Care Codes in Ankota

Overview

Care codes in Ankota are used to make alterations in billing and payroll. These codes can be applied to visit types, individual visits, and clients.

Normally, these care codes are designed and assigned by an Ankota specialist. For organizations which wish to better understand or manage their own care codes, this article will break down the many options Ankota provides. Please note the examples in this article are assuming that units are in hours. If your units are in 15-minute intervals, your care codes would be designed differently.

This article includes the following sections on care codes:

For other billing and payroll options, you may wish to see:

Care Codes and Visit Types

Care codes are most often used on specific visit types. When these codes are applied to the visit type, they will alter the financial rules associated with this visit type.

For example, if an overtime care code is created and then applied to a Personal Care - IHS visit type, all caregivers working that Personal Care - IHS visit type will receive overtime after 40 hours. Typically, if a company pays overtime, overtime will be assigned to all visit types that bill by the unit (as opposed to billing by visit).

Overtime Care Code + Visit Type = Overtime Paid On This Visit Type

Most often, visit type care codes are created for the following situations:

Private Pay client billing upcharges for weekends, overnights, and/or holidays
Additional caregiver pay for weekends, overnights, and/or holidays
Caregiver overtime or double time
Limiting the maximum billable or payable time based on the authorization

For holiday care codes, holidays will need to be defined in Ankota in order for the special rates to be applied on the appropriate holidays. See Adding Calendar Holidays for more information about defining holidays in your system.

Care Codes and Individual Visits

(NOTE: This feature must be turned on by Ankota. If desired, please request this.) Care codes are usually placed on individual visits when you need to offer an incentive in order to get the visit covered.

For example, the client may live in a distant area, and their regular caregiver is unavailable. To help compensate the fill-in caregiver, you may offer a one-time $1/hour bonus and apply it to the individual visit type.

Bonus Care Code + Visit = Bonus Paid On This Specific Visit (One-Time)

Care Codes and Clients

Care codes are placed on client care code tabs for a variety of reasons. Some typical uses include:

A courtesy discount (typically assigned to grandfathered private pay clients)
An upcharge for clients due to challenging coverage options (for example, they are an hour away from your closest caregiver)
A pay bonus incentive for caregivers due to challenging circumstance (for example, to pass along the upcharge to the caregiver for the long drive)
Multi-client upcharges
Multi-client pay bonuses

For example, a private pay client may receive a courtesy discount of -$4/hour since they have been with you several years and still pay the old rates. You would create a discount care code and then apply it to the client. (Note this is listed as an upcharge, but the amount listed in the care code is negative, so it acts as a discount. The code is also labeled Discount to avoid confusion.)

Courtesy Discount Care Code + Client = Discount Applied to All Services for Client

Care Codes and Caregivers

Care codes are generally not used for caregivers. There is a different function for when a specific pay rate is needed for a single caregiver when working for a single client. See Assigned Caregiver Pay Rates function for more information on that option.

Creating a Care Code

To create a care code, you will take the following actions:

Click Settings
Click Organization Detail
Click the Billing Configuration tab
Click the Care Code subtab
Click Add New

Once you have opened the care code creation window, you will:

Define the care code name
Define the care code type (usually payable)
Select the charge type (varies)
If needed, check the box next to Do not apply care code when charge per visit
Select the timing
Select the amount
Select the days/times if needed
Apply a skill or duration if needed

Care code creation does require experience in the system. If you wish to build a new care code and are not completely sure of the best charge type or other options, reach out to an Ankota specialist for assistance.

Commonly Used Care Codes

Commonly used care codes include:

Upcharges to bills for certain time periods, such as holidays, weekends, or overnights
Shift differentials or overtime for certain time periods, such as holidays, weekends, or overnights
Hourly-based or visit-based pay bonuses for caregivers picking up unwanted shifts (applied by admin on visit-by-visit basis)
Auto-reason coding of 2nd address approval (primarily Georgia Medicaid clients at this time - 9134)
Travel pay adjustments
Maximum payable times
Using a bill or pay rate for specific durations
Sleep time
Exempting a visit from overtime
Discount hours creates TWO rates: this is usually used to create a higher initial rate and then a discounted rate after a certain number of hours
- Can also be used to create a higher secondary rate, although this is more rare
- Can be applied to a visit type or directly to a client

Reach out to Ankota support if you would like one of these configured.