When providing a short-term billable service it is important that you use the number of provided hours to provide the level of care needed to your clients. The number of approved billable hours is decided from your company’s assessment of the client, their diagnosis(es), and the level of support and care already in place for the clients. MCOs pay attention to the number of hours billed, they want to ensure that their policyholders are getting the best level of care while enrolled in your short-term services.

Diagnosis:  Lack of Employee Buy-In is what this company faced. The majority of the company’s direct support staff were part-timer’s. Their level of investment was not the same as the full-time employees. This job was not their primary source of income so they were not as empowered to pursue clients for sessions. This resulted in clients not being properly serviced as deemed appropriate by their assessment, service authorization, and individualized service plan. Additionally, this caused a loss in profit for the company.

Solution: We created an innovative approach for this company called Bridge the Gap. The organization was at a standstill because of three things; as we dug deeper into this problem. Billing was not maximized, full-time employees were needed, and the company was part-time heavy. Bridge the Gap had three goals: maximize hours, hire ten new employees, and continue community connection. In order to maximize hours it was important to reestablish communication with the employees about the importance of billing for the targeted number of hours each week. They needed to understand it was not about increasing their workload, but it was more about ensuring our clients had continuity of care. The employees were introduced to an incentive program, wherein there received a stipend per client they maximized. There was also an internal morale booster where teams were formed and the team with the highest number of hours each month received accolades in front of the entire company. Next we implemented an employee referral bonus that was paid out over a 90 day period. The first allotment was received after 30 days then it followed to 60 day and finally 90 days. The last goal was to implement virtual events and videos. Due to the COVID-19 pandemic, it was not possible to have public community events so we made the events virtual. This was a 30-day campaign that included a virtual day party, self-care videos, Netflix parties, and weekly Quarantine + Cope sessions.

Results: The hour maximization plan was a major success. Productivity doubled as the first numbers changed from an average of 15 of 47 clients being maxed out weekly to 34 out of 46  being maxed out weekly. The highest team productivity rate was 94 percent with the lowest at 77.6 percent. 13 out of 19 eligible employees maximized their hours during this reporting period.