We’ve listened to your feedback and are excited to introduce a new improvement to the review process. We know reviewing a letter can be complex, and that experienced users don’t always benefit from manually acknowledging warnings and AI suggestions.
That’s why we’re giving practice admins more control - so you can choose the level of interaction that helps your users work quickly and safely.
To start, you can select from three built-in profiles, each defining a different level of interaction during Review.
This article will cover:
How to manage approval controls in Practice Settings
The differences between High touch, Risk-based, and Low touch approval profiles
How to configure user-specific approval levels
Where coders can view their assigned approval profile
1. Managing Approvals in Practice Settings
Admins set approval controls for their users in Practice Settings, under Approval Control.
Open Practice Settings and select Approval Control.
Set the practice-wide default profile. This applies to every user on the default profile and to any newly created users.
Each profile controls three things during Review: which AI suggestions need per-row approval, whether you must confirm a letter has no tasks before filing, and which warnings you must acknowledge before completing the letter. The colour key at the top of the page shows, for each item, whether it is Required, Partially required, or Not required under that profile.
High touch - every AI suggestion requires individual approval.
Approve AI suggestions: per-row approval required for high clinical risk annotations (e.g. diagnoses, bloods and safeguarding), for all general values (e.g. weight, height and b.p.), and for all other annotations.
Tickbox for no tasks: a tickbox must be checked to confirm there are no tasks on the letter before filing.
Warnings requiring acknowledgement: all listed warnings must be acknowledged before the letter can be completed (Benign cancer codes, Missing letter text, Cancer code not QOF, Old date, Fracture code).
Best for new users, or anyone who wants the most safeguards while they build confidence.
Risk-based - only high clinical risk AI suggestions require individual approval.
Approve AI suggestions: per-row approval required for high clinical risk annotations (e.g. diagnoses, bloods and safeguarding). No approval required for general values or other annotations.
Tickbox for no tasks: no confirmation is required before filing.
Warnings requiring acknowledgement: some of the listed warnings must be acknowledged before the letter can be completed.
Best for users comfortable with BetterLetter who want critical risks highlighted while they work at speed.
Low touch - most AI suggestions do not require individual approval.
Approve AI suggestions: no approval required for high clinical risk annotations, general values, or other annotations. The AI's high clinical risk suggestions, including diagnoses, bloods, and safeguarding, are filed without a per-row approval step, so assign this profile only to experienced coders who are confident reviewing AI output.
Tickbox for no tasks: no confirmation is required before filing.
Warnings requiring acknowledgement: some of the listed warnings must be acknowledged before the letter can be completed.
Best for experienced users who want to code at the highest speed.
📝 Note: The current practice default is High touch.
After selecting a default approval control, admins must check the confirmation box at the bottom of the page. This acknowledges that changing the default approval control will affect all users in the practice.
This update ensures both safety and efficiency are tailored to user experience and skill level, providing flexibility for practices to balance speed and risk.
2. How to Configure User-Specific Approval Levels
Admins can also set an approval profile for individual users, so settings can be tailored to each person's experience and familiarity with reviewing AI output.
To configure a user-specific approval level:
Open the approval control settings.
Choose the appropriate approval level:
High touch - recommended for users still becoming familiar with the system and with reviewing AI output.
Risk-based - recommended for users comfortable with the system who want critical risks highlighted.
Low touch - recommended for experienced users who want to increase coding speed.
Select the user(s) you want to configure, then click confirm.
You can also move users to different levels of approval by dragging their name from one group to another.
Save the changes and as mentioned before, make sure to check the confirmation box at the bottom of the page.
User-specific profiles override the practice-wide default, giving you the flexibility to support different workflows and experience levels across your team.
3. Information for Coders
Under My Account, you’ll now see a new Approval column. This shows your approval profile for each practice you belong to, giving you quick visibility of your current settings. If you’re part of multiple practices, your approval level may vary between them.
