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Day 1 as a Clinician / Supervisor

Outcome

By the end of your first day, you have taken attendance for a group session, requested an authorization, and verified eligibility for a member. The billing side will pick up from there — your job is to make sure the data the billing team sees is right.

You are responsible for

  • Group session attendance — recording who was present, late, or absent in the room or right after.
  • Bulk-entering charges for sessions that don't run through an EVV or EHR integration.
  • Requesting authorizations before services start, and renewing them before they expire.
  • Verifying eligibility before a visit, especially for members new to your facility.
  • Documenting per-diem stays with admit / discharge / leaves of absence.

You are not responsible for claim build, denials, or remittance posting — that's the billing clerk's job. But the cleaner the data you submit, the less the billing team has to chase you for clarifications.

Your first day

  1. Sign in and find your members. Open /members and filter by facility. Skim the list; click any member to see the detail page tabs. See 6.1 — Member detail walkthrough.

  2. Take attendance for a group session. Open /group-sessions, find today's session, click in. Mark each participant as ATTENDED, LATE, or ABSENT. Watch the billing preview as you go — issues appear live. See 3.1 — Group session attendance.

  3. Request an authorization. Open the member, click + New authorization. Pick payer + program + service code + units + effective window. Submit. The platform fires a 278 (or queues for manual submission per the program's workflow). See 3.3 — Manage authorizations.

  4. Verify a member's eligibility. Open /eligibility, pick a member, click Submit 270. Read the 271 response panel — confirm the plan is active for today. See 3.4 — Eligibility.

  5. (If applicable) walk a per-diem stay. If your service line includes residential / inpatient services, open a stay's encounter detail and review the Institutional context tab. See 3.5 — Per-diem & institutional billing.

Things to watch for

WatchWhy
SUPERVISION_RATIO_BREACH warning during group sessionIf you can't bring in a second supervisor, the session may not bill at full rate.
Auth required flag on a chargeA service requires an authorization that doesn't yet exist; create it before services start.
Auth nearing exhaustion notificationRenew before the auth runs out, not after.
Eligibility 271 says member is termedStop services or confirm with the member; do not deliver care that won't be reimbursed.

Working with the billing team

Common requests they will send your way:

Their askYour response
"Need a clarifying clinical note for an appeal"Open the member's Documents tab and upload. The note becomes visible on the appeal packet.
"Auth missing — can you backfill?"Some payers permit retroactive auth submission; some don't. Check the program config or ask your tenant admin.
"Late check-out / EVV exception — what happened?"Open /evv/exceptions/:id and add a Communication note explaining what you remember; the exceptions worker uses it to triage.
"Wrong member on a session"Edit attendance with Force update if charges are already locked; document the reason.

Common Day-1 mistakes (avoid them)

MistakeBetter way
Marking everyone ATTENDED then leaving the pageMark ABSENT / LATE accurately — billing depends on it.
Submitting a charge before the auth is on fileThe scrubber will catch it later, but the round-trip wastes time; create the auth first.
Voiding a stay because of a single LOA misclassificationEdit the LOA on the existing stay; voiding loses the audit trail.
Assuming eligibility verified yesterday is still goodCoverage churn is real for Medicaid populations; re-verify before each visit if uncertain.

Your daily rhythm

  • Start of session / shift: take attendance live; verify eligibility for any members you haven't seen this month.
  • After session: confirm bulk-entry charges if you handle them yourself.
  • End of day: review outstanding authorizations on /authorizations; renew any due in the next 7 days.

Where to next