Virginia: Complexities of Back-to-Back/Contiguous Visits

Overview

Scheduling back-to-back (also referred to as contiguous) visits is a simple process in Ankota. To ensure two back-to-back visits flow from one visit into the next:

• Schedule two visits of different visit types (for example, Personal Care and Respite)
• Assign the two visits to the same caregiver and client
• Schedule the two visits without a time gap in the middle (end time of first visit = start time of second visit)

Both visits must be scheduled before the caregiver clocks into the first visit. If the second visit is added after the caregiver has clocked into the first visit, the two visits will not be treated as one visit. In that case, the caregiver must clock out of the first visit and into the second new visit.

See the initial article on back-to-back visits for general guidance. The sections below cover additional complexities specific to Virginia.

This article includes:

• Longer Second Visits & Automatic Closure of Unbillable/Unpayable Visits
• DMAS90 Functionality
• On Hold Caregiver Closure of Contiguous Visits

Longer Second Visits & Automatic Closure of Unbillable/Unpayable Visits

In Virginia, it is more common to pay caregivers only up to the scheduled length of a visit. This means that typically, Respite "safety net" visits must be scheduled longer so that if they are needed, the caregiver will be paid appropriately. If these Respite visits are not used, that will be correctly reflected.

Example A — Unbilled Second Visit (unused second visit)

• SCHEDULED: Personal Care 8:00 a.m. to 9:00 a.m. + Respite 9:00 a.m. to 11:00 a.m. (3 hours total duration)
• ACTUAL: 7:55 a.m. to 8:45 a.m. (50 minutes duration)
• BILLED/PAID: Personal Care = billed and paid 50 minutes (rounded if your company rounds); Respite = not billed, not paid

Example B — Billed Second Visit (appropriate billing of both visits)

• SCHEDULED: Personal Care 8:00 a.m. to 9:00 a.m. + Respite 9:00 a.m. to 11:00 a.m. (3 hours total duration)
• ACTUAL: 7:55 a.m. to 9:55 a.m. (2 hours duration)
• BILLED/PAID: Personal Care = billed and paid 1 hour; Respite = billed and paid 1 hour

DMAS90 Functionality

For Virginia organizations, contiguous visits for Personal Care and Respite will show on the DMAS90 in their separate visit type pages. For any care plan items to show on the Respite page, those care plan items must be added during the telephony or mobile app reporting process. See the Virginia Respite reporting article for more, and the general DMAS forms article for more on DMAS forms in Ankota.

If back-to-back Personal Care and Respite visits are scheduled according to the rules above, Personal Care and Respite will naturally separate out in the DMAS90 to separate pages.

Respite takes a few minutes after closure to reflect the adjusted Respite times. Allow the Ankota system time to run the update before expecting to see the visits correctly reflected on the calendar or on the DMAS90. Five minutes is usually sufficient.

On Hold Caregiver Closure of Contiguous Visits

Contiguous visits that are returned to caregivers as On Hold visits (see the On Hold manual caregiver closure feature documentation for details) allow users to report their times in a single visit.

The On Hold visit will also indicate that the entry is for a contiguous block of 2 or more visits (for example, a combination of an 8–4 Personal Care and a 4–6 Respite).

Based on the reported duration, the minutes and care plan items will be correctly divided.