---
title: "Merging Duplicate Patients"
description: "How to merge duplicate patient records in NICE HMS — rules, encounter behavior, accounting, ABHA handling, and step-by-step instructions."
date: 2026-07-22
lastModified: 2026-07-22
category: "patient-management"
author: "Dr. Umesh Bilagi"
beta: false
---

## Overview

When the same patient has multiple records, NICE HMS merges them so all data appears under one patient. This is a soft link — the source record continues to exist but its data is displayed through the target.

## How Merging Works

Merging sets the source patient's `merge` field to the target patient's ID. It does not physically move or copy data.

**After merging:**
- All records from the source (encounters, prescriptions, bills, lab reports) appear when viewing the target patient.
- Encounters remain mapped to their original patient. Accounting, which is tallied per encounter, stays with the encounter.
- Balances display together under the target, but each encounter's accounting belongs to its original patient.

## Merge Rules

### Target Selection

| Scenario | Rule |
|----------|------|
| One patient has ABHA, the other doesn't | ABHA patient **must** be the target. Reverse is prevented. |
| Both are non-ABHA | Either can be the target — choose which record to keep. |
| Both have ABHA | Merge is blocked — ABHA must be unique per organization. |

### Encounter States Before Merging

Merging does not block on encounter state — you can merge even if the source patient has in-progress encounters. However, after merging, the system enforces a strict rule: **only one encounter may be in-progress at a time across the merged patient record.**

If the source and target together have more than one in-progress encounter after merging, the system warns you and blocks new encounters until all but one are marked finished. Finish any unwanted encounters on the source **before merging** to avoid this.

Once an encounter is marked finished, **only an admin** can revert it back to in-progress. If you accidentally finish the wrong encounter, an admin must step in to reopen it.

### Accounting

- All accounting is per encounter, not per patient.
- Merging does not recalculate or combine balances — each encounter keeps its own accounting.
- When viewing the target patient, totals across all encounters (both target's and source's) are shown for convenience.

## How to Merge

1. Identify the **target record** (the one to keep).
2. Open the **source record** (the duplicate).
3. Click **Merge**.
4. Enter the target patient's ID.
5. Confirm the merge.

The source record becomes linked to the target. All data from the source is now visible under the target patient.

## Pre-Merge Checklist

- If the target will have an ABHA, create the ABHA patient record first, then merge duplicates into it.
- Review in-progress encounters on the source. Finish any that should not carry over.
- Ensure the source patient has no ABHA linked (ABHA must be unique per organization).
- If unsure which record to keep, consult the patient history — choose the record with more complete data.

## FAQ

**Q: Can I undo a merge?**
A: No. Merging is not reversible. Verify before confirming.

**Q: What happens to the source patient after merging?**
A: The source record continues to exist (it is not deleted). It is hidden from normal views and its data appears under the target.

**Q: Can I merge more than two records?**
A: Yes. Merge duplicates one at a time into the same target.

**Q: Does merging affect the patient's ABHA?**
A: The merge target keeps its ABHA. The source must not have an ABHA. If both records have ABHA, merge is blocked.