--- id: release-notes-2026-08 title: August 2026 release notes module: getting-started audience: [clinician, intake, admin, billing, bd, vendor] type: release-note last_reviewed: 2026-09-01 tags: [release-notes] related: - release-notes-2026-06 - visit-wizard-ehr-aprn-credential - visit-wizard-ehr-signature-timestamp - visit-wizard-ehr-note-honesty-guardrails - billing-claim-scrub - billing-stedi-actions-inbox - billing-ptan-and-payer-enrollment - billing-timely-filing - billing-cms-1500-and-837p-fields - billing-retired-cpt-guard --- Changes shipped between 2026-08-01 and 2026-09-01. Items are grouped by module. Entries marked ★ are high-impact or frequently requested. The month was heavy on billing correctness, note honesty, and shipping the native app photo capture. 241 non-refactor feat/fix commits landed, spanning 8 release trains (v1.1.267 through v1.1.300). --- ## Provider Attestation & Notes - ★ **APRN is a first-class credential.** The attestation dropdown used to offer a combined "NP / APRN" option that always stored `NP`. APRN and NP are now separate options; pick the one your state licence uses. See [APRN as a signature credential](../modules/visit-wizard-ehr/aprn-credential.md). - ★ **Signature timestamp is readable and carries a timezone.** Notes used to print a raw UTC ISO instant (24% of signed notes) or a false "same day" fallback (99% of finalized notes). Now they print `Aug 25, 2026, 11:07 PM EDT` in the reader's device timezone with the zone abbreviation always shown. Legacy PDF fallback that stamped `new Date()` onto unsigned notes is deleted. See [How the signature timestamp prints on a signed note](../modules/visit-wizard-ehr/signature-timestamp.md). - ★ **Provider credential prints on the signature line.** Previously the credential (NP, PA, MD, etc.) was silently dropped from the printed signature. Now it renders beside the provider's name on every signed note. - ★ **Note-honesty guardrails.** The renderer no longer synthesizes a post-debridement measurement that was never taken, and no longer invents an undocumented comorbidity type or stage. See [Note-honesty guardrails](../modules/visit-wizard-ehr/note-honesty-guardrails.md). - **Contradictory `is_clean` formulas reconciled** in the perfect-note pipeline. - **Wizard binding hardened.** Visit Wizard now renders against the URL patient (not a frozen copy) and blocks documenting against another patient's appointment. - **Running HPI preserved on resume.** Fixed a defect that blanked and erased the Running HPI when a draft was reopened. - **Exudate: allow "no exudate" wounds** and resolve exudate type on write at every hydration path. --- ## Addendum - ★ **Addendum surfaces in Progress Notes with download.** Signed corrections after the fact are now visible from the Progress Notes tab, not buried in audit logs. - **Encounter identity on every amendment.** An addendum now identifies which encounter it belongs to — no more ambiguous "which visit is this?" corrections. - **Patient name, MRN, and DOB print on every addendum page** — required for HH agencies that receive faxed amendments. --- ## Billing & Claims - ★ **$0.00 claim guard.** Auto-drafted claims now refuse to submit if the claim total is zero. Companion fix: unpriced-line rejections are readable to a biller. See [Charge Master and the $0.00 claim guard](../modules/billing/charge-master-and-zero-dollar-guard.md). - ★ **Coding Review Drawer soft-blocks and closes bypasses.** Coding findings are soft-blocks — you can override with a reason — and the manual bypasses that used to skip the drawer entirely are closed. Coding Review now resolves 174 of 461 clinical notes (was 60). - ★ **Service-date guard.** Stops silent today-substitution when a service date is missing; uses the existing CMS-1500 date convention rather than inventing anchoring. Reworked twice after hostile review to close 84 findings. - ★ **The claim scrubber shipped.** Five wound-care-specific pre-submission rules (deleted C-codes, JW/JZ on Q-codes, WISeR PA, MAC state mismatch, debridement+CTP bundled). Advisory only, never hard-blocks. See [The claim scrubber](../modules/billing/claim-scrub.md). - ★ **Area-based CPT coding for debridement, CTP, and NPWT.** Correct code selection driven by measured wound area. - ★ **Retired CPT 99343 no longer emitted.** Deleted by AMA on 2023-01-01; three prod notes had been billed with it in July 2026. See [Retired CPT guard](../modules/billing/retired-cpt-guard.md). - **ICD-10 catalog reconciled to CDC FY2026 billable leaf set.** Diagnosis validation now checks against the billable catalog, not a regex. - **CMS-1500 Box 1 marked from the same source as the 837P wire** — the two now agree. - **CMS-1500 checkboxes that never got marked are now marked.** - **Timely filing severity thresholds** with day-count math resistant to timezone drift. See [Timely filing windows](../modules/billing/timely-filing.md). --- ## Stedi / 837P - ★ **837P payload validator built from Stedi's own JSON Schema.** Catches structural errors before submission. - ★ **PTAN and payer enrollment surface.** Full self-service enrollment page at `/billing/enrollment` covering four transaction types. See [PTAN and payer enrollment](../modules/billing/ptan-and-payer-enrollment.md). - ★ **Stedi Actions Inbox.** Triage surface for four Stedi event types (file failed, transaction processed, enrollment rejected, enrollment task assigned) with five actions and superadmin facility stamping. See [Stedi Actions Inbox](../modules/billing/stedi-actions-inbox.md). - ★ **First-ever coverage of the inbound path** (277CA + 835 ERA). Documented why the inbound path was previously unproven — never ran, never failed. - **Two Stedi webhook systems disambiguated** in documentation. - **Subscriber DOB recovered and paired with DMG03.** - **DMG03 patient sex populated;** stops CMS-1500 guessing Male when the field was blank. - **All 6 always-required 837P `claimInformation` fields sent.** - **Diagnosis pointers capped at 12** per 837P spec; fix applied to frontend builder. - **Resolved charge carried onto 837P service lines** (previously blanked in some paths). - **Primary line no longer counted twice** on auto claims. - **$0 claims blocked before Stedi submission** — reads the charge/modifier keys the builder actually writes. - **CMS-1500 field mapping documented.** DMG03 M/F/U mapping, SV107 diagnosis pointer, DTP*472 format. See [CMS-1500 and 837P fields](../modules/billing/cms-1500-and-837p-fields.md). --- ## ZusHealth & Interoperability - ★ **Import write layer rebuilt.** Five mappers, `lab_tests` redirect, `Immunization` inlet, unique indexes, honest save counts. Medications imports unblocked after August 4 prod forensics. - ★ **Patient.active preserved on identifier write-back.** One-shot repair function shipped for patients whose `active` flag was stripped by the prior defect. Also unblocked FQS reads on Patient 403 responses. - **UPID settlement against demographics** before scoping FQS reads. - **Sync button in pre-charting** with toast feedback; SELECT RLS policy added for `zushealth_patient_relations`. - **One pull button + honest post-pull import summary** in precharting. - **Legacy JWT + `sb_sec_` key formats both accepted** in Zus edge functions. - **Zus-Account header attached only to CE-delegated writes;** reads go headerless at BA level. - **PHI logs removed** from Zus code paths. - **CE Builder ID added for Integ Advanced Nursing (CA).** --- ## Native / Electron App The native tablet build ("electron") shipped its wound-photo capture pipeline this month. - ★ **Wound photos capture and file on the tablet, sync to web §7.** 26 commits, culminating in an end-to-end path: photos are queued as base64 rows, filed under `facility_id` for storage RLS, content-addressed to prevent duplicates, and linked back to the web wizard's §7 by shared wound id. - ★ **Cross-device visit continuity.** Resuming a web visit on the tablet (or vice versa) keeps its wound and photo links intact; the tablet emits `id` in web's key shape so the two builds share one identity. - **Refused picks surfaced** to the clinician instead of silently dropped. - **Removed photos cancel their queued upload.** - **Persisted-file fallback** when the picked file no longer exists on the device. --- ## Scheduling & Appointments - ★ **Appointment-integrity review surface (Phase 2/3).** Admin view for reviewing appointments with data-integrity flags. - **Reassign dropdown reads the bookable roster,** not every facility member. Scoped to the appointment's facility. - **Shared clinician-id normalizer** applied to create-appointment and reassign. - **Explicit unassign on reschedule honored.** - **Stale count fix inside the anti-stale-comment guard.** --- ## Fleet Map & Calendar - ★ **Map stays mounted during date-change refetch** — no more full remount + flicker. - ★ **Map pins no longer randomized for unresolved CA addresses.** - **Marker listeners registered once,** not once per render. - **Fleet Calendar drains paged reads** instead of truncating at max_rows. --- ## Fax - ★ **File faxes to charts from an edge function,** not the browser. Closes tenancy and idempotency gaps. - ★ **Cover page + message box on progress-note faxes.** - **Fax IDP tables scoped by facility grant,** not `user_profile.facility_id`. --- ## Insurance - ★ **Verify-insurance writes the verified boolean + raw 271 eligibility response.** Single `isInsuranceVerified` predicate for all readers. - **NIM-202 closed.** Fixed a defect that recorded "self" as an answer nobody gave, and shipped a documented, reproducible row repair. - **Coinsurance fractions normalized to whole percents** across legacy rows. - **Payer shown in Claims picker;** warns on duplicates and gates removal. - **Billing & Auth insurance add path guarded.** - **Sex editable after intake;** ends `patient.gender` drift between demographics and claims. --- ## Consent - ★ **Typed-name attestation as a backup signature method** for consent capture. - **Signer identity shared across modalities** (paper, digital, typed). - **Per-modality coherence** enforced via AST walk rather than regex census. - **Prefills may only add information,** never remove it. --- ## Notifications - ★ **Phase 0-2 shipped.** Catalog + data-driven router → dispatcher + delivery ledger → real email/SMS/push wiring. Email launches first; SMS and push are "coming soon". Email sends through the existing Gmail SMTP path. - **Retention purge moved into an edge function.** - **Both service-role key formats accepted.** --- ## Business Development - ★ **BD Activities: row menu, archive confirm with undo, edit modal, archived view.** - **Archive-aware mode in `useBdActivities`;** archived activities excluded from daily suggestions. - **`bd-activity-mutate` edge function** with authorization predicate; soft-delete columns, privilege lockdown, reader filters on `bd_activities`. --- ## Home Health - **"Add New Agency" in the home-health picker.** - **Legacy soak gate retired** — was reading 0 in front of a live table. --- ## Facility Setup - **Blank Tax ID no longer silently blocks facility edit.** - **RLS-denied edit no longer reports success.** - **Migration aborted on rows with two bad identifiers is now idempotent.** --- ## Security & Access - ★ **Billing-surface role gates.** Billers and superadmin now 403 on Submit Claim, fax, auth email, and verification — matching the documented permission model. - **Client code can no longer hard-delete clinical records** — DELETE policy dropped on `visit_data_v2`, and higher-level clinical writes routed through edge functions. - **Verify-insurance bound to the facility** on write. - **Concise-arrow `console.*` calls stripped** from the production build. - **Coverage routing hostile-review findings closed:** A+B state, Zus dup rows, Stedi timeout, hospice race, indeterminate payer gate, NPI fallback audit. --- ## Referral Intake - **Cross-patient note bleed fixed** in the referral intake pipeline; UTC note-date regressions pinned with timezone-independent tests. --- ## Analytics - **GA4 wired at router root.** SPA page views, `begin_checkout` before Stripe redirect, `sign_up` conversion on `/mini/confirmation`. - **PostHog suppressed on `/mini/*` signup routes** to isolate marketing-funnel telemetry. --- ## Release Trains Eight release PRs landed in August: **v1.1.267** → **v1.1.300**. The largest single train was v1.1.297, which carried the Stedi 837P DMG03 recovery, the referring-provider write gap fix, and the coverage-routing hostile-review round. ## Related Auto-rendered from `related:` in frontmatter.