Create Visits

Non-clinical visits in the system are classified as Non-Skilled, meaning only non-skilled disciplines can be assigned to them. Follow the steps below to create a non-skilled visit.

1. Go to the desired Patient and click the Calendar page on the Index.

2. Click the Date Number link at the top-right of the Calendar cell and select New non-skilled visit from the options.

   

3. The Non-Skilled Schedule window opens on the visit Schedule tab. Complete the required fields marked with a red asterisk.

   If a Caregiver is marked as Absent, has a Restriction for the select Contract, or is scheduled for an In Service on the date of the visit, the system issues a warning either requesting confirmation or stating that the selected Caregiver cannot be scheduled.

   

   The Visit Info and Bill Info tabs are used to review visit information after the visit has been completed and billed.

4. Click the Save button to schedule.

   Once saved, the system automatically performs a series of validation and authorization checks to ensure any Agency rules or contractual obligations are not breached. If a validation error is detected, then the system warns or restricts one from saving the visit.

5. Visits displayed in green are within Authorization parameters, while those in pink indicate an Authorization issue.

   

   The system only reviews visits in a 14-day block based on the current date. Visits outside of this range display in white.

Visits scheduled with a Service Code that is not covered by the Authorization, or setup to bypass Prebilling validations also display in white, even if within the 14-day block. Consult with an Administrator to discuss which Service Codes the Agency has authorized to skip Prebilling validations.

Skilled visits (Clinical) are those involving medical services and only skilled disciplines such as Nurses or Physical Therapists can be assigned to them. Follow the steps below to create a Skilled visit.

1. Go to the desired Patient and click the Calendar page on the Index.

2. Click the Date Number link at the top-right of the Calendar cell and select New skilled visit from the options.

   

3. The Skilled Schedule window opens on the Visit Schedule tab. Complete the required fields marked with a red asterisk.

   

4. Click the Save button to schedule.

   Once saved, the system automatically performs a series of validation and authorization checks to ensure any Agency rules or contractual obligations are not breached. If a validation error is detected, then the system warns or restricts one from saving the visit.

5. Visits displayed in green are within Authorization parameters, while those in pink indicate an Authorization issue.

   

   The system only reviews visits in a 14-day block based on the current date. visits outside of this range display in white.

The Patient Calendar includes reasons for Unauthorized visits displayed in pink. Hovering over the red Thumbs Down icon displays a pop-up message indicating the reason the visit is not Authorized.

The following table provides a list of Scenarios, the associated Unauthorized Visit Reason and a description for each.

Agencies may review and edit Authorizations automatically applied to Scheduled visits on the visit Bill Info tab.

The Authorization section of the Bill Info tab contains the following fields / functionality:

The Authorization functionality is available for both Primary and Secondary Contracts, allowing Agencies to split Authorization hours between the two:

The Authorization section of the Bill Info tab has several statuses depending on how the Authorization is applied to the visit, as well the Contract’s scheduling requirements, as follows:

Over or under applying Authorization Units to a visit results in a validation error. For example, if a single Authorization Unit is applied a to a visit scheduled for 2 hours, one is only authorizing a single hour of the visit. In the other hand, applying 3 Authorization Units to a 2-hour visit authorizes an hour of non-scheduled service.

The system does not allow for either scenario. If over or under Authorization Units are applied, the following validation messages display:

Users may choose to apply 0 Authorizations Units to a visit without triggering a validation error. Instead, the visit displays in pink, indicating that it is unauthorized and will be held on the Prebilling Review page. The system requests confirmation before saving a visit with 0 Authorization Units.

Authorizations applied to Visits may exist in two states: Automatic and Manual.

An Automatic state refers to a visit Authorization unedited or removed by a user. The Authorization/Units are automatically applied to the visit by the system at the time of scheduling. When a visit Authorization is in this state, the system automatically updates the Authorization information with respect to changes to the visit schedule.

A Manual state is when a user manually edits, removes, or adds Authorization information for either the Primary or Secondary Contract to a visit. In this case, the system does not automatically adjust the Authorization to fit changes to the visit schedule. More specifically, if the visit schedule duration is extended or the Service Code is changed, the system automatically reduces the Authorization Units to 0. The visit subsequently turns pink on the Patient Calendar signifying that there is an Authorization issue.

The system reduces the number of applied Units in a Manual state if a visit is rescheduled with a shorter duration.

This logic also applies when the Authorization is edited on the Patient Authorization page. The system reassesses visits in an Automatic state to ensure they are still compliant, whereas visits in a Manual state are automatically reduced to 0 Units.

If the Service Code selected for the Primary Contract is set to bypass Prebilling validation, or the Primary Contract does not require an Authorization, the visit Authorization section for both the Primary and Secondary Contract is set to Authorization Not Required.

When invoicing a visit with more than one Authorization applied to the Primary Contract and/or Secondary Contract, the system applies the first Authorization for each to the invoice. For example, in the following image, Auth 1 for Primary Contract and Auth 3 for the Secondary Contract would be applied to the invoice for this visit.

Any visits associated with an Authorization that have been billed or exported cannot be deleted. If a user attempts to delete an authorization where visits have been billed or exported, the system displays the following message: This Authorization has already been applied to billed visits and cannot be deleted.

With the Copy and Create tool apply new visits to the Calendar in either of the following ways:

• Select Copy to duplicate visit information to a ‘clipboard’. Once copied, apply the visit information to other dates.

• Select Copy and Create to copy the visit information and open a new window to apply the information to other dates and also edit the visit information.

The following tables provide step-by-step instructions on how to use the Copy and Create tool.

Copy a Visit

1. From the Patient’s Calendar page, click the Copy and Create icon on the right side of the Calendar day cell. Click Copy. The system informs that the visit details have been copied to the clipboard.

   

2. Once copied, click the date number link in the desired Calendar day cell. Select Paste visit information from the options.

   

3. Upon selecting, the visit details from the first shift are copied to the selected date. The visit details may be applied to multiple dates, as desired.

   

   Even if a copied visit is authorized, pasting the visit information on a day that is not covered by the Authorization results in an Unauthorized visit - displays in pink.

Copy and Create Multiple Visits

1. From the Patient’s Calendar page, click the Copy and Create icon on the right side of the Calendar day cell. Click Copy and Create. The system informs that the visit details have been copied to the clipboard.

   

2. The Copy and Create Multiple Visits page opens. Select the checkboxes in the right column to copy the visit information to multiple days. Visit information may also be edited for each day it is applied to.

   

3. Once the visit information has been applied to the selected days, scroll down and click the Save button. Refresh the webpage to see the updated Calendar.

If a Patient receives the same service on a regular basis, the Master Week function is used to generate a permanent schedule. Once set, the system uses the information in the Master Week to update the Patient’s Calendar every night for 14 days into the future in a process known as roll over. Any changes to the Master Week are reflected in future visit when it rolls over again.

Note that if a Master Week schedule results in a Caregiver surpassing the Agencies set overtime threshold, the Master Week only needs to be validated once. The system does not inform/require users to validate the Caregiver’s overtime in the future.