Clinical Operations & Service Delivery answers the question: Are services being delivered as authorized and planned?
Ensuring services are delivered as authorized is essential for compliance, quality care, and maximizing reimbursement. This section helps you track whether your team is meeting supervision requirements, scheduling authorized hours appropriately, and identifying clients who may need plan adjustments to stay on track.
Table of Contents:
- What percentage of authorized hours are actually delivered?
- Which clients are underutilizing or overutilizing authorization?
- Are RBT supervision requirements being met consistently?
- What percentage of authorized hours are/were scheduled?
What percentage of authorized hours are actually delivered?
This metric reveals whether you're maximizing the reimbursement potential of your approved authorizations and delivering the recommended level of care to your clients. Low utilization rates may indicate scheduling inefficiencies, staffing gaps, or client attendance issues that prevent you from delivering services you're authorized to provide, ultimately impacting both revenue and client outcomes.
Reports Used: Authorizations report > Auth Utilization
Helpful Filters:
- Set the date range you want to see (e.g., last month, last week)
How to Read the Report:
- View the % Auth Utilization tile at the top
- Filter by facilities/people for more granular information
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Which clients are underutilizing or overutilizing authorization?
Identifying clients who consistently under or over-utilize their authorized hours allows you to address barriers to care, adjust treatment intensity, or proactively request authorization changes that align with actual clinical need. Under-utilization may signal attendance issues or access barriers that require intervention, while over-utilization could indicate the need for an authorization increase or potential compliance concerns if services exceed approved limits.
Reports Used: Authorizations report > Auth Utilization
Helpful Filters:
- Set the date range you want to see (e.g., last month, last week)
How to Read the Report:
- View the “Which Clients have the Highest/Lowest Utilization?” visual
- Sort by clicking on the column names
- Look at the % Auth Utilization column
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Are RBT supervision requirements being met consistently?
Meeting RBT supervision requirements is a critical compliance mandate that directly impacts your ability to bill for services and maintain payer contracts and accreditation. Failure to provide adequate supervision can result in claim denials, audit findings, regulatory sanctions, and compromised quality of care, making proactive monitoring essential to avoid costly compliance gaps.
Reports Used: RBT Supervision
Helpful Filters:
- Set your desired date range
How to Read the Report:
- Look ahead for planning purposes, as long as schedules have been entered
- Look at the previous month to see where BTs fell short
- Look at the previous week to plan for the remaining weeks in a month
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What percentage of authorized hours are/were scheduled?
This metric identifies whether your scheduling processes and capacity are keeping pace with authorizations, revealing operational bottlenecks before sessions are even attempted. A low percentage indicates you're not getting authorized hours onto the calendar due to staffing constraints, scheduling conflicts, or client availability issues, which is a different problem than cancellations and requires different solutions like hiring, schedule optimization, or client engagement.
Reports Used: Authorizations report > Auth Utilization
Helpful Filters:
- Set the desired date range
How to Read the Report:
- Compare the Scheduled hours to the Auth hours in the “Auth to Billable Funnel” visual
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