second average produces an estimated 100-report time of about 1 hour 44 minutes. The GPU total is measured. The CPU 100-report total is a calculated projection from a measured partial run. Calculated comparisons use CUDA cores, architecture, memory bandwidth, and the measured RTX 4000 Ada and RTX PRO 6000 Blackwell endpoints. They do not assign provider counts from VRAM. The DGX Spark is a future Linux/ARM candidate: its 128 GB unified memory offers unusual capacity, but its 6,144 CUDA cores and 273 GB/s bandwidth do not make it an automatic speed upgrade for LocalChart's short interactive drafts. It requires a separate runtime and portability qualification. NVIDIA/CUDA is the currently qualified Windows GPU path. AMD, Intel, Apple Metal, and other accelerators require their own LocalChart qualification. These figures are planning ranges rather than a compatibility guarantee, and they do not expose LocalChart's internal model, prompt, or test-corpus details.

No. LocalChart provides tools that support clinic review, including local storage, protected-record flags, audit trails, retention-rule status, source confidence, and manual-review holds. The clinic remains responsible for confirming its HIPAA, state-law, payer, malpractice, professional-board, and care-setting obligations. LocalChart output is not legal advice and should not be treated as a compliance certification.

LocalChart uses a Retention Review Center. It can show retention timelines, protected categories, state-rule status, source confidence, and whether legal review is required. Unknown, fallback, deceased-patient, and protected legal-record cases require manual review. LocalChart does not treat retention rules as permission to routinely delete legal records.

Retention rules vary by state, provider type, payer, setting, and clinic policy. Source confidence makes it visible whether a rule is source-referenced or still a conservative fallback awaiting verification. This helps the clinic and legal reviewer see what is known, what is uncertain, and what should not be relied on automatically.

No. Clinician-reviewed notes, submitted intake forms, legal-record audit logs, and similar chart/legal records are manual-review only by default. LocalChart should not make deletion of legal records feel routine.

Retention changes and deletion-sensitive workflows should happen only after backup and recovery checks. Protected-record cases require manual review, and disposition workflows should preserve audit history. LocalChart is designed to remove items from active workflow cautiously, not silently purge legal records.

Production claim transmission and payment processing are not released. The Blue development build includes a guarded Claim.MD claims/remittance workbench; sending requires a verified vendor test account. Recorded payments are bookkeeping entries, not bank or card transactions. No reimbursement or eligibility result is guaranteed. Authorized staff can prepare service-time and unit evidence from a clinician-reviewed note, route it to a reviewer, and export a manual handoff summary. The licensed coding catalog is stored and searched on the clinic host. Development CPT content is restricted to synthetic testing and is not bundled into customer releases. Candidate codes require a human choice; saving a proposal does not approve a claim. Production use requires the appropriate commercial content license, the clinic's insurance add-on entitlement, staff permissions and verified clearinghouse setup.

Open Insurance Billing after saving and clinician-reviewing a visit. A profile needs explicit billing preparation access; administrator status alone does not confer it. Review service evidence checks the reviewed note and same-day reviewed flowsheet together. Distinct documented services remain visible. Repeated treatment entries require confirmation of whether they describe one interval or separate work before minutes are included. Clinician and assistant attribution stays with the evidence. A changed source requires a fresh preview. Unit calculation settings contains the counting method and assistant-involvement flag for the clinic reviewer to verify against payer requirements. Where licensed catalog access is configured, local code candidates show their release and effective date. Proposed codes remain separate from final claim approval. The preparer must review or correct every suggestion. LocalChart then calculates proposed units, encrypts the review, and shows authorization or credential holds. The assigned-review queue lists only work assigned to the signed-in reviewer and names each hold, responsible clinic role, and deterministic next verification action. Reviewers can open their held, ready, or approved work; an export-only profile can open only an already approved or exported review. The exported WebPT summary is for manual human transfer and review, not claim submission or automatic writeback.

In Blue, use Insurance Billing → Billing setup & getting paid → Billing identities before the first visit, or expand Claim details on a clinician-reviewed visit. An administrator with billing-rule permission can save the clinic's legal billing identity and each clinician's own identity locally. Defaults carry into subsequent claim preparation. A reviewed direct-reporting policy may be reused within its provider, product, location, billing-entity and date scope. Previously reviewed episode diagnoses can also be reused, but an authorized reviewer must confirm diagnosis-to-service links for each visit. Changed identities, sources, codes, dates or withdrawn policies require renewed review. Saving setup does not enroll a provider, approve a claim or transmit anything.

Sometimes, under the applicable payer and supervision rules. LocalChart keeps the recorded caregiver separate from the clinician reported on the claim and the billing practice receiving payment. Blue supports direct clinician reporting and a staff-reviewed PTA/supervising-PT arrangement with current source, policy, date and group-authority evidence. It does not treat a co-signature as automatic permission to use another NPI. Unsupported arrangements remain on hold. NPI identities and payer routing cannot be substituted in the claim after review, and paid claim attribution cannot be silently reassigned. Licensure, scope, exclusions, payer requirements and modifier review still require qualified staff verification; LocalChart does not certify credentialing or perform automated sanctions screening.

Open Insurance Billing → Billing setup & getting paid → Setup guide. The guide separates provider qualification/group authority, the clinic's Claim.MD account, claim submission enrollment, ERA payment-report delivery and EFT/bank-deposit enrollment. LocalChart tracks each payer's EDI, ERA and payment-method status separately. A status saved by staff does not connect a bank or enroll with an insurer. Official instructions are included for Original Medicare, BCBS New Mexico, Cigna, Aetna and UnitedHealthcare, with a reminder to confirm the exact payer/product and home Blue plan. Bank details belong in the payer-approved enrollment service, not LocalChart. An ERA is a payment explanation, not proof of bank settlement. Current Blue stores verified test-account credentials through a host-only tool; customer self-service live connection and production transmission remain unreleased until vendor and release qualification.

Yes, in Blue. An administrator can grant Manage provider credentialing workflow (no billing approval) under People and Roles → Billing workspace access. Insurance Billing → Provider credentials provides cases by provider and insurer, assigned owners, application stages, next actions, follow-up dates, revalidation/expiry warnings and encrypted revision history. Authorized users also see reminders in Today. A case can start before the payer ID or product/location scope is fully collected; that missing information must be resolved before evidence verification. Duplicate and stale updates cannot silently overwrite the current case. Existing published enrollments can be brought into the queue for tracking. This permission does not grant patient-note access, billing approval or permission to submit claims. Related billing holds show only reviews the caller is already authorized to access. Administrators with existing billing-rule authority separately publish enrollment evidence and confirm its link to the case. Marking an application submitted, payer-confirmed, denied or closed does not itself enable, suspend or transmit billing. Evidence expiry or changes remain visible even after a prior link was verified. Staff retain supporting documents in controlled clinic records and record references here; no application or email is sent automatically.

In Insurance Billing → Billing setup & getting paid → Timed-unit policies, an administrator with billing-rule permission records the verified payer routing ID, exact plan/product, location, clinician or explicitly practice-wide contract scope, policy state, effective dates and supporting references. The local register supports CMS-style combined timed minutes and CPT midpoint per distinct service. Matching patients reuse the verified policy; a member number or insurer brand alone does not select a rule. Four separate eligible eight-minute services produce two units with combined counting, or potentially four with per-service counting when the payer permits it. The visit worksheet shows the selected method, source and verification alongside documented minutes and allowed units. Missing, expired, held or overlapping policies block timed-unit approval. Changed policies invalidate prior worksheet approval without rewriting signed notes or historical claims. Multiple reviewed notes for the same patient, discipline and day require consolidation review; they cannot each receive an independent timed allowance. Existing explicitly verified Original Medicare scope remains usable when no shared policy exists, but cannot override an expired, conflicting or held policy. These time rules do not independently approve commercial modifiers, coverage, service-pair edits, enrollment or payment. Clinic charges, payer allowances and received payments remain separate.

Blue shows a compact symbol and label on appointments for recorded payment, partial payment, a recorded billing handoff, pending payer payment, or billing attention. Sent and accepted do not mean paid. A zero balance from adjustments alone is not shown as a payment. The payment/billing queue can open the linked calendar visit, and Return to previous calendar position restores the prior date and scroll position. Indicators reflect locally recorded reconciliation, not a guarantee that money reached the bank.

Billing intake and manual checkout are being tested in Blue. From Patients, open Billing intake to collect patient/subscriber identity, primary and secondary coverage, accident/referral details and acknowledgements. Self coverage reuses patient details only when explicitly selected. Missing information remains visible; collected information is not verified eligibility. Updated intake supplies claim preparation without silently changing signed clinical notes. The Payments & billing queue separates patient payment status from insurance handoff status. Staff can record an agreed self-pay charge, receipts, partial payments, completed refunds and returned payments. Duplicate receipt entries are blocked; administrator exceptions and corrections retain history. Ready, sent, rejected and returned billing statuses are manual records, not automatic claim transmission. Stripe, Wave and other payment receipt connections are not enabled by this workflow.

The Clinical workspace supports four explicit source types: patient conversation, focused clinician dictation, typed notes, and reviewed handwriting from a photo, scan, or PDF. A note can contain multiple source types without a separate mixed-source mode. Each source remains independently editable, reorderable, replaceable, or removable before drafting.

Transcript & sources shows a flat row for every reviewed source. Up and down arrows change the clinical order. Redo replaces one source, Remove excludes it, and Record more appends another clip to the selected source instead of creating an unrelated block. The combined transcript follows that order and does not insert source labels into clinical text.

Select the patient first, then choose Handwriting. On a desktop, choose Upload photo or PDF. On an iPhone, iPad, or other direct-camera device, choose Take a photo for a new JPEG capture or Choose existing photo or PDF for a supported library file. LocalChart accepts JPEG, PNG, WebP, or PDF, checks page orientation, and prepares editable text. Existing HEIC or HEIF library photos are not supported yet; convert or export them as JPEG before uploading. Compare the original file and text, remove any content belonging to another patient, and choose Add reviewed text to note. Read handwriting again retries the recognition step. The reviewed source remains visible to the clinician. OCR is assistance, not approval, and the clinician must correct it before using it as chart evidence.

Both views use the same reviewed source text. Full Draft is the narrative review path. Review Facts exposes individual statements with their likely source and destination so a clinician can approve, reject, edit, copy, or inspect the source before drafting. A source link is navigation evidence, not automatic clinical approval.

Abandon Test Run is a permanent-deletion workflow for an unapproved draft that should not become a clinical record. LocalChart blocks the action while capture, finalization, or transcription is active, lists what will be deleted, and requires explicit confirmation. The unapproved draft and uniquely owned source files are deleted; reviewed or filed records are not part of this action. This is different from retention or legal-record disposition. Never use it to erase a reviewed note, submitted intake form, audit record, or protected chart artifact.

The flowsheet stores clinician-reviewed structured measures captured from dictation or entered during review. The Exercise Sheet tracks exercise, sets, repetitions or time, resistance, and notes by visit. Historical Measures shows change over time. Structured data supports the note and patient-memory view; it does not replace the clinician's signed narrative.

Yes. The current scheduling workspace includes Day, Stacked, and Week views; provider calendars; location filters; calendar zoom; a compact opposite-side appointment editor; provider availability and PTO; recurring series; classes and clinic events; conflict-checked rooms and equipment; reminders and confirmations; gap filling; provider metrics; a day sheet; schedule-health review; patient booking-change requests; private outbound calendar subscriptions; and external busy-calendar import. Patient-facing booking is request-based. A patient can request a new visit, reschedule, or cancellation through a private link, but staff must review and confirm it before the schedule changes. LocalChart does not submit claims, decide payer authorization, collect payment, or replace a full practice-management system. A clinic using WebPT, Jane, SimplePractice, or another established system should define which system owns each workflow and validate every handoff.

After a clinician-reviewed note linked to a completed scheduled visit is saved, choose Review next visit series. LocalChart first creates a read-only preview from the recorded plan cadence. The preview lists every proposed date and checks the current schedule revision, provider availability, overlap, location, resources, plan end date, and recorded authorization capacity. It also shows warnings such as an unconfigured travel buffer. Nothing is booked during preview. Confirm visit series is available only when the preview has no blockers. Confirmation sends the exact preview identity, schedule revision, and one stable request identity so a retry cannot silently duplicate the series. If the schedule or recommendation changed, LocalChart requires a fresh preview. Staff should still review the resulting visits in Scheduling; this workflow does not make a clinical plan or payer-authorization decision.

Use Today, previous, and next to move the date. Choose Day, Stacked, or Week, filter Location, and adjust Zoom without shrinking the calendar. Find / Go searches commands and appointments already authorized and loaded in the current calendar. More contains Provider Hours, Work Hours, Export CSV, and Print PDF. Schedule Operations opens operational work, and + New Appointment opens a blank editor. Press Ctrl+K on Windows/Linux or Command+K on macOS to search LocalChart workspaces and actions. In Scheduling, slash outside a field opens calendar Find / Go. When keyboard focus is not inside a field, T returns to today, D selects Day, W selects Week, N and P move next and previous, and A opens a new appointment for an authorized scheduler. The provider-calendar list supports keyboard reordering. On a phone, LocalChart uses a day agenda with Previous day, Next day, Today, New, Find, Calendars and Operations. Calendars opens a dismissible filter sheet. Dense Week is a start-time overview with readable appointment rows; open a day to see proportional durations and provider lanes.

Open Find / Go → Find an opening, choose exactly one clinic location, set a date range of up to 31 days, and optionally choose a provider, time window, duration, or conflict-checked resource. LocalChart ranks current gaps and labels openings that need manual review. It also states when travel buffers, plan-of-care windows, or authorization were not evaluated. An eligible result's Prepare button changes the calendar date and opens a prefilled appointment editor. It does not book an appointment, move a patient, contact anyone, or bypass the ordinary conflict and save checks. If the calendar changes after the search, LocalChart discards the stale recommendation and requires a new search.

The compact editor opens on the side opposite the selected time slot so the relevant calendar remains visible. Patient, provider, visit type, date, start, end, and Save Appointment remain primary. Contact and intake, coverage and authorization, and visit settings are flat disclosures. Secondary commands—including Add Another, Fill Queue, Patient History, Start Daily Note, and Delete—are under More actions.

While creating an appointment, turn on Repeat, choose the interval, weekdays, and end rule, review the occurrence count, and save the series. When changing or cancelling a member of a series, choose This visit, This and future, or Whole series. Completed, no-show, cancelled, and documented historical visits are preserved, and a changed single occurrence remains an exception rather than silently rewriting the whole history.

Schedule Operations groups work that should not crowd the calendar toolbar: • Reminders & confirmations shows consent-aware outreach and patient responses. • Fill openings ranks cancellation and waitlist matches by visit need, availability, provider preference, authorization posture, and recorded outreach consent. • Provider metrics summarizes capacity, utilization, confirmations, and outcomes. • Day sheet shows authorization, copay, intake, confirmation, and unsigned-documentation readiness. • Schedule health highlights cadence gaps, expiring authorizations, unresolved cancellations, and documentation backlog. • Online booking requests holds patient requests for staff review. • Locations, resources & calendars manages clinic sites, rooms, equipment, private calendar feeds, and external busy calendars. These are decision-support tools. Staff must verify the source record before making a clinical, payer, employment, or patient-contact decision.

Scheduler Tasks is the flat exception list at the top of Scheduling → Operations. It derives bounded, deterministic work from LocalChart's existing patient, schedule, plan-of-care, authorization, intake, confirmation, cancellation, and documentation facts. It does not create a second patient chart and does not invent clinical need, coverage, authorization, consent, or contact information. Each row explains its priority, source facts, recommended next staff action, recorded channel eligibility, and any suggested opening. Call remains manual. Prepare Email creates a review-only communication job and sends nothing. Book opens the ordinary appointment editor with a suggested opening but does not save it. Staff can record the outcome, snooze, mark the task not needed, or resolve it. LocalChart does not automatically contact patients, determine eligibility, make clinical decisions, or submit billing.

Yes. Authorized staff can define resources such as rooms, treatment tables, and equipment and assign them in Visit settings. LocalChart checks time conflicts and requires the resource to belong to the appointment's location. Resource availability is still only as accurate as the maintained location, hours, and maintenance data.

Authorized staff can create a private subscription URL and add it to Apple Calendar, Outlook, or Google Calendar by URL. The outbound feed excludes clinical detail. LocalChart can also connect to a credential-free HTTPS calendar and import generic busy blocks; staff refreshes it with Sync now. Private subscription URLs should be protected and revoked like credentials. This calendar feed is not the planned offline iOS Provider Daybook. A future companion app will require separate device enrollment, revocation, minimum-necessary snapshot, expiry, and replay protections before it is exposed.

It lets a patient request a new visit, reschedule, or cancellation. It gathers preferences and sends them to the clinic's request inbox. It does not directly book, move, or cancel an appointment. Staff remains responsible for identity, availability, authorization, clinic rules, and confirmation.

Fill openings ranks eligible candidates using recorded visit need, availability, provider preference, authorization posture, and outreach consent. Missing or invalid authorization is held for manual review rather than presented as a confident match. LocalChart does not contact a patient without the appropriate recorded permission and does not make the final scheduling decision.

The day sheet is a compact operations list for each visit's authorization, copay, intake, confirmation, and unsigned-documentation status. It helps staff prepare without opening every patient form. It does not replace the underlying chart, authorization document, or billing system.

Schedule health highlights underbooked plan cadence, authorizations nearing expiration, unresolved cancellations, and documentation backlog. A flag is a prompt to inspect the patient and episode; it is not an automatic plan-of-care, payer, or staffing decision.

The Invoice Support Packet summarizes reviewed clinical documentation and payer, authorization, and visit-reference context for clinic review. It is not a claim, payment request, eligibility check, coding decision, payer-rule output, reimbursement guarantee, or compliance guarantee.

In Blue, authorized staff can open Review billing after saving a clinician-reviewed note. The worksheet shows the saved source beside procedure proposals from a licensed local catalog, documented treatment time, deterministic unit/modifier proposals, and alternatives. PT treatment, PT evaluation/re-evaluation, chiropractic spinal treatment, and chiropractic examination/adjunct work have separate paths. Optional local AI extracts quoted clinical facts; it does not receive the CPT catalog or select final billing codes. Documentation and coding questions are separate from coverage holds, so missing payer information does not hide a supported procedure proposal. Staff verify payer rules in patient Billing intake, review or amend incomplete source documentation, confirm the coding worksheet, and create an assigned billing review without retyping admitted service rows. Coding review is not claim approval, eligibility verification, a payment, or transmission. Multi-service edits, unfamiliar payer policies and unsupported service types remain held for human review. The current synthetic development tests do not establish real-world accuracy or reimbursement. Production availability requires licensing and release qualification. If local AI proposes an unfamiliar service interpretation, an authorized billing reviewer can confirm that mapping beside its exact source quotation. Confirmation is attributed and saved; it does not invent missing time or clear other checks. Replacing a prior assigned review requires an explicit revision-bound action, retains its encrypted historical snapshot and resets authorization/approval. The worksheet also supports reviewed alternative-code selection, billed-unit adjustments with a reason, per-unit clinic charges and administrator-managed effective-dated fee defaults. Alternatives exclude the current code; an alternative requiring different source evidence cannot be selected as though that evidence already exists. Increases beyond the documented/payer-supported unit allowance are blocked. A reduction remains reduced through the assigned review; LocalChart does not silently restore the original calculated amount. Changes reset coding approval and retain encrypted adjustment history. The time audit compares the linked scheduled slot, documented timed treatment, selected units and any reviewer-recorded actual encounter times. The appointment length does not create billable minutes. A documented overrun can be recorded separately without rewriting the calendar. Clinic billed charges are not insurer allowances, expected reimbursement or patient responsibility. Service-pair checks remain manual where verified edit data is unavailable: a reviewer may document their current reference and explicitly attest that no distinct-service modifier is required; this never adds a 59/X modifier or constitutes an automated NCCI verification. Patient billing intake is saved once and reused. Update demographic or policy information when it changes. Secondary coverage and accident, referral, guarantor and authorization details apply only when relevant. Insurance coverage-start dates are not universally required just to collect intake, and postal addresses are not required by this intake screen for a basic self-pay visit. New demonstration patients have complete, explicitly synthetic billing information; example clinic fees are not real prices or evidence of coverage.

The clinic controls its LocalChart instance and patient-record decisions. LocalChart is designed around clinic-owned local data, explicit review, backup/recovery checks, export, and protected-record handling.

It should not block historical clinical record access, read/export, or legal-record retrieval. A payment hold should affect future paid functionality, not a clinic's ability to access and export prior patient records. A conservative product policy is cancellation/read-only at paid-period end with grace/offline cache, while preserving historical record access/export.

For local clinic use, LocalChart is served by the clinic host over HTTPS. The managed setup assigns a memorable address such as https://wellnessworks.localchart.app that resolves to the host's private LAN address. It is not a public internet patient portal. Localhost HTTP remains acceptable for host-only diagnostics, but plain HTTP on a clinic IP is not a patient workflow route. Routine clinicians, schedulers, front-desk computers, and iPads do not need Tailscale. On the clinic Wi-Fi/LAN they open the memorable https://clinicname.localchart.app address, which resolves directly to that clinic workstation's private LAN address and uses its browser-trusted certificate. Approved remote superusers may optionally use one separately installed, vendor-supported Tailscale client and a clinic-approved private route. LocalChart does not bundle, duplicate, restart, or enroll Tailscale, and it never changes Tailscale or Windows networking automatically. Clinic devices continue to reach the memorable address directly without Tailscale; approved off-site superusers use the same clinic bookmark or the private .ts.net recovery address. Both paths must reach the same production LocalChart host, sessions, and data store. No remote path creates a second production runtime. Public exposure, Tailscale Funnel, plain HTTP, and router port forwarding are not supported patient-workflow routes. Remote setup is an administrator maintenance task with a fresh snapshot, an independent recovery channel, timed automatic rollback, real external application proof, and explicit commit. What does the LocalChart superuser need to do for private remote access? 1. Install and prove LocalChart Production on the clinic LAN first. 2. If remote-superuser access is required, the clinic owner or IT administrator separately installs and enrolls the official Tailscale client. This is not part of the LocalChart installer. 3. In Administration > System Health & Devices, open Remote Access Configuration, choose Set up or Re-configure, and identify a verified second recovery channel. 4. Confirm that the private route and least-privilege access rule name the current clinic host and only the approved remote superusers. A changed host address or access policy requires a new guarded maintenance transaction; do not reuse old network assumptions. 5. Preserve every unrelated Tailscale rule and route, arm restoration of the exact prior state, and make only the one approved change. 6. Prove the original clinic bookmark from a non-LAN enrolled test device with a real authenticated synthetic application workflow. Match its production instance and data identity to a direct LAN proof, then explicitly commit. If proof or commit does not happen before the deadline, the bounded change rolls back. Windows and Tailscale own service recovery. LocalChart reports drift and offers the explicit guarded reconfiguration transaction; it does not silently repair connectivity by restarting Tailscale or changing Windows networking, DNS, forwarding, firewall, default routes, or identity. The committed DNS, single-host route, tailnet policy, and Tailscale Serve state persist independently of LocalChart. LocalChart diagnoses them read-only. Re-configure Remote Access repeats the same snapshot, rollback, proof, and commit safeguards used during initial setup; it does not silently alter workstation networking or DNS.

LocalChart can continue to work during a public-internet outage when the clinic host workstation is running and the clinic's Wi-Fi/LAN is still working. Client devices on that same clinic network can still send data to and receive data from the host. Local records, scheduling, and locally hosted drafting remain inside the clinic network. The clinic router, wireless access points, switches, and local name resolution still need to be available. Remote Tailscale access, public website access, software updates, new public DNS changes, license refresh, new certificate issuance or renewal, and optional off-site sync will not work until internet service returns. The local app uses its most recently cached license window; the account-service outage does not move patient data to the cloud or shut down the local database. Keep a clinic-owned downtime process for workflows that depend on outside services.

Open Clinic Administration > System Health. Start with the four summary blocks, then inspect Active devices. A green host check means only that the host answered; it does not claim that a recording, transcript, or draft completed. Open Recording workflow support and read the stages in order: Browser capture, Server transcript, and LLM draft saved. Stop at the first incomplete stage and follow the displayed support action. Failed or stalled workflows open automatically. Older completed workflows, offline devices, raw events, device IDs, and other technical data remain collapsed until support needs them.

Yes. Once active capture/finalization has safely stopped, the unfinished recording remains encrypted and bound to its original note while the provider opens another patient's note and records normally. LocalChart never inserts the older transcript into the new note. Return to the original note and choose Retry sync to recover it or Discard saved recording if it is an unwanted duplicate. Discard requires confirmation, removes the device-side copy only after the clinic host records the decision, and leaves any host-received evidence under the clinic's normal audit and retention rules. The provider does not need to troubleshoot the older recording while another patient is waiting.

One LocalChart installation keeps Real Clinic and Demo Clinic as separate workspaces. The desktop sign-in screen can switch between them at any time. Demo is local-only, contains marked synthetic data, and resets independently after its final user signs out. The real clinic keeps its own encrypted records, profiles, license, and clinic key; neither workspace can read, write, restore, or back up into the other. To connect an existing clinic, choose Real Clinic, expand Connect an existing clinic, and sign in with the primary clinic-owner account. LocalChart verifies the owner, applies that clinic's license to the real workspace, opens the clinic as that owner, and enforces the clinic's one-workstation limit. Demo remains available separately. No activation-code or operator-portal step is required. A brand-new clinic can still create its first administrator locally, and advanced support retains activation codes as a fallback. After connection, an administrator chooses an available name in Clinic Administration > System Health > Device connection details. LocalChart reserves the name, connects it to that host's private LAN address, and coordinates a public browser-trusted certificate. A bounded second workstation is allowed only for an encrypted export/import migration and must be retired after verification. That name is a private clinic route, not a public patient portal. defaultclinic.app is not a LocalChart-controlled domain and should not be used. Use the clinic's assigned LocalChart-managed subdomain or a separately reviewed clinic-owned domain; do not deploy a placeholder name unchanged.

Not when the managed clinic address reports a valid public certificate. Let's Encrypt issues that certificate, so normal current browsers trust it without installing a LocalChart profile. The older root-certificate download remains an advanced fallback for a clinic that deliberately uses a self-managed/private certificate path; do not use that fallback when the managed card says Secure & connected. The clinic browser still must be on the clinic's Wi-Fi/LAN, open the exact assigned address, and sign in with an individual LocalChart profile. The certificate proves the encrypted connection to the assigned host; it does not replace LocalChart login permissions.

At minimum, LocalChart needs a clean reviewed branch, focused auth/retention/provider/patient-identity/runtime tests, a live llama.cpp synthetic-note probe, rendered UI smoke through the clinic workflow, PHI/security proof, backup/restore proof, and a fake-patient pilot simulation. Passing a model benchmark alone is not enough.

The workstation menu bar stays at the top while the page scrolls. File opens new-visit, records, import, and export actions. Admin opens only the workforce, clinic-operations, data, and configuration controls allowed for the signed-in role. View changes palette, density, reload, or full screen. Help opens role dry runs, device setup, the Tailscale superuser guide, FAQ, legal guidance, and About. The profile menu contains billing when permitted, profile switching, and sign-out.

View or Clinic Administration > My preferences > Appearance offers LocalChart light (the default), Lunar, Ocean light, Warm gray, Ocean dark, High contrast, and optional Follow system. The dark evergreen palette has been removed; old evergreen selections open in LocalChart light. Palette and density are remembered per profile on this device across reload and sign-in, and the signed-out screen keeps the last styling used. A profile without its own saved styling inherits the device's last choice. Workspace density can be Comfortable or Compact. The same area controls calendar patient-name order, the default Full draft or Review facts view, and the current browser's human-readable device name.

Open Help > FAQ & Support in the workstation app, or Clinic Administration > My settings & training > Help & FAQ in a browser. Watch G01 — Introduction explains the clinic host, client devices, local AI, and visit workflow; Watch G02 — Tour introduces the workspaces. Video links appear above written guidance. The app verifies the signed-in clinic profile, and the account service verifies trial or active clinic access before opening a protected LocalChart web page. Demo profiles can use videos when their host has trial or active access. There is no public video listing or durable direct media URL. Videos require internet; packaged written guidance remains usable offline. Search ordinary words or filter topics by Admin, Scheduler, or Provider / PTA. Clear or Escape in the search field resets the query.

For a connected real clinic, open Manage clinic accounts from People & Permissions. An owner or authorized administrator invites each person, then uses Manage person to change their account role, clinical profession, scheduling access, or active status. PT, PTA, and chiropractor roles use one provider seat, including treating owners and administrators. Deactivation preserves clinic records. Account acceptance, clinic sign-in, and host-confirmed offline setup are shown separately. Access changes reach offline devices when they reconnect or their offline access expires. Clinic-specific billing preparation, review, export, rule management, and WebPT import permissions remain separate grants in the clinic app. Signed-in devices lists current clinic sessions. Demo and internal test profiles remain separate from real-clinic accounts.

Data & recovery contains Storage, Backup & Restore, the Data Safety view, and Retention Review Center. Storage changes require admin reauthentication and explicit confirmation. In Backup & Restore, an admin chooses a separate external drive, network share, or approved cloud-synced folder, then chooses Manual only, Every day, or Every week, the run time, and how many recent routine packages to keep. LocalChart uses the clinic's existing encryption key automatically, writes one encrypted package directly to that destination, verifies it there, and keeps no second routine package beside live data. The screen explains how to validate and test-restore a package and that a separate or off-site copy protects against loss of the clinic computer or live data—not against loss of both the computer and a backup stored only on it. A cloud-sync provider may still keep its own local synchronized copy; its storage and online-only settings are controlled by that provider. LocalChart removes only older current-format packages that are registered to the same clinic and exceed the clinic's chosen limit after a new package succeeds. Recovery previews stage a copy before any live restore. Older v1 backup packages still accept their original passphrase under advanced disaster recovery; legacy packages and renamed owner copies are never removed automatically. Retention timelines do not authorize deletion of protected or uncertain records. Audit & support contains the Settings Change Log, PHI-free support reporting, and report-template management.

LocalChart uses one encryption key for the clinic, not separate keys for each provider. On the new computer's first-run screen, choose Recover an existing clinic and Sign In to Recover Clinic. The primary clinic owner signs in through the central account portal, selects the clinic, re-enters the current password, and approves the one-time code. LocalChart then installs the clinic key into the operating-system-protected key store so the encrypted backup can be restored. Recovery remains available when a trial, payment, or subscription has expired. It still requires a current active primary-owner account; old passwords, disabled accounts, and revoked owner memberships are rejected. A downloaded .lckey file is an offline fallback. Windows BitLocker or Device Encryption is recommended extra stolen-device protection but is not forced by LocalChart.

The intended packaged drafting path is LocalChart-managed llama.cpp. LM Studio can still be useful for development and QA comparisons, but production-readiness evidence should prove that a fake-patient note can be generated through managed llama.cpp without silently falling back to LM Studio.

Pilot pricing is private and available by request. Public-facing material at https://localchart.app should not publish prices until pricing, support expectations, and pilot terms are intentionally approved.

During private pilots, customer billing and bookkeeping should run through Wave invoices or recurring invoices. LocalChart should not collect card numbers, process payments, or store payment credentials. LocalChart may track a manual license status, plan, paid-through date, and grace period for access control. That billing status should never include PHI, patient names, clinical notes, appointment details, or chart content.

No. Real-patient use should stay on hold until setup, profile access, PHI/security readiness, backup/recovery, device route, and fake-patient workflow checks are complete. Demo mode is for testing and training only.

No. LocalChart drafts and organizes documentation for clinician review. Clinicians remain responsible for the final note, missing information, clinical decisions, sign-off, and use of exported records.

For now, support should be handled through the FAQ at https://localchart.app/faq, a support page at https://localchart.app/support, and a help email. Set the public help address before external pilot use, and set LOCALCHART_SUPPORT_EMAIL on the clinic host so the production blocker checklist can confirm that the support route is configured. AI may help draft internal support responses later, but customer-facing replies should be human-approved before delivery. Responses about clinical, legal, HIPAA, billing, reimbursement, payer, or compliance questions should be reviewed before sending and should not promise legal compliance, claim acceptance, reimbursement, or patient-care clearance.

No. The supervised pilot gate and the broad-production blocker checklist answer different questions. A supervised pilot can prove the clinic workflow under controlled conditions, while broad production still requires closing identity, clinic-device HTTPS trust, PHI-vault-primary storage, all-state retention source verification, and support operations blockers.