Simply put, the Authorization List CANNOT be trusted.
We have the option in the company setup, on the Scheduling tab, Scheduling option set to: Alert the scheduler and prevent scheduling outside of authorizations.
Units are allocated to each month from the Notice of Authorization (NOA).
We schedule all of the units possible each month for each client as long as the hours do not exceed what is on the NOA.
When one of the scheduled visits runs over the scheduled time, for example, nothing indicates that the client is now over-scheduled for this example month. In fact, sometimes the Authorization for the example month will now show available units that can be used.
The only way to know the truth of the situation is to manually add up the worked hours and scheduled hours and determine if the schedule is still on track or over.
Who else has had this issue with scheduling and authorizations?
Who else uses the option: Alert the scheduler and prevent scheduling outside of authorizations.?
Does anyone experience any of this with the alternative option: Warn the scheduler, and provide an option to continue scheduling tasks outside of authorization parameters.?
Are there any ideas on how this can be fixed or prevented? (keep in mind, that there are many acceptable reasons why a visit may run over the scheduled time, and that the scheduler cannot be expected to manually check every client, every month.)
I will check with our authorization person tomorrow but I don't think we have had problems with the auth not calculating correctly. But we don't use work hours. Most of our authorization is per visit. But we are not a fan of the scheduling. Simply put I don't think you can trust many of the reports.
Thank you for your input. I feel like we are in similar situations with Axxess. I pray they can get it together soon.
Thank you again @Annlyn Purdon
How long have you been with axxess?
We started getting everything setup with Axxess in January 2020, then fully moved from our previous software on February 01, 2020. It both feels like longer than that, but also doesn't seem that long ago.
There have been many improvements through this time. The biggest improvement has been the uptime reliability. When the Axxess system was completely down, all we could do was call and complain. This Community discussion page didn't exist, there were just tickets and the support phone number to turn to for help with issues. When everything was down, the ticket system would not work either.
We are a long way past that now. I am so glad that Axxess has corrected whatever the issue was that caused the downtime. That leads to the next issue that has still never been considered an issue. Axxess does not believe in communicating any details, timeline, ETA, cause, resolution or even acknowledgement of issues or downtime that happens.
All of the reputable software out there have done away with these ancient thoughts. It has now gained these software companies higher respect to show to their customers that issues happen and it is real life. There are commonly publicly available logs to show if there are any ongoing issues or when their last downtime was (with at least the cause, resolution and preventative measures of the issue).
All of this to say in the 2 1/2+ years our agency has been with Axxess, there has been growth and improvements. However, there is still a lot of room for improvements. Growth is slow when the majority of a software company's resources are focused on adding more features instead of resolving existing issues and optimizing the existing system for higher efficiency.
I did double check with our authorization lady. We use date range and authorized units and she has not had any problem with it letting people go over.
Thanks for the reply. Since we are only 4 months in and still have a lot to learn some of our issues are on us but I can say they don't give a new client enough time and resources to master this program. So we are just struggling to make it through ever day.
Hello Terrance,
I know what you are talking about. I recently lost a biller and now have to do it myself and keep all records in Axxess, so in order to create the claim I had alot of mishaps with the authorziation. I can help with this issue but it is way to much to type out. If you would like to reach out I am in MN in office from 8;30am to 5pm Central time. there are a few things to help the authorzations be right and I learned a few tricks to update the authorzations numbers with out manual adding. I too agree that they have lots of room for improvments, I have about 6 enhancement tickets placed over the past couple years but, none have been added as of yet. I really do like alot of things about Axxess, just a few tweeks could make it awesome. I can be reached at 651-665-9795 option 3
That would be very helpful @Christina. You can send me an email and we can exchange contact information.
I greatly appreciate the offer to help and know what you mean by too much typin.
Thank you again!
@Terrance next week is good for me as well. I look forward to talking with you. I have learned so much about Axxess on my own without the help of them. Hopefully we can all help each other. Quick question did you recently have an increase in your monthly charge?
i feel your pains....................
@Christina I didn't hear from you last week. I noticed you had spelt my name wrong and wondered if you had sent a PM to the wrong name? My name is spelt Terrence, there is no letter a in it.
It was a very busy week for our agency, and my other guess is that your agency also had a lot going on. Reach out to me if you still want to discuss things. I am almost always here.
Thank you
@Annlyn Purdon Hello, I was curious on how your agency uses the Authorizations without any incidents of going over the units permitted by the authorization? When your scheduler(s) schedule an authorization period, are any clients scheduled for all available units permitted in an authorization period? For any client that this is true, what does your agency do when an aide works over the scheduled time for any of the visits in the authorization period? Have you seen the effects on the Axxess authorizations when this occurs? If yes, what steps is your agency taking to prevent additional units being worked for a client that is scheduled already to the maximum permitted?
I'm sorry if this is a bother, I just wanted to see if there was something that I am potentially missing here. I feel like I understand the mechanics of this Axxess system well, but there are many methods to completing some tasks.
My current understanding of the authorization system leads me to believe there is some component(s) to it that is(are) broken.
Any of your thoughts or comments are very welcome.
Thank you
No bother at all. I think the difference is that we don't do units. For all of our payers a visit is a visit regardless if it is 15 mins or one and a half hours. We might have to report the units on the claim but it does not change what we get paid. We just enter the authorization as a number of visits for whatever timeframe the authorization is for and so far it has worked. If the visit is not authorized and that payer is setup to require authorization than it will not let the aide open the visit forcing them to call in (to our authorization person) to review why there is no authorization.
I don't do authorization or scheduling but if you would like to call me at 606-564-9481 Ext. 1117 I will get you to our authorization person who can go over what she does. If you want to schedule a time you can email me at annlynp@hayswood.com
Hope this helps.
With your agency is this billing with Medicare or Medicaid? We only bill with Medicaid. Our DON told me there is a big difference between how each of them bill.
Thank you for your help.
We do both Medicare and Kentucky Medicaid.
We do only Indiana Medicaid.
Thank you for the reply back.
Hello all, we are fairly new with Axxess. We did our onboarding in April and have found many good things about Axxess, but also some bad. We had a problem that started in May and just got resolved in the last week. Now one of my clinicians is having issues with her skilled notes populating and no resolution as of today. If anyone had this problem and knows how to solve it, please let me know.
Fast forward regarding the auths. We receive authorizations from the patient's insurer, however, it does not indicate the units only the hours per week. Can anyone tell me how to figure out the units? I am unable to complete the auth without this information. Someone had mentioned their auths were per visit. I too need training with authorizations if Christina or someone else has the time to assist me. Thank you in advance.
Hello @Patricia
Its nice to meet you. Regarding the clinician and skilled notes, there are a lot of elements to consider and verify for the Skilled Care Plan to be applied properly to the Skilled Care Notes. I would check the following;
Company Setup > Document Management: confirm that the Skilled Care Plan and Skilled Care Notes are properly are properly defined.
Company Setup > Custom Care Documentation (yours may be slightly different location) > Care Plan/Note Associations: confirm that the Skilled Care Plan and Skilled Care Notes are properly associated.
Client - Schedule Center > Care Period > List Care Periods: Confirm the care period is correct and that the Skilled Care Plan and Skilled Care Notes are not in different Care Periods.
Confirm that the following are completed and correctly define the care period; OASIS D1 (soon E) Start of Care (or Recertification) and Plan of Care.
I hope that helps.
About the authorizations, when adding the authorizations to the client (Client Center > View > Authorizations Listing > Add Authorization) define the unit type to: Per Hour and the Frequency of Units to: Week. The rest will depend on the authorization start & end date, payment source and task(s) that are defined on the authorization letter.
I hope that helps this also.
Terrence, nice to meet you as well. Thank you for reaching out to me. I will definitely check the company setup as you suggested. Would it have anything to do with her permissions? I will keep you posted. Thanks again for sharing your knowledge. It is appreciated.
Hi Terrence, okay I checked one of the clinician's patients and noticed tasks not completed: transfer and recert, but visits are done. Would this block the skilled notes from populating? The terminology may be different at your agency. We do not have a "Skilled Care Plan", Skilled Care Notes", or any type of "Note" association. The care periods are listed.
What do you select for "Unit Type?"
Thank you.
Hello @Patricia
TO answer your question about permissions. YES, and Yes again. Permissions have a lot to do with how certain parts of the system work. I have found that some permissions control components that are completely unrelated to their respective permission name and category.
It would be challenging to define all of the current permission I know and how they work. Most of the ones for nursing are going to be under the Clinical, Clerical and Administration. The more important thing to check is the System Roles. Make sure that you only select one system role. If there are multiple system roles selected, I have seen many times that Axxess will apply the Most Restrictive system role to the user.
This took a lot of trial and error to discover. All of our management fulfill multiple roles in the Agency and we had to determine the best option for each of them within Axxess.
The Skilled Care Plans, Skilled Care Notes and Note associations are all defined in the company setup on the Document Management tab. For one of our Agencies we also use the Custom Service Documentation option from the Clinical tab in Company Setup.
If Care Plan and Note associations are not defined in Document Management & Custom Care Documentation > Care Plan/Note Associations within Company Setup, that could be a big part of the current issue.
From here, it gets pretty deep into the system and how it all works together.
Let me know if any of this helps. I will be back in the office on Friday.
There are still no updates from Axxess on this issue. How many agencies are encountering this issue? Did you have a work around? Does any Agency use the Authorizations in units and have a different result as the issue described above?
Any feedback could benefit the progress of a fix for this issue.
Thank you
I am not getting any responses/help from Axxess. I stayed late at work last night trying to resolve the issue.
Have you put in a ticket for your experiences with the Authorization List? I was told by Axxess that the more tickets that are submitted on an issue, the more priority the issue will get. I have had the ticket I placed on this issue in since 08/31/2022. This is not the oldest ticket I still have open though..
As a community, we all need to voice our need for these issues to be corrected. The strongest communication Axxess has is the form of tickets.
@Alex,
What issue with Authorizations and the Authorization List has your agency experienced? Do you have any work arounds? Have you opened a tick on the issue? What are your thoughts on how the issue I have described above could be corrected and work as expected?
Thank you
UPDATE 01/05/2022
I am told that this issue has been resolved. I have been unable to test this yet. Has any other agency that experienced this issue been able to confirm if the issue is resolved? What testing methods have you used? Any comments or details would be greatly appreciated. I will also post another update with my further testing.
Thank you all,
Have a Blessed New Year!!