Date: Thu, 28 Mar 2024 21:47:02 +0000 (UTC)
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Auto Approval
What is Auto Approv=
al?
Auto approval is a system process that runs daily to compare entries sub=
mitted against the rules of the system.
After an entry is submitted, it will initially be in a pending status an=
d can still be edited by providers. (Providers cannot edit entries in an ap=
proved or processed status.) Once the auto approval runs, it will approve e=
ntries that follow the rules which allows for these entries to be paid.
How to Determine Available Balance for a Provider
There are multiple options for how you can determine what the Available =
Balance is for a provider. Available Balance means the number of hours from=
the provider=E2=80=99s total authorized hours available to claim.
This differs from Remaining Balance because Remaining Balance does not c=
onsider entries that are in a pending status. This means Remaining Balance =
minus entries in a pending status (called Pre-Authorization holds) equals t=
he Available Balance.
Example:
Authorized Hours (Initial Balance) |
20 hours |
Pending Hours (Pre-Authorization Holds) =
td>
| 2 hours |
Approved and Processed Hours |
5 hours |
Remaining Balance |
20 =E2=80=93 5 =3D 15 hours |
Available Balance |
15 =E2=80=93 2 =3D 13 hours |
Option One: Client Total Hours Per Week Widget
Client Total Hours Per Week widget on the dashboard can be used to deter=
mine the Available Balance. To do so:
- Search for the consumer by name.
- Add the Weekly Total for the provider in question for the two-week pay =
period.
- Compare this to the authorized hours. To do this, add the total hours f=
or each week together to get the total hours claimed for the pay period. Th=
en subtract this from the authorized hours. This will tell you the Availabl=
e Balance.
Option T=
wo: Authorizations Widget
The Authorizations Widget on the dashboard tells you the following:
- Start and End Date of the pay period
- Initial Balance: the number of authorized hours/miles
- Remaining Balance: the number of hours/miles not in an approved or proc=
essed status
- Pre-Authorization Holds: the number of hours/miles in a pending status<=
/li>
- Current Available Balance: the number of hours the provider has left to=
claim (calculated as Remaining Balance minus Pre-Authorization Holds)
To use the Authorizations Widget:
- After you log into the web portal, you will be on the home page or dash=
board. Scroll down to see Authorizations in the middle of the page. This is=
called the Authorizations Widget.
- Begin typing the consumer=E2=80=99s name in the Type Client Name field.=
After 3 or more characters are typed, a drop-down list will appear. Select=
the consumer=E2=80=99s name from the drop-down.
- Select the Date of Service field. From the calendar, select a date with=
in the pay period in question. For example, if the provider wants to know w=
hat their Available Balance is for the current pay period, enter today=E2=
=80=99s date.
- Select Search.
- All authorizations for this consumer and pay period will appear. Identi=
fy the service code associated with the provider in question to find the co=
rrect authorization.
- Identify the Current Available Balance for the specific authorization o=
f interest.
Option Thr=
ee: Authorization Tab
You can also use the authorization tab if you have the Authorization Per=
mission. On this tab, you can calculate the Available Balance. You can calc=
ulate available balance as Remaining Balance minus Pre-Authorization Holds.=
For example, using the screenshot to the right, the available balance is=
0.50 =E2=80=93 0.25 =3D 0.25 hours. 0.25 hours equals 15 minutes per the <=
a href=3D"https://dciconfluenceprod.dcisoftware.com/display/ORPD/Time+Conve=
rsion+Chart+-+Minutes+to+Decimal+Hours" rel=3D"nofollow">Time Conversion Ch=
art.
O=
ption Four: Authorization Entries Report
The Authorization Entries Report will show you the Available Balance. To=
find and read the Authorization Entries Report:
- Select the Reports tab.
- Hover over Authorization Reports, then select Authorization Entries Rep=
ort.
- Enter the consumer=E2=80=99s name.
- Check Include Ended Authorizations.
- Select Search.
- On the report, identify the authorization in question (identified by th=
e Authorization ID Reference, Authorization ID Reference 1, and start and e=
nd dates). Once you identify the appropriate row, scroll over to find the A=
vailable column. This will show the Available Balance.
Convert=
ing Decimal Hours to Minutes
Use this chart to convert hours to minutes. To view the chart online, go=
to https://dcico=
nfluenceprod.dcisoftware.com/display/ORPD/Time+Conversion+Chart+-+Minutes+t=
o+Decimal+Hours.
Correcting an =
Entry Mistake
- When it is identified that a mistake has been made on an entry, or if a=
consumer or consumer employer representative disputes an entry, it should =
be corrected by the provider.
- If the entry is already in an approved or processed status, it will be =
canceled by a staff member with the Supervisor Role for the provider to cre=
ate a new historical entry.
The path to correcting the error can go a variety of ways depending upon=
the situation. We will look at each path and what a staff member=E2=80=99s=
role will be within the process.
Note: If the consumer or con=
sumer employer representative is disputing the entry, the case manager will=
contact the consumer or consumer employer representative to resolve the di=
spute. |
Corre=
cting Paid Versus Unpaid Entries
If an entry has been paid, you will need to follow the business process =
4.4.0 Over and Underpaym=
ents, which includes making an adjustment to the entry in OR PTC DCI.=
p>
- Time entry adjustments in OR PTC DCI are covered in Adjustments.
- The paperwork and payment adjustment process in Mainframe will remain t=
he same.
If an entry has not been paid, there are several ways the entry can be c=
orrected. See business process 2.2.3 Correct Entry Mistake for more information.
Process for Ed=
iting an Entry
The following paths are a simplified display of the appropriate pa=
th based on the status of the entry and whether the entry was made u=
sing the landline method.
How to Verify an Ent=
ry
If a staff member edits or creates an entry, the entry will be created i=
n an unverified status. The staff member must have another staff member wit=
h a Supervisor Role over the consumer=E2=80=99s cost center verify this ent=
ry. The system will not notify another staff member to do this. Entries cre=
ated or edited by staff must be verified. Entries that remain in an unverif=
ied status will not be pulled into a batch and will not be paid. The same s=
taff member who created/edited the entry cannot also verify it.
- On the Punch Detail screen for the specific entry in question, scroll t=
o Status.
- You will see it display Unverified in red. Select Verify.
Your office may choose to run a Punch Entry Details Report filtered on u=
nverified entries to ensure all entries are verified. Instructions for pull=
ing this report can be found in the Repo=
rts Guide.
Entry Edits
Staff can also edit entries in a pending status. You can do this from ei=
ther the consumer or provider=E2=80=99s profile.
- To find the entry that needs to be edited, navigate to either the consu=
mer or provider=E2=80=99s profile. Scroll down to see the Entries tab. Use =
the filters to help you find the entry in question. Once identified, select=
the entry to see the Punch Detail screen.
- From the Punch Detail screen, Select Actions.
- Select Edit Entry.
- Make the necessary changes.
- Select the blue plus sign next to Reason. After selecting, it will chan=
ge to a minus sign and the Add Reason Codes field will appear.
- Select Reason Code: State-Other from the drop-down list. Staff must sel=
ect this reason.
- Add Note to explain the reason for the edit. Note: Whe=
n making edits, it is important to add a note that explains why you are mak=
ing the edit and that you have validated the information with the provider.=
- Select the larger blue plus sign to save the Reason Code and note to th=
e entry. The reason code will not save if you do not select the larger blue=
plus sign, meaning your entry will not save. Step 9 shows how to verify th=
e reason code was saved properly.
- Added Reason Codes displays the reason and note. If you need to remove =
a Reason Code, select the minus sign next to it. If you do not see a Reason=
Code here, you did not successfully add one.
- From the Statements field, select the check box next to the attestation=
, to specify the time is correct to the best of your knowledge.
- Select Save.
- When the Alert appears, select Yes.
The original entry will be rejected, and a new entry will be added.
The new entry will be in an unverified status until verified by a separa=
te staff member or the provider.
Adjustments
The Agency uses the term adjustment to refer to modifications and cancel=
lations to entries after they have been paid through Mainframe (DHR). In OR=
PTC DCI, the term adjustment will refer to any modifications or cancellati=
ons on entries in an approved or processed status.
Note: Providers cannot adjus=
t their own entries that have a status of approved, processed, or paid.&nbs=
p; |
Who can adjust entries in an approved status?
- Staff users with a Supervisor role.
- You will only be able to adjust entries under your Cost Center. Fo=
r example, if Suzy has the Supervisor role over Cost Center A, Suzy will on=
ly be able to adjust entries in Cost Center A.
To make an adjustment (meaning it is in an approved or processed=
status) to a provider=E2=80=99s time entry:
- Select the Employees tab.
- Enter the provider=E2=80=99s name and/or Uni ID into the search criteri=
a. Note: The Uni ID is not the same as a provider number.<=
/li>
- Select Search.
- Select the correct provider from the results to go to their Employee De=
tails page.
- Select Entries Tab located after provider demographics.
- Enter search criteria to find the entry you need to edit. For example: =
enter a start and end date, select Approved or Processed in the status filt=
er (whichever status the entry needing adjusting is in), or enter a client =
name.
- Select Search to display entries matching your search criteria.
- Select the entry that needs to be adjusted. This will take you to the P=
unch Detail page.
- From the Punch Detail page, select Actions.
- Select Edit Entry.
- Make the necessary adjustment(s).
- Select the blue plus sign next to Reason.
- Select State-Other =E2=80=93 StateO from the Add Reason Codes drop-down=
list.
- In the Add Note field, explain why you are adjusting the entry.
- Select the larger blue plus sign to add the reason code.
- The Reason Code will show in the Added Reason Codes section. If you nee=
d to remove a Reason Code, select the minus sign next to it. If you don=E2=
=80=99t see a Reason Code here, you did not successfully add one. You will =
need to repeat the same steps to add a reason code.
- Select Save.
- When the Alert appears, select Yes.
- The original entry will be flagged as Compensated.
- An entry for the negative amount of the original will be created and au=
tomatically approved. This negative entry is called a Compensating entry.=
li>
- A new entry will be created; this new entry will reflect the adjustment=
s made. The new entry will have a status of Pending.
Working Ove=
r and Under Payments
For the full business process, see 4.4.0 Over and Underpayments.
Identifying Over and Under Payments Caused by Staff
Once it has been determined there was a staff related entry erro=
r:
- The voucher specialist updates OR PTC DCI with the correct hours and an=
explanation as to why an update is made and if OR PTC DCI is inaccurate.=
li>
- Another staff member verifies the punch entry if OR PTC DCI was updated=
.
- The voucher specialist adjusts, deletes, or adds shift(s) in the Mainfr=
ame to correct the time.
Note: From here, follow loca=
l office procedures for completing forms for under or overpayments. Central=
office staff will follow the current procedure for resolving the issue. |
Identifying Provider/Consumer Over and Under Payments
Once it has been determined there was a provider/consumer relate=
d entry error:
- For Overpayment:
- The voucher specialist updates the approved punch entry with the correc=
t time and includes an explanation for why the update was made.
- The voucher specialist adjusts STIM data entries and deletes or adds sh=
ift(s) in the Mainframe to correct the time.
- For Underpayment:
- The provider creates a historical punch entry for the unpaid time.
- The voucher specialist adjusts STIM data entries and deletes or adds sh=
ift(s) in the Mainframe to correct the time.
Note: From here, follow loca=
l office procedures for completing forms for under or overpayments. Central=
office staff will follow the current procedure for resolving the issue. |
Historical Entries
Entries that are entered via the web portal without valid fob codes or l=
andline entries for previous days and times are called historical entries. =
These entries are not EVV compliant.
Historical entries may be needed if a provider forgot to clock-in/out or=
could not clock-in/out for a variety of reasons.
Who can enter historical entries?
- Staff with the Supervisor role
- Note that staff will only be able to add historical entries for consume=
rs in cost centers they have a role over. For example, if Suzy only has the=
Supervisor role over Cost Center A, Suzy will only be able to create histo=
rical entries in Cost Center A. Staff may have roles over more than one cos=
t center. In these instances, the staff may create historical entries for c=
onsumers in each cost center they have a role over.
- Providers can retroactively make historical entries themselves.
Note: There are no reasons f=
or staff to make entries on a provider=E2=80=99s behalf. It is the provider=
=E2=80=99s responsibility to enter their time accurately, including correct=
ions and historical entries. |
How to Add a H=
istorical Entry
As a staff member, to add a historical entry:
- Select the Employees tab.
- Enter the provider=E2=80=99s name and/or Uni ID in the search criteria.=
- Select Search.
- Select the provider in the search results that you want to add an entry=
for.
- From the Employee Details page, select Actions.
- Select New Entry from the drop-down menu.
- Select Account Type as Hourly or Client Transportation.
- Enter the consumer=E2=80=99s name in the Client field.
- Select the proper Service Code. There will likely only be one option. T=
here may be more than one option if the provider/consumer pairing worked to=
gether under a different program previously.
- Enter the Service Date.
- Enter Check In as the time the provider started working.
- Enter Check Out as the time the provider stopped working.
- Select Portal Signoff as the EVV Method.
- Select the blue plus sign next to Reason.
- Select the Reason Code State-Other - StateO from the drop-down list.
- Add a note in the Add Note field to explain why you are creating the en=
try. As part of this note, also add that the time is accurate to the best o=
f your knowledge based on the information provided by the provider.
- Select the blue plus sign to add the reason code.
- The Added Reason Codes field shows the reason and note. If it does not =
appear, return to step 15. If you need to change it, select the blue minus =
sign next to the reason code to remove it and then return to step 15.
- From the Statements field, select the checkbox next to the attestation =
statement confirming the time is correct. This must be checked to save the =
entry and this is why the addition of the time being correct to the best of=
your knowledge to the reason code note is important.
- Select Save.
- When the Alert appears, select Yes.
The new entry will be in an unverified status until verified by the staf=
f or the provider.
Related articles
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