CLIENT ATTENDANCE, DOCUMENTATION, AND BILLING

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1 CLIENT ATTENDANCE, DOCUMENTATION, AND BILLING FROM A LEADER IN AGENCY WORKFORCE MANAGEMENT SOLUTIONS

2 INTRODUCTION Tracking client attendance and streamlining billing has never been more important for agencies. Underserving a client can lead to loss of revenue, while overserving can result in nonreimbursable payroll costs. Paper based systems are often time consuming, lack visibility and reporting capabilities and are error prone and risky At many agencies, client attendance is tracked manually, calculations are also performed manually and then entered into billing. These manual processes often fail to provide agencies with the visibility needed for day-to-day activities to make real-time operational decisions that ensure client services are delivered in a timely manner, or the reporting required for management to understand service delivery in relation to the authorization. MINIMIZE RISK OF AUDIT FAILURES Billing audits are becoming more frequent and aggressive as regulators try to eliminate fraud and abuse in billing. Even where errors are accidental, they are embarrassing to an agency. Using paper forms, with their associated labor-intensive data entry, makes agencies vulnerable to audit problems, especially if multiple staff accidentally bill the same hours for the same consumer, or a single member of staff bills for multiple consumers during the same date/time interval. Detecting these errors is time-consuming. Where staff work at remote locations such as group homes or individuals homes, these problems are compounded, and the risk of errors multiplied exponentially. TIME AND ATTENDANCE SOLUTIONS Agencies can use time and attendance solutions to track hours of service and capture documentation. These solutions eliminate duplicate billing errors and provide much greater visibility into hours of service across the agency. Using paper forms, with their associated labor-intensive data entry, makes agencies vulnerable to audit problems... Eliminating reliance on paper forms, data entry, and traditional case management systems not only reduces the internal cost structure at an agency, but significantly minimizes the risk of audit failure, and is proven to increase billing and productivity. REAL-TIME BILLING DATA Collecting client attendance and the delivery of services in real time facilitates the daily monitoring of hours worked against budget and schedule. In service organizations where hours worked affect billing, collecting time and attendance in real time can potentially improve both productivity and revenue. 1

3 Automated no-show alerts can be incorporated into day-to-day operating procedures. Irrespective of where the consumer is serviced, hours, units and costs can be integrated into a single database, eliminating data entry and the risk of transcription errors. With real-time data capture, agencies are able to track variances to budget and to schedule on a daily basis. The enhanced insight into agency operations opens a whole new way to manage an agency. SUPPORTED LIVING AND OTHER INDIVIDUALIZED SERVICE PROGRAMS Staff providing supported living, respite care, homemaking, nursing, or other individualized services at a client s home, or in a community living arrangement or group home may use the telephone or PC to record their own attendance and the services provided. Where those services vary or are billed at different rates a service code is entered. Caller ID and voice identification provides security. Did you bathe the client? Press 1 for Yes. Press 2 for No Enter activity code Supported Living Press 1 o clock in Automated no-show alerts can be incorporated into day-to-day operating procedures. CASE NOTES AND ACTIVITY DOCUMENTATION At the end of a visit, staff can respond to pre-recorded prompts based on each individual plan of care indicating which services were provided. Telephone timekeeping solutions provide a very affordable way to track hours and units of service in supported living programs. There are no equipment costs. Hours can be reliably tracked by consumer and the type of service provided, and compared to the consumer s plan of care to maximize authorized billing, minimize under-billing, and control over-billing outside the plan of care. In addition, the cost of servicing each consumer can be identified quickly, making the application for greater funding easier and more compelling. DAY PROGRAMS Using tablets provides a cost-effective way of verifying client attendance at busy day programs. There are practical considerations with any time and attendance technology depending on entrances, attendance patterns and staff availability which need to be reviewed prior to implementing any solution. Client attendance at day programs varies, because clients do not always attend, or may leave early for personal reasons. Handwritten attendance forms that have to be re-entered into spreadsheets and databases can be replaced by using tethered or mobile infrared scanners to record attendance in real time. Recording attendance in real time provides management with immediate insight into client attendance and absenteeism. If the clients move into different programs that are billed at different rates, the same technology can be used to keep track of the clients as they move in and out of different rooms and programs throughout the day. 2

4 8 WAYS AGENCY-READY WORKFORCE MANAGEMENT HELPS AGENCIES ATTENDANCE BY EXCEPTION If real time data capture is impractical (too many entrances, insufficient staff available etc.) another alternative is to use a scheduling software to create a master client schedule that is then adjusted on an exception basis if the client is late, leaves early, or fails to attend. This method can reduce the volume of data entry by percent and provide the data for daily, weekly and management reports. SPREADSHEETS For providers of specialized services such as case managers or therapists who work with many clients throughout the day, an effective solution is to use a spreadsheet to track which clients were served and when. The spreadsheet can be ed to a billing administrator who can then import it automatically. BUDGETS Under/over hours reports highlight missing billable hours for client services. For instance, individualized services are usually provided under a plan of care. Hours provided in excess of the plan of care may be denied payment, while hours not provided may not be recoverable. Creating hourly budgets by location or cost center (client) is relatively easy to maintain, as budgets change infrequently. Using variance reports speeds billing approval and boosts accuracy. Budget variances are easy to spot using summary hours variance reports by cost center or location. More detailed information can then be obtained where discrepancies are highlighted. Sometimes agencies may not be aware of billing problems. Time and attendance should be captured in real time to allow decisions to be made before problems occur. SCHEDULING Scheduling software used for staff may also be used for clients to schedule their attendance in different programs and locations. Real-time attendance tracking can generate variance data that automatically identifies a client s missing scheduled service. AUTHORIZATIONS Recording attendance in real time provides management with immediate insight into client attendance and absenteeism. Once attendance data is captured management reporting will be more practical. Reports can be easily generated to provide information on utilization of authorized hours, percentage used based on current usage within the plan of care dates. This reporting can allow agency management to adjust services within a billing period to maximize billing and minimize payroll overruns without diminishing client service. 3

5 AUTOMATED PROCEDURES All manual calculations and entries that affect billing should be embedded in the time and attendance solution. This will minimize manual entries, avoid errors, and ensure the consistent delivery of accurate billing. These procedures include, but are not limited to, multiple billing rates based on job/shift /service provided, and reallocations. INTEGRATION Data should flow seamlessly between timekeeping and billing when necessary. Otherwise, it is possible that the data will be incorrectly updated, or will not be maintained in a timely manner. In that case, duplicate data entry will be required to keep the system in order. WITHSTANDING AUDITS When the costs and risks of paper-based systems have been eliminated, withstanding audits become easier. Client attendance, documentation and billing data can be retrieved instantly for any date and time period. Errors such as duplicated or missed billing are less likely as the quality of the data going into the system would have been easily validated against schedule, budget and authorization at the time of service. When the costs and risks of paperbased systems have been eliminated, withstanding audits become easier. ABOUT MITC MITC provides modular workforce management solutions and services to support all the needs of agencies time and attendance, advanced employee scheduling, service documentation, payroll rules and reporting engine, workforce analytics, payroll and billing integration, and more. For 25 years, MITC has grown to serve over 1,500 organizations (with anywhere form 5 to 10,000 employees) in the USA, the UK, Africa, Australia, Canada, Ireland and New Zealand. They have selected MITC to help control costs, save time, improve productivity and ensure compliance. Visit to learn more. 4