Compensation Program

The Compensation Program manages provider payments by calculating revenue share, bonuses, and invoices based on documented clinical activity and configured compensation rules configured in the Admin Settings. Invoices are generated automatically, ensuring accurate and transparent reimbursement tracking.

Invoice Generation and Period Structure

Provider invoices are generated automatically once a progress note is submitted and meets active compensation criteria.

Calculations are based on three components:

• Visit Complexity Bonuses

• Urgent visits, covering another provider, outside service area coverage, and visits without an assistant.

• Procedure Based Bonuses

• Skin Graft, Ultrasound Therapy, ABI, and any additional configured procedures.

• Provider Compensation Parameters

• Invoice Frequency (once or twice per month) and Revenue Share percentage applied to collected claim revenue.

Note : All calculations are derived from documented activity and active compensation settings.

Compensation Program Structure

The program consists of two main tabs: Bonuses and Provider Compensation.

For reporting and analytical purposes, bonus and compensation data are organized by payment periods based on the selected invoice frequency. This period based structure provides a consolidated financial view for each payment cycle.

Bonuses Tab

The Bonuses tab provides an aggregated view of total bonus amounts across all providers for each pay period. Data aligns with the invoice frequency selected in Compensation Program settings.

• Bonuses - Periods Tab

Provides a period based summary of total bonus amounts by provider and payment cycle. This view allows administrators to evaluate total bonus exposure prior to invoice approval and payout. Manual bonuses not tied to a visit or procedure may also be added.

• Bonuses - Visits Tab

Displays bonus activity generated from documented visits and procedures within each payment cycle. This view allows detailed review of how individual bonuses contribute to period totals.

Note : Administrators can filter by specific pay periods to review total bonus amounts for designated dates of service.

Provider Compensation Tab

The Provider Compensation tab displays summarized financial data by pay period for all configured provider invoices. Using period based views, administrators can analyze compensation by cycle, review totals across visits, bonuses, and collected revenue, and compare provider performance across periods.

Provider Compensation - Periods Tab

Provides a consolidated financial summary of compensation activity across all providers for each payment cycle, including collected revenue, revenue share liability, and total bonuses.

• Column Definitions

  • Period: Displays the date range for the payment cycle.

    • Invoice Count: Displays three color coded counts reflecting invoice status

      • Yellow indicates In Progress and pending review.

      • Green indicates Approved and ready for reimbursement.

      • Blue indicates Paid.

• Collected Revenue: Displays total collected revenue by all providers for the selected period.

• PRS: Displays Provider Revenue Share percentage currently active.

• Compensation: Displays the total revenue share amount for all providers that is expected to be reimbursed for the selected period.

• Bonuses: Displays the total bonus amount for all providers that is expected to be reimbursed for the selected period.

Provider Compensation - Invoices Tab

Contains provider specific invoices by pay period and serves as the primary location for invoice review, verification, and status management.

• Column Definitions

  • Period: Displays the date range for the payment cycle.

  • Provider: Displays the provider that is associated with the invoice

  • Invoice No.: Displays the invoice number associated with the pay period

  • Visit Count: Displays the total number of scheduled visits with submitted progress notes. Ensure all scheduled visits have submitted progress notes before changing invoice status.

  • Collected Revenue: Displays total collected revenue by a provider for the selected period.

  • PRS: Displays Provider Revenue Share percentage currently active.

  • Compensation: Displays the total revenue share amount expected to be reimbursed for the selected period.

  • Bonuses: Displays the total bonus amount expected to be reimbursed for the selected period. Bonus percentages can be adjusted on each invoice to align with the applicable provider compensation structure.

  • Total: Displays the total amount expected to be reimbursed to the provider for the selected period.

Reviewing Invoices

Navigate to the Provider Compensation - Invoices section. Click the arrow icon next to an invoice number to open a detailed line by line breakdown of revenue share and bonus calculations.

Updating Invoice Status

Navigate to the Provider Compensation - Invoices section. Click the provider name within a period to open the status panel. Select one of the following statuses: In Progress, Approved, or Paid.

Bulk Updating Invoice Statuses

Navigate to the Provider Compensation - Invoices section. Under the Period column, select the checkboxes for the invoices requiring a status update. Select applicable invoices using the checkboxes. Click the red Update Status for Selected button and confirm the new status.

Compensation Program Settings

Located in Admin Settings under the Compensation Program tab and accessible only to Administrators.

This section defines default compensation rules, including visit complexity bonuses, procedure based bonuses, invoice frequency, and provider revenue share percentage.

Changes take effect on the first day of the following month and are recorded in system change history.