Holiday and Weekend Code Updates
Numerous states require Providers to pay higher rates to staff who work during holidays or weekend schedules. To accommodate this need, the system allows Providers to apply different Codes for the various pay types.
A Holiday Template can be added to the existing Holiday/Weekend Codes Reference Table under Admin > Reference Table Management > Holiday/Weekend Codes. Click the Add button to add a new template.
The Add Holiday Template window opens. Enter a new Template Name. Under the Holiday Name, New Year’s Day with Jan 1 is the date provided as the default value when creating a new Holiday Template. On this screen one can Add a Holiday, Edit or Delete any existing holiday by clicking the respective links.
On the Edit Holiday window, specify a Holiday Name and Holiday Date. Click OK to add the edited holiday to the Holiday Template. Click Save. Upon saving, the new Holiday Template appears in the Holiday/Weekend Codes Reference Table.
A template becomes independent once a Service Code is assigned. New changes on the Service Code Template do not reflect on the Holiday Template Reference Table, and vice versa.
In conjunction with the Weekend/Holiday Rates checkbox is the Apply the Weekend/Holiday Codes to Weekday checkbox. This checkbox is only visible when the Weekend/Holiday Codes checkbox is selected and overrides the Weekday Codes on Weekdays that fall on a Holiday, based on the Holiday Table set in the Reference Table Management.
A View/Edit Holidays link on the Contract Service Code window on the lower-right corner provides a Holiday List based on the Contract setup. This link is only available if the Weekend/Holiday Codes checkbox is selected. Refer to the Contract Holiday Template section for further details.
The Authorization functionality is aligned with the Service Code functionality as described in the Apply the Weekend/Holiday Codes to Weekday Option allowing Providers to apply weekend/holiday authorizations to holidays that fall on a weekday. On the Contract level under Admin > Contract Search > Billing Rates, when the Apply the Holiday Codes to Weekday checkbox is selected in the Contract Service Code window, the applicable Holiday Service Code can be applied to a Visit if it happens to fall on a weekday.
This is also reflected in the Bill Info tab in the Visit Details window .
Click the View/Edit Holidays link on the Contract Service Code window only visible if a Non-Linked Contract is selected, along with the selected Weekend/Holiday Codes checkbox to open the Contract Holiday Template window allows one to assign a Holiday Template to the selected Contract.
The Add and Edit functions work the same as what is covered in the Managing Holiday/Weekend Codes section.
On the Contract Holiday Template window, one can add, edit, or delete holidays at a Contract level. By default, the Holiday Template US Federal Holidays is selected with the defined Holiday List underneath managed via the Reference Table Management function.
Applying changes to the selected Holiday Template, repopulates the applicable Holiday List defined at the Provider level.
The Holiday Template dropdown shows only active templates, except when an assigned template for the selected Contract is changed to Inactive. The Inactive template is included in the selection dropdown listed as Template Name (Inactive).
Saving the selected Template assigns it to the selected Contract in the Service Code page, and the Holiday List is saved for the Contract in the database.
In the US, the following holidays are federal holidays:
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New Year's Day
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Martin Luther King Day
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President's Day
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Memorial Day
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Independence Day
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Labor Day
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Columbus Day
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Veteran's Day
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Thanksgiving Day
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Christmas Day
Click here to view further details on these federal holidays. To accommodate Agency calendars, these holidays are pre-populated at the Agency level using the US Federal Holiday template. This template is a 10-holiday template which populates every year accordingly. Agencies can modify their calendars as needed via the Reference Table Management function in the Holiday/Weekend Codes table (Fiscal section).
The US Federal Holiday template is selected by default. When selected as the default template on a Contract level, then the holidays are copied at a Contract level; hence, the template remains unchanged. If the template is rolled over and if the Federal template is selected at a Contract level, then the new holidays are added at Contract level as well.
The process to rollover holidays for the following year run on the 25th of Dec of every year.
This applies only to Agencies who are using the Banked Hours functionality.
When checking for authorization availability before allocating banked hours, authorization is checked against the Contract Holiday List and the applicable Service Code when Apply the Holiday Codes to Weekdays is selected.
For example, suppose there are 45 banked minutes and the Apply when Bank Reaches field is set to 60. A visit is created on a Friday which is added in Contract Holiday List and the applicable Service Code applies when the Apply the Holiday Codes to Weekdays option is selected; adding 15 minutes to the bank to complete the hour. In this case, the system checks if the authorization available for Friday is at least 1 hour greater than scheduled time.
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If the Authorization Type is set to Weekend, then the banked hour is applied.
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If the Authorization Type is set to Weekday, then the system does not apply the banked hour to the Friday visit, even if the weekly authorization has sufficient hours.
The same applies if the authorization is set with a Daily Period.
A Holiday/Weekend Codes Reference Table in the Reference Table Management list provides Holiday templates which can be edited as necessary.
To edit a Holiday template, select the Template Name link to open the Edit Holiday Template window. The Template Name populates at the top followed by the Status of the template. The Holidays are listed by Holiday Name, Date, and the options to Edit or Delete links. From this window, one can rename the Template, adjust the Status (Active/Inactive), and add, edit, or delete Holidays from the template.
To add a Holiday, click the Add Holiday link to open the Add Holiday window. Enter the Holiday Name and enter/select the Holiday Date. Click the OK button to apply to the template.
To edit a Holiday, click the Edit link for the corresponding holiday to open the Edit Holiday window. Edit the Holiday Name or the existing Holiday Date. Click the OK button to apply to the template.
The system does not allow duplicate Holiday Dates or Holidays that do not fall within the current year.
Three years of Holidays for the previous, current, and following year can be seen. When viewing the Holiday List History, the Edit and Delete options are only enabled for the current year; disabled for the previous and following year holidays.
On the Patient Authorization page Patient > Authorizations, The Weekend/Holiday radio button accommodates authorization for holidays which fall on a weekday. Select the Specific Date Type checkbox to enable the Weekday and Weekday/Holiday radio buttons. Selecting the Weekend/Holiday radio button opens all weekdays to allow adjustments. This selection automatically applies specified holiday service codes for visits (worked hours) on a weekday.
All changes made for a Patient Authorization are also reflected in the Visit-> Appointments-> View Authorizations screen.
Weekend/Holiday Codes are set via the Reference Table Management function under Admin > Reference Table Management > Contract Service Code. The Contract Service Code table has various components to include two checkboxes titled Weekend/Holiday Codes and Apply the Holiday Code to Weekday.
On the Contract Service Code window, a Code Configuration section is used to apply applicable Codes to respective fields, including: Export Code, Revenue Code, Taxonomy Code, HCPCS Code, and the GL Code. Selecting a Contract in the Contract field populates any existing Codes.
When the Weekend/Holiday Codes checkbox is selected, the current set of codes becomes two columns of codes, allowing Providers to define the Codes for Weekday separate from Weekend/Holiday.
This checkbox is unselected by default; therefore, must be selected to display the Weekend/Holiday column.
If the Weekend/Holiday Codes checkbox is unchecked, only a Code column is available indicating that differentiation between Weekday Codes, and Codes used for Weekend/Holiday is not applicable.
The Yearly Job Update performed every year on December 25, updates the holiday schedule for the coming year based on the Federal Holiday Template. The system is set to also update and adjust authorizations based on the Service Code settings which have the Apply Holiday Codes to Weekday selected.