Used Time Column

The Used Time column feature gives users the ability to adjust the treatment time for a patient in contrast with the time for which the patient was scheduled. For example, a patient may have been scheduled for 30 minutes, but actually received only 15 minutes of therapy. Or maybe she received 45 minutes instead of the scheduled 30 minutes. A typical example for which this feature was designed is in therapy clinics, which have stringent billing compliance requirements under Medicare. Used in conjunction with the scheduling compliance feature, the treatment time option helps users more accurately manage patient compliance.

To begin:

1. Click the Used Time field in the appropriate line item.



In multisegment appointments, each resource can be assigned their own treatment time so you must first expand the appointment to expose the resources.



Then click the right-facing arrow next to the appointment time (as illustrated above) to display the appointment details for each resource in the appointment. Each resource line item has its own Used Time data entry field (illustrated in the following screen shot).



2. Enter the actual treatment time and then press the Tab or Enter key to commit your change. (If you click out of the field, your change will not be saved.)

Keep in mind that if you schedule multisegment appointments, the entries are summed. So for example, if you have a 30-minute appointment with two resources and enter 30 minutes for each resource, the total treatment time will be 1 hour, not 30 minutes.

3. Repeat as necessary.

Treatment Time and Compliance

To determine a patient's compliance status, WellSky Resource Manager calculates the total treatment time for a given day based on the following criteria:

• Total Scheduled Time: The total time scheduled establishes the baseline for the calculation of whether a patient is in compliance. The baseline can then be adjusted either manually or through documentation.
• Manual Adjustments to the Appointment: As therapists treat the patient they can, if necessary, adjust the treatment time on the patient's appointment.
• Actual Treatment Time Charted: Additionally, in installations of WellSky Resource Manager that are integrated with MediLinks, the final actual treatment time will be determined by whatever is documented. This could be the same as what was scheduled or it could be adjusted up or down according to how the treatment progressed.

Consider the following example. Per CMS requirements, inpatient therapy patients must receive on average 3 hours of treatment a day. In the first column of the example, we see that Ms. Gnu B. Case has been scheduled for 2 hours and 45 minutes: She has an appointment with

• OT for 45-minutes
• PT for 60-minutes
• SLP for 60-minutes

The scheduled time falls short of the required average of 3:00 hours. However, the PT therapist was able to provide an additional 15 minutes of treatment, which is illustrated in the second column statistic and by the adjustment to the treatment time in the palette. So by adjusting the treatment time on the appointment, the patient is compliant for the day and the clinic will have a more accurate time to use for final billing.

In addition to the manual adjustment on the appointment (illustrated above), the actual treatment time can also be adjusted through the patient's documentation (this occurs with installations that are integrated with MediLinks). Once a therapist documents the actual treatment time and signs the chart, any variation in what was scheduled will be adjusted up or down as needed through the interface, which in turn will update compliance.

NOTE – See the Schedule Hours by Discipline topic for a discussion how the statistics can be used to help manage patients who need additional treatment time.

Regardless of how the time is adjusted, the following behavior will occur as time is adjusted. See the Schedule Compliance Statistic topic for additional information.

Increasing Treatment Time

When treatment time is adjusted so that it exceeds the scheduled appointment (or appointment segment length), the program will either

1. Automatically increase the duration of the appointment/segment to the treatment time if it is divisible by 5. For example, consider a resource who has a 15-minute appointment that actually required 20 minutes of treatment. When you adjust (or document in integrated versions) the treatment time to 20, the appointment will increase to 20 minutes.
NOTE – The resource will experience partially filled time slots if the treatment time is not divisible with the defined time slot for the resource.
2. Automatically increase the duration to the next time that is divisible by 5 minutes (the smallest increment used to define an appointment in WellSky Resource Manager). Using the previous 15-minute appointment as an example then, if the treatment time you enter is 27 minutes, the program will automatically round up to 30 minutes.
NOTE – WellSky Resource Manager does not perform conflict checking when appointments or appointment segments are increased because of treatment time, but if any conflicts occur because of a change to treatment time, they are displayed on the grid.

Reducing Treatment Time

A goal of therapy is to provide the required and necessary treatment that your patients need, but circumstances occur that prevent this. For example, the patient could be unable to continue treatment on a given day, or they could outright refuse treatment one day. When you adjust the treatment time to less than the scheduled time, WellSky Resource Manager prompts you to choose a reason from predefined set. Though this field is not required, you can use this mechanism to support your documentation in any review or audit of your treatment as to why a patient wasn't in compliance on a given day.

The reasons that are used for reduction in treatment time come from the Cancel/No-show Reason set. Applying one automatically becomes part of the workflow for entering a treatment time. For example,

1. Locate the appointment that requires a treatment time adjustment.
2. Enter the treatment time. As soon as you tab out of the field to commit a time that is less than the scheduled time, a screen similar to the following will appear.



3. Do one of the following:
• Click the Select button and choose the reason you did not provide full treatment: e.g., Patient refused treatment. Then click Yes to proceed.
• Click No to apply the treatment time without supporting reason.
• Click Cancel to abort the modification altogether: e.g., you realized you selected the wrong patient.

Appointments that have a reduced treatment time for which a reason was supplied display an Information icon. Simply hover over the icon to view the reason.

Keep in mind that if no reason is supplied, there are no visual indicators in the check-in grid. But you can view the appointment details or run the Treatment Time Differential report.

A similar workflow will occur when you enter the treatment time on the grid through the Options menu or palette.

Key Considerations

• Users must have the security right Edit Treatment Time (Appointment Operations) set to Full in order to make changes to time.
• Press the Tab or Enter key to commit changes to the Used Time field.
• If you enter treatment time without a colon, the time is calculated in minutes. If you include a colon, the format is assumed as hh:mm or hours and minutes. For example, enter 120 for 120 minutes or 2 hours; 1:30 for an hour and a half; :15 for 15 minutes.
• In that additional time is automatically scheduled whenever a treatment time exceeds the scheduled time, we suggest a workflow that routinely monitors overbooked appointments on the grid so that conflicts can be resolved according to your own business workflow.
• You cannot edit the treatment time of appointments that are in the future.

Related Topics