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What share of shifts get billed differently to how they were scheduled?

Most agencies cannot answer this, and that is the most common answer we get. Both records already exist, so unlike most things on this site it is a straight count rather than an estimate. Take one month, compare every scheduled shift against what was invoiced, and classify each disagreement. The method is below and it needs no software.

01 · Why

Why you probably do not know

The schedule lives in one place and the invoice is produced in another. That is true whether the second place is a billing system, a spreadsheet or somebody's memory on a Friday afternoon. Almost nothing in a standard agency stack automatically compares the two and reports the difference, because each system is built to be correct about its own half.

So discrepancies are found one at a time, when a client queries a bill or a caregiver queries a payslip. Found that way, each one looks like an isolated administrative annoyance rather than a rate.

02 · The method

How to work it out for your agency

Take one complete month. For every shift, put the scheduled record next to the invoiced record and sort each disagreement into one of five buckets:

  • Under-billed. Hours worked that were not invoiced.
  • Over-billed. Hours invoiced that were not worked.
  • Recorded twice. The same shift invoiced more than once.
  • Never recorded. A shift that happened and appears nowhere.
  • Corrected after the fact. Found and fixed already, which still cost somebody time.
discrepancy rate = shifts with any disagreement ÷ total shifts in the month
exposure         = annual billings × discrepancy rate

Agree three rules before you start, or your number will not be comparable to anything, including your own next month. How do you treat a corrected invoice? How do you treat a cancelled shift? How many minutes of difference counts as a disagreement rather than a rounding?

03 · The figure

What a typical figure looks like

We cannot tell you, and we are wary of anyone who can. We have not measured it across enough agencies to have a distribution, and we have not found one published.

We can tell you what the number means once you have it. It is exposure, not loss. It runs in both directions: under-billing costs you revenue, over-billing is a compliance problem, and the two do not cancel out just because they might net to a small figure. We do not model a recovery figure, because we have not measured what proportion of a discrepancy is actually recoverable and neither has anyone else.

04 · The limits

What this is not

This is not electronic visit verification and it does not cross-check it. It compares what was scheduled against what was invoiced. It cannot tell you whether the caregiver was physically present when they said they were, and if that is your question this count does not answer it.

It is also not a fraud finding. The overwhelming majority of what this exercise surfaces is ordinary administrative drift.

05 · Next

Next

The calculator will show you what one percentage point of discrepancy is worth against your billings, which is usually the number that decides whether a month of counting is worth it.

Not sure this is your biggest one? Rank all eight against your own numbers — fourteen questions, no score, and it asks for nothing before showing you the result.

All eight costs →