> For the complete documentation index, see [llms.txt](https://docs.mdintegrations.com/llms.txt). Markdown versions of documentation pages are available by appending `.md` to page URLs; this page is available as [Markdown](https://docs.mdintegrations.com/partner/key-concepts/refills-and-follow-up.md).

# Refills & Follow-Up

After an Encounter completes, the next fill follows one of two paths, depending on the prescription itself: **refill available on the original prescription**, or **follow-up consult required**.

|                  | Refill on file                                     | Follow-up consult                                       |
| ---------------- | -------------------------------------------------- | ------------------------------------------------------- |
| When to use it   | The prescription has refills remaining.            | Refills are exhausted or policy requires re-evaluation. |
| New Encounter    | No                                                 | Yes                                                     |
| Physician review | No                                                 | Yes                                                     |
| Who initiates it | Partner or MDI, depending on pharmacy fulfillment. | Partner                                                 |

### Refill on file

When the prescription still has remaining refills, the path is simple: no new clinical review occurs, and no new Encounter needs to be created at all.

Instead, you place the next pharmacy order when the refill is due:

* In a partner-managed model, your system places the reorder.
* With [Direct to Pharmacy (DTP)](/partner/key-concepts/pharmacy-fulfillment/direct-to-pharmacy-dtp.md), MDI manages the reorder for you upon approval.

Which of these applies to you depends on your configured [Pharmacy Fulfillment](/partner/key-concepts/pharmacy-fulfillment.md) model.

{% hint style="info" %}
Refills on file do not enter the Encounter status lifecycle. Track their progress through the pharmacy order, not `Created`, `Assigned`, or `Completed`.
{% endhint %}

### Follow-up consult

By contrast, create a follow-up consult when the prescription has no refills remaining, or when clinical policy requires another evaluation before the patient can continue treatment.

{% stepper %}
{% step %}

#### Charge the patient

Charge for the follow-up through your subscription or one-time payment flow.
{% endstep %}

{% step %}

#### Remind the patient

Send a reminder when a follow-up is due. You can also use [Automations](/partner/exploring-features/automations.md) to set up time- or event-based reminders instead of tracking this manually.
{% endstep %}

{% step %}

#### Generate and send a Voucher

Create a new Voucher for the follow-up Questionnaire, then send it through your chosen patient channel.
{% endstep %}

{% step %}

#### Complete the follow-up intake

When the patient submits intake, MDI creates a new Encounter under their existing Patient record — there's no need to create a new Patient for a returning patient.
{% endstep %}

{% step %}

#### Complete clinical review

From here, the new Encounter follows the standard lifecycle: `Created` → `Assigned` → clinical review → `Completed` or `Cancelled`.
{% endstep %}
{% endstepper %}


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