KOGSY Clinical, our work on post-discharge follow-up workflows, is at kogsycare.com

KOGSYMethodThe model

How the documentation figure is calculated

The whole model, in the open. It is arithmetic on figures you supply plus one assumption we name. There is nothing else in it.

01 · In words

The formula in words

Multiply your caregivers by shifts per caregiver per week by working weeks per year to get shifts per year. Multiply that by your average shift length to get billable hours, and by your bill rate to get annual billings.

Take your minutes per shift note, divide by sixty, and multiply by shifts per year. That is documentation hours. Multiply those hours by the hourly rate of whoever actually writes the note — the office rate if admin staff do it, the caregiver rate in either case where the caregiver does — and that is your documentation cost.

The modelled reduction is a range. The low end always assumes half the documentation time is removed. The high end uses the assumption you select on screen, which starts at 80%.

Exposure is annual billings multiplied by your estimated discrepancy rate. It is not a loss figure. See the limits section below.

02 · As code

The formula as code

shiftsPerYear     = caregivers × shiftsPerWeek × weeksPerYear
billableHours     = shiftsPerYear × shiftHours
annualBillings    = billableHours × billRate
marginPerHour     = billRate − caregiverRate
annualGrossMargin = billableHours × marginPerHour
docHours          = shiftsPerYear × (minutesPerNote ÷ 60)
docRate           = noteAuthor is office ? adminRate : caregiverRate
docCost           = docHours × docRate
savingsLow        = docCost × 0.50
savingsHigh       = docCost × reductionHigh
exposure          = annualBillings × discrepancyMidpoint
perPointBillings  = annualBillings × 0.01

Nothing is rounded at any intermediate step. Rounding happens only when a figure is displayed.

03 · Worked example

A worked example

An agency with 50 caregivers, each working 3 shifts a week averaging 12 hours, across 50 working weeks. Billing at 35 an hour, paying caregivers 24 and office staff 25. Fifteen minutes per shift note, written by office staff. Discrepancy estimated at 2 to 5 in 100 shifts. Assumption left at 80%.

Every figure here matches the calculator's own assertions.
ValueResult
Shifts per year7,500
Billable hours per year90,000
Annual billings$3,150,000
Gross margin per hour$11
Annual gross margin$990,000
Documentation hours per year1,875
Documentation cost per year$46,875
Modelled reduction, low end (50%)$23,438
Modelled reduction, high end (80%)$37,500
Billing exposure at 2 to 5 in 100$78,750

04 · The assumption

The one assumption

The high end of the modelled reduction assumes voice capture removes 80% of documentation time.

This is our working assumption and it is not measured. We could not find a measured figure published by anyone in home care, and we have not published one either. That search is written up in full. The calculator states this on screen and lets you move it to 50% or 65% instead, and recalculates live.

The low end is fixed at 50% regardless of what you select, which is why the range collapses to a single figure when you set the assumption to 50%.

We could not find a measured figure to use instead, from anyone. That search is now written up: are there any measured results from AI in non-medical home care? It publishes every query, the eight candidates that came closest, and our own commercial interest in the answer.

05 · The bands

The discrepancy bands

You pick a band; the calculator uses a single rate for it.

BandRate used
I do not know, we do not track thisnone
Less than 1 in 100 shifts0.5%
1 to 2 in 1001.5%
2 to 5 in 1002.5%
5 to 10 in 1007.5%
More than 10 in 10012%

One of these needs flagging rather than hiding. The 2 to 5 in 100 band uses 2.5%, which is the conservative end of its own range rather than its arithmetic midpoint of 3.5%. That understates the exposure figure by roughly a third for anyone in that band. We would rather the number be too small than too large, but the label and the rate do disagree, and this is under review.

Choosing "I do not know" produces no exposure figure at all. Instead the calculator shows what a single point of discrepancy is worth on your volume — annual billings multiplied by one per cent — so you get a sense of scale without guessing a rate you do not have. On the worked example above that is $31,500 for every 1 in 100 shifts.

06 · The limits

What this model deliberately does not do

The limits matter more than the arithmetic.

  • It does not apply a recovery rate to the exposure figure. We could multiply it by some percentage and call the result recoverable revenue. We do not, because we have not measured what proportion is recoverable and neither has anyone else. Exposure runs both ways: under-billing costs you revenue, over-billing is a compliance problem.
  • It does not model anything about your workforce. No claim about recruitment, hiring or how long people stay. There is no evidence for such a claim and we are not going to imply one.
  • It does not measure anything. Every output is arithmetic on figures you typed in plus the one stated assumption. If you enter a wrong number you will get a confident wrong answer.
  • It does not produce a cash figure when the caregiver writes notes unpaid. In that case the agency has no cash cost, and saying otherwise would be false. What it has instead is a dependency on unpaid work, and the calculator says exactly that.

07 · Try it

Try it on your own figures

The calculator takes about a minute. It asks for nothing before it shows you the result.

Open the calculator

08 · Questions

Questions we get asked

How much time do caregivers spend on shift notes?

We do not know, and neither does anyone we could find a published figure from. The calculator asks you for your own estimate in minutes per shift and multiplies it out. On a roster of 50 caregivers working 3 shifts a week of 12 hours across 50 working weeks, 15 minutes per shift note is 1,875 hours a year.

How do you calculate what documentation costs a home care agency?

Shifts per year is caregivers multiplied by shifts per caregiver per week multiplied by working weeks per year. Documentation hours is shifts per year multiplied by minutes per note divided by 60. Documentation cost is those hours multiplied by the hourly rate of whoever writes the note: the office rate if admin staff write it, otherwise the caregiver rate.

What is a home care billing discrepancy rate?

The proportion of shifts where the logged record and the invoice disagree: under-billed hours, over-billed hours, shifts logged twice, shifts never logged. The calculator multiplies your estimated rate by annual billings to give an exposure figure. It runs both ways and is not a loss figure.