Department of Health Care Services Physician and Non-Physician Practitioners

11SPA 05-023 Time StudySPA 05-023 Time Study

DepartmentDepartment of Health Care of Health Care Services Services

Physician and Non-Physician Physician and Non-Physician PractitionersPractitioners

Time Study TrainingTime Study Training

20082008

SPA 05-023 Time StudySPA 05-023 Time Study 22

Table of ContentsTable of Contents• DHCS GoalsDHCS Goals• Medi-Cal Waiver and State Plan Medi-Cal Waiver and State Plan

AmendmentsAmendments• Time Study OverviewTime Study Overview• Purpose of the Time StudyPurpose of the Time Study• Claiming Time on the Time Study FormClaiming Time on the Time Study Form• How to Time Study for Best ResultsHow to Time Study for Best Results• Secondary DocumentationSecondary Documentation• Sample of Time Study SheetSample of Time Study Sheet• Best PracticesBest Practices


DHCS Goals for this DHCS Goals for this trainingtraining

Today’s presentation will help you:Today’s presentation will help you:

• Understand the purpose for implementing Understand the purpose for implementing this time study.this time study.

• Successfully complete the Time Study for Successfully complete the Time Study for Physician and Non-Physician Practitioners.Physician and Non-Physician Practitioners.

• Stress the importance of the Time Study.Stress the importance of the Time Study.• Record time accurately.Record time accurately.• Maintain a good audit file to minimize the Maintain a good audit file to minimize the

risk of audit disallowances.risk of audit disallowances.


Please ask questions as we move through the presentation, if you need clarification.


1115 Medi-Cal Waiver 1115 Medi-Cal Waiver (Demonstration)(Demonstration)

• CMS approved 1115 Medi-Cal waiver CMS approved 1115 Medi-Cal waiver August 31, 2005, which is effective August 31, 2005, which is effective September 1, 2005, through August 31, September 1, 2005, through August 31, 2010 for 23 Designated Public Hospitals 2010 for 23 Designated Public Hospitals (DPHs).(DPHs).

• Senate Bill (SB) 1100 (Stats 2005, ch.560), Senate Bill (SB) 1100 (Stats 2005, ch.560), commencing with Article 5.2 of Chapter 7, commencing with Article 5.2 of Chapter 7, Division 9 of the Welfare and Institution Division 9 of the Welfare and Institution (W&I) Code, was enacted to provide the (W&I) Code, was enacted to provide the statutory framework for the “Medi-Cal statutory framework for the “Medi-Cal Hospital / Uninsured Care Demonstration Hospital / Uninsured Care Demonstration Act (Demonstration).Act (Demonstration).


State Plan Amendments State Plan Amendments (SPAs)(SPAs)• State Plan Amendment 05-021, established State Plan Amendment 05-021, established

Certified Public Expenditures as a basis for Certified Public Expenditures as a basis for reimbursement for the DPHs. Prior to 05-021, reimbursement for the DPHs. Prior to 05-021, DPHs were paid a CMAC negotiated rate.DPHs were paid a CMAC negotiated rate.

• State Plan Amendment 05-022, established State Plan Amendment 05-022, established an increase in Medi-Cal payments amounts, an increase in Medi-Cal payments amounts, and and the manner in which Medi-Cal payments for acute inpatient hospital services take into account the situation of hospitals which serve a disproportionate number of low-income patients with special needs--Disproportionate Share Hospitals Fund (DSH).


State Plan Amendment 05-State Plan Amendment 05-023023

• State Plan Amendment 05-023, State Plan Amendment 05-023, approved by Centers for Medicare and approved by Centers for Medicare and Medicaid Services, on December 21, Medicaid Services, on December 21, 2007, provided for the reimbursement 2007, provided for the reimbursement of uncompensated physician and non-of uncompensated physician and non-physician practitioner professional physician practitioner professional services costs for the DPHs for services costs for the DPHs for Medicaid (Medi-Cal) and uninsured Medicaid (Medi-Cal) and uninsured care. care.


Time Study Overview Time Study Overview The BasicsThe Basics

• Physician and Non-Physician practitioners must time Physician and Non-Physician practitioners must time study for study for one week each quarter*one week each quarter*. .

• Uncompensated (unreimbursed) allowable Uncompensated (unreimbursed) allowable professional services component reimbursable under professional services component reimbursable under SPA 05-023 and the Demonstration (1115 federal SPA 05-023 and the Demonstration (1115 federal Waiver).Waiver).

• Those Physicians working at a Non-UC hospital who Those Physicians working at a Non-UC hospital who currently complete a Medicare approved time study currently complete a Medicare approved time study for the purpose of reporting and identifying costs for for the purpose of reporting and identifying costs for reimbursement on the Medi-Cal 2552 cost report reimbursement on the Medi-Cal 2552 cost report do do not neednot need to complete this time study. to complete this time study.


The Basics - ContinuedThe Basics - Continued

• An An appropriateappropriate claiming mechanism claiming mechanism must be used to accurately capture must be used to accurately capture the time spent for professional and the time spent for professional and provider services that may receive provider services that may receive payment under the Demonstration.payment under the Demonstration.

• Time Study is the primary Time Study is the primary mechanism to capture and allocate mechanism to capture and allocate time spent for services among time spent for services among professional, provider, and non-professional, provider, and non-allowable components.allowable components.


The Basics – ContinuedThe Basics – Continued

• The Time Study form must reflect all of the The Time Study form must reflect all of the direct, administrative and teaching, and direct, administrative and teaching, and non-billable activities performed by non-billable activities performed by physician and non-physician practitioners physician and non-physician practitioners approved for claiming under SPA 05-023.approved for claiming under SPA 05-023.

• The Time Study form is considered a legal The Time Study form is considered a legal document which verifies the actual time document which verifies the actual time spent performing the activities used to claim spent performing the activities used to claim payment for uncompensated professional payment for uncompensated professional services costs.services costs.


The Basics – ContinuedThe Basics – Continued

• The Time Study identifies direct The Time Study identifies direct patient care services, hospital patient care services, hospital administration and teaching services, administration and teaching services, and other non-billable services and other non-billable services activities and ensures that those costs activities and ensures that those costs can be properly allocated to programs.can be properly allocated to programs.

• Time study codes distinguish each Time study codes distinguish each activity a physician or non-physician is activity a physician or non-physician is engaged in during a Time Study week.engaged in during a Time Study week.


The Purpose of the Time The Purpose of the Time StudyStudy

What is the purpose of the Time Study?What is the purpose of the Time Study?• To identify time spent on the performance of To identify time spent on the performance of

provider, professional, and non reimbursable provider, professional, and non reimbursable activities.activities.

• For UC physician and non-physician practitioners For UC physician and non-physician practitioners this may be referred and identified as clinical and this may be referred and identified as clinical and non-clinical time.non-clinical time.

• Results are used to calculate and determine the Results are used to calculate and determine the amount that a Designated Public Hospital may amount that a Designated Public Hospital may claim under the Demonstration.claim under the Demonstration.

• To ensure appropriate claiming.To ensure appropriate claiming.• It is a Federal requirementIt is a Federal requirement..


Who Must Time StudyWho Must Time Study

Which employees should time study?Which employees should time study?•All physicians working in settings All physicians working in settings

for the University of California for the University of California hospitals that have the status as a hospitals that have the status as a Designated Public Hospital.Designated Public Hospital.

•All non-physician practitioners All non-physician practitioners working in settings for the working in settings for the University of California hospitals University of California hospitals that have the status as a that have the status as a Designated Public Hospital.Designated Public Hospital.


Who Must Time Study -Who Must Time Study -ContinuedContinued

• All physicians working in settings for All physicians working in settings for the Non-University of California the Non-University of California hospitals that have the status as a hospitals that have the status as a Designated Public Hospital.Designated Public Hospital.

• All non-physician practitioners working All non-physician practitioners working in settings for the Non-University of in settings for the Non-University of California hospitals that have the California hospitals that have the status as a Designated Public Hospital.status as a Designated Public Hospital.


Who Must Time Study –Who Must Time Study –ContinuedContinued

•This time study will also be This time study will also be performed by those physician and performed by those physician and non-physician practitioners non-physician practitioners providing services at governmental providing services at governmental operated entities and their operated entities and their affiliated government-operated affiliated government-operated physician practice groups that are physician practice groups that are affiliated with a Designated Public affiliated with a Designated Public Hospital.Hospital.


Who May Not Be Required Who May Not Be Required To Complete This Time To Complete This Time

StudyStudy• Those Physicians working at a Non-Those Physicians working at a Non-

UC hospital who currently complete a UC hospital who currently complete a Medicare approved time study for Medicare approved time study for the purpose of the hospital reporting the purpose of the hospital reporting and identifying costs for and identifying costs for reimbursement on the Medi-Cal 2552 reimbursement on the Medi-Cal 2552 cost report do not need to complete cost report do not need to complete this time study.this time study.


Who May Not Be Required Who May Not Be Required To Complete This Time To Complete This Time

Study –ContinuedStudy –Continued• Those Physicians and non-physician Those Physicians and non-physician

practitioners who are under a contract practitioners who are under a contract that is specific for services that must be that is specific for services that must be provided do not need to complete this provided do not need to complete this time study.time study.

• Those non-physician practitioners for Those non-physician practitioners for whom a separate bill is not completed or whom a separate bill is not completed or for whom charges are not established do for whom charges are not established do not need to complete this time study.not need to complete this time study.


*Exception / Explanation of *Exception / Explanation of “One Week”“One Week”

• A one-week time study typically means A one-week time study typically means studying five consecutive paid work days studying five consecutive paid work days (skipping unpaid work days), starting on a (skipping unpaid work days), starting on a randomly selected day in a quarter. randomly selected day in a quarter.

• Should a work interruption occur during the Should a work interruption occur during the course of the time study (such as a natural course of the time study (such as a natural disaster), which prevents the participants from disaster), which prevents the participants from completing the time study for completing the time study for five five consecutive paid work daysconsecutive paid work days, the time study , the time study will resume on the first feasible paid work day will resume on the first feasible paid work day and continue thereafter until the consecutive and continue thereafter until the consecutive five paid work days requirement is met. five paid work days requirement is met.


Exception / Explanation of Exception / Explanation of “One Week” - Continued“One Week” - Continued

• Example:Example:– In a randomly selected time study week of In a randomly selected time study week of

Monday through Friday, a time study was Monday through Friday, a time study was conducted on Monday and Tuesday of that week. conducted on Monday and Tuesday of that week. A disaster occurred on Wednesday through the A disaster occurred on Wednesday through the rest of that week, two consecutive days would rest of that week, two consecutive days would have been time studied for that week. have been time studied for that week.

• The time study The time study shouldshould resume from the next feasible paid resume from the next feasible paid work day for work day for three consecutive daysthree consecutive days to meet the five to meet the five consecutive paid work days’ requirement. If another event consecutive paid work days’ requirement. If another event causes a stoppage or results in an interruption/break in causes a stoppage or results in an interruption/break in between the remaining consecutive days, the remaining between the remaining consecutive days, the remaining time study would start from the next feasible paid work time study would start from the next feasible paid work day until the five consecutive paid work days are day until the five consecutive paid work days are completed. completed.

• In this case, the only break(s) of the required five In this case, the only break(s) of the required five consecutive paid work week would be the disaster days. consecutive paid work week would be the disaster days.


Approved Time Study Approved Time Study FormatsFormats

•UC Physician Time Study Report UC Physician Time Study Report

•Non-Physician Practitioner Time Non-Physician Practitioner Time Study - UC Study - UC

•Non-Physician Practitioner Time Non-Physician Practitioner Time Study – Non-UCStudy – Non-UC


Required TrainingRequired Training• All physicians and non-physicians who All physicians and non-physicians who

time study MUST participate in time time study MUST participate in time study training annuallystudy training annually

• Annual time study training cannot be Annual time study training cannot be claimed during any time study week. claimed during any time study week.

• Physicians and non-physician who are Physicians and non-physician who are filling out a time study form for the filling out a time study form for the first time must attend training before first time must attend training before time study week.time study week.


Requirements Regarding Requirements Regarding the Approved Time Studythe Approved Time Study

The time study must include a list of The time study must include a list of activities performed and must include activities performed and must include time study activity/object codes to time study activity/object codes to capture all the activities performed by capture all the activities performed by the physician and non-physician the physician and non-physician practitioners.practitioners.

The time study must account for The time study must account for 100%100% of the physician and non-physician of the physician and non-physician practitioner’s time.practitioner’s time.


Requirements Regarding Requirements Regarding the Time Study - Continuedthe Time Study - Continued

Each code must provide a specific Each code must provide a specific description to indicate the type of activity description to indicate the type of activity performed for proper allocation to the performed for proper allocation to the provider and professional components.provider and professional components.

Results of the time study will be used as a Results of the time study will be used as a basis for claims for unreimbursed basis for claims for unreimbursed physician and non-physician practitioner physician and non-physician practitioner costs applicable for period starting July 1, costs applicable for period starting July 1, 2005.2005.


Time Study Activities Time Study Activities Which Must Be CapturedWhich Must Be Captured1)1) Direct Patient Care Services Direct Patient Care Services 2)2) Hospital Administration and Hospital Administration and

Teaching ServicesTeaching Services3)3)Other Non-Billable ActivitiesOther Non-Billable Activities

Note: For some hospitals, these Note: For some hospitals, these services may be referred to as services may be referred to as clinical and non-clinical activities.clinical and non-clinical activities.


Activity Codes Specific to Activity Codes Specific to PhysiciansPhysicians

• The Physician time study includes The Physician time study includes expanded activity codes for Hospital expanded activity codes for Hospital Administration and Teaching Services Administration and Teaching Services to include time spent for supervision to include time spent for supervision and teaching of Intern and Residents and teaching of Intern and Residents and Allied Health Professionals.and Allied Health Professionals.

• Non-physician practitioners Non-physician practitioners may notmay not charge to these Activity Codes.charge to these Activity Codes.


Please Refer to Your Hard Please Refer to Your Hard copy and Sample Time copy and Sample Time

Study FormStudy Form


Direct Patient Care Direct Patient Care (Professional Services)(Professional Services)


Activity / Object Code Activity / Object Code 00001: Direct Patient Care 00001: Direct Patient Care ServicesServices Direct patient care is the care which Direct patient care is the care which

is medically reasonable, necessary is medically reasonable, necessary and ordinarily furnished (absent and ordinarily furnished (absent research programs) in the treatment research programs) in the treatment of patients by physicians and of patients by physicians and providers under the supervision of providers under the supervision of physicians as indicated by the physicians as indicated by the medical condition of the patients. medical condition of the patients.


Activity / Object Code Activity / Object Code 00001: Direct Patient Care 00001: Direct Patient Care ServicesServices

This definition intends that the This definition intends that the appropriate level of care criteria must be appropriate level of care criteria must be met for the costs of the care to be met for the costs of the care to be reimbursable. Such care is represented reimbursable. Such care is represented by items and services (routine and by items and services (routine and ancillary) which may be diagnostic, ancillary) which may be diagnostic, therapeutic, rehabilitative, medical, therapeutic, rehabilitative, medical, psychiatric, skilled nursing, and other psychiatric, skilled nursing, and other related professional health services.related professional health services.


Activity / Object Code Activity / Object Code 00001: Direct Patient Care 00001: Direct Patient Care

ServicesServices• Direct patient care services are those services Direct patient care services are those services that would give rise to a separate physician that would give rise to a separate physician bill in a private practice, and involve activities bill in a private practice, and involve activities that are identifiable, medical services.that are identifiable, medical services.– Use this code when performing duties and Use this code when performing duties and

providing services which include diagnosis, providing services which include diagnosis, treatment, therapeutic, rehabilitative, treatment, therapeutic, rehabilitative, medical, psychiatric, etc.medical, psychiatric, etc.

– These direct patient care duties may occur These direct patient care duties may occur in a teaching or non-teaching setting.in a teaching or non-teaching setting.


Activity / Object Code Activity / Object Code 00001: Direct Patient Care 00001: Direct Patient Care ServicesServices• Please distinguish between teaching Please distinguish between teaching

rounds (where the primary purpose is rounds (where the primary purpose is teaching and the clinical care is teaching and the clinical care is incidental) and clinical rounds (where incidental) and clinical rounds (where the primary purpose is patient care the primary purpose is patient care and teaching is a by product of the and teaching is a by product of the activity. activity.


Activity / Object Code Activity / Object Code 00001: Direct Patient Care 00001: Direct Patient Care ServicesServices

– Clinical research conducted in conjunction Clinical research conducted in conjunction with, and a part of, caring for patients is also with, and a part of, caring for patients is also considered patient care services if the services considered patient care services if the services are considered are considered usualusual patient care, and are patient care, and are not not compensated through research funds. compensated through research funds.

– Routine services that would be provided Routine services that would be provided absent a clinical trial; services required solely absent a clinical trial; services required solely for the provision of the investigation item or for the provision of the investigation item or service; and services needed for reasonable service; and services needed for reasonable and necessary care for complications resulting and necessary care for complications resulting from the clinical trial should be included in this from the clinical trial should be included in this Activity/Object Code. Activity/Object Code.


Hospital Administration Hospital Administration and Teaching Services and Teaching Services

(Provider Services)(Provider Services)


Hospital Administration Hospital Administration and Teaching Servicesand Teaching Services

Generally these are services for Generally these are services for which NO PATIENT BILL is which NO PATIENT BILL is prepared or sent. These are prepared or sent. These are usually activities which directly usually activities which directly deal with the operation of the deal with the operation of the hospital, and which affect its hospital, and which affect its operating efficiency.operating efficiency.


Activity/Object Code Activity/Object Code 00002: Supervision and 00002: Supervision and

Training of Nurses, Training of Nurses, Technicians, etc.Technicians, etc.

• Use this code for the supervision and Use this code for the supervision and training of nurses, technicians, other training of nurses, technicians, other hospital staff, etc. in a setting that hospital staff, etc. in a setting that does does notnot involve any of the approved medical involve any of the approved medical education programs.education programs.

• In addition to supervision and training, In addition to supervision and training, activities for this code include review of activities for this code include review of care related to a specific patient, hospital care related to a specific patient, hospital or departmental administration, involving or departmental administration, involving the supervision of hospital employees.the supervision of hospital employees.


Activity/Object Code 00003: Activity/Object Code 00003: Utilization Review and Other Utilization Review and Other Committee MeetingsCommittee Meetings

• Use this code when performing Use this code when performing utilization review, participating on utilization review, participating on committees, or attending meetings.committees, or attending meetings.– Activities include meeting preparation Activities include meeting preparation

and attendance for hospital, medical and attendance for hospital, medical staff, and departmental meetings.staff, and departmental meetings.

– Activities include preparation and Activities include preparation and attendance at tumor boards and peer attendance at tumor boards and peer reviews.reviews.


Activity/Object Code 00004: Activity/Object Code 00004: Quality Control, Medical Quality Control, Medical Review, and AutopsiesReview, and Autopsies• Use this code when performing quality Use this code when performing quality

control reviews or quality control control reviews or quality control investigations, or autopsies. Activities investigations, or autopsies. Activities include:include:– Participating individually or as a panel or board Participating individually or as a panel or board

member in: quality assurance functions, informal member in: quality assurance functions, informal and formal investigations, and medical review and formal investigations, and medical review functions related to quality improvement.functions related to quality improvement.

– Autopsies performed at a physician’s request, to Autopsies performed at a physician’s request, to advance the knowledge base regarding advance the knowledge base regarding (deceased) patient conditions. (deceased) patient conditions.


Activity/Object Code 00005: Activity/Object Code 00005: Supervision of Interns and Supervision of Interns and Residents – Physicians OnlyResidents – Physicians Only

• Use this code when performing duties Use this code when performing duties related to the direct supervision of related to the direct supervision of Interns /Residents. Activities include:Interns /Residents. Activities include:– Providing teaching and guidance during rounds, Providing teaching and guidance during rounds,

reviews with Interns/Residents regarding individual reviews with Interns/Residents regarding individual patient care.patient care.

– Time spent managing, planning, and evaluating Time spent managing, planning, and evaluating work of Interns/Residents.work of Interns/Residents.

Note: This activity code Note: This activity code does notdoes not include direct patient include direct patient care. care.


Activity/Object Code 00006: Activity/Object Code 00006: Teaching of Interns and Teaching of Interns and Residents – Physician OnlyResidents – Physician Only• Use this code when performing Use this code when performing

duties related to teaching duties related to teaching Intern/Residents. Activities include:Intern/Residents. Activities include:– Teaching in an approved educational Teaching in an approved educational

program in a classroom, lecture hall, program in a classroom, lecture hall, formal or subject appropriate setting.formal or subject appropriate setting.

– Preparation of materials and time spent Preparation of materials and time spent preparing materials and subject matter preparing materials and subject matter for presentation.for presentation.


Activity/Object Code 00007: Activity/Object Code 00007: Teaching and Supervision of Allied Teaching and Supervision of Allied Health Professionals-Physicians Health Professionals-Physicians OnlyOnly• Use this code when performing duties related Use this code when performing duties related

to the teaching and/or supervision of Allied to the teaching and/or supervision of Allied Health Professionals. Activities include:Health Professionals. Activities include:– Teaching in an approved educational program in a Teaching in an approved educational program in a

classroom, lecture hall, formal or subject matter classroom, lecture hall, formal or subject matter appropriate setting.appropriate setting.

– Preparation of materials and time spent preparing Preparation of materials and time spent preparing materials and subject matter for presentation.materials and subject matter for presentation.

– Supervision of Allied Health Professionals Supervision of Allied Health Professionals performing procedures related to specific patients. performing procedures related to specific patients.


Activity/Object Code 00008: Activity/Object Code 00008: Other Administrative or Other Administrative or TeachingTeaching

• Use this code to include other time spent, Use this code to include other time spent, as appropriate, related to other as appropriate, related to other administrative or teaching functions. administrative or teaching functions.

• Activities must be fully described and Activities must be fully described and explained, and explained, and should notshould not be applicable to be applicable to other teaching activity/object codes.other teaching activity/object codes.


Professional / Provider / Professional / Provider / Non-Reimbursable ServicesNon-Reimbursable Services

•Due to the nature of some services Due to the nature of some services under the following categories, the under the following categories, the Physician or non-physician Physician or non-physician practitioner’s time may be coded practitioner’s time may be coded and/or allocated as professional or and/or allocated as professional or provider services, or may be provider services, or may be determined to be non-determined to be non-reimbursable.reimbursable.


Activity/Object Code Activity/Object Code 00009: Conferences and 00009: Conferences and LecturesLectures• Use this code when attending Use this code when attending

conferences and lectures, or similar conferences and lectures, or similar education forums including continuing education forums including continuing medical education classes. Activities medical education classes. Activities include:include:– Travel and attendance either as a presenter or Travel and attendance either as a presenter or

attendee, planning, and preparation.attendee, planning, and preparation.– Attendance at lectures or similar education Attendance at lectures or similar education

forums, including continuing medical education forums, including continuing medical education classes and workshops to maintain active licensure classes and workshops to maintain active licensure status if done during compensation time.status if done during compensation time.


Activity/Object Code 00010: Activity/Object Code 00010: Non-Productive Hours – Non-Productive Hours – Paid Sick Leave, Paid Paid Sick Leave, Paid Vacations, etc.Vacations, etc.

• Self explanatory. Self explanatory.


Other Non-Billable Other Non-Billable ActivitiesActivities


Activity/Object Code 00011: Activity/Object Code 00011: Research Research

Use this code for non-patient Use this code for non-patient related activities which include:related activities which include:– Research performed for scientific Research performed for scientific

knowledge, planning, preparation of knowledge, planning, preparation of research materials and reports.research materials and reports.

– Research involving a systematic, Research involving a systematic, extensive study directed at better extensive study directed at better scientific knowledge of the science scientific knowledge of the science and diagnosis, treatment, cure, or and diagnosis, treatment, cure, or prevention of mental or physical prevention of mental or physical disease. disease.


Activity/Object Code 00011: Activity/Object Code 00011: Research - ContinuedResearch - Continued

– Usually obtained in the laboratory or on chart Usually obtained in the laboratory or on chart review, and does not necessarily involve review, and does not necessarily involve direct individual or collective patient care.direct individual or collective patient care.

– To the extent that this activity is not done on To the extent that this activity is not done on hospital/facility time, (hospital/facility time hospital/facility time, (hospital/facility time includes time applicable to a Medical School includes time applicable to a Medical School Operating or Professional Services Operating or Professional Services Agreement and other contracts,) this time Agreement and other contracts,) this time should be should be excludedexcluded from your time study from your time study report.report.


Catch –All: Professional / Catch –All: Professional / Provider / Non-Provider / Non-

Reimbursable ServicesReimbursable Services

•The time reported in this final The time reported in this final activity/object code may be for activity/object code may be for services that fall under the services that fall under the professional or provider professional or provider component, or may be determined component, or may be determined to be non-reimbursable.to be non-reimbursable.


Activity/Object Code 00012: Activity/Object Code 00012: Other Non-Billable Other Non-Billable ActivitiesActivities• Use this code for other non-patient Use this code for other non-patient

care related activities that are care related activities that are compensated by the compensated by the hospital/County/UC, are not specified hospital/County/UC, are not specified under other activity/object codes; and under other activity/object codes; and would not ordinarily permit or generate would not ordinarily permit or generate a bill for patient care services, e.g., a bill for patient care services, e.g., consulting or medical review that is consulting or medical review that is chargeable to another entity (non-chargeable to another entity (non-hospital, non-UC, etc.).hospital, non-UC, etc.).


General Form General Form RequirementsRequirements• Participant’s NameParticipant’s Name

• Job/Classification / Position / TitleJob/Classification / Position / Title

• Participant’s Employee NumberParticipant’s Employee Number

• Facility / Hospital / DepartmentFacility / Hospital / Department

• Dates Time Study was conductedDates Time Study was conducted

• Signature / Telephone Number / DateSignature / Telephone Number / Date

• Descriptions of activities or services Descriptions of activities or services performed, if applicableperformed, if applicable


Physician / Employee Physician / Employee Signature and Signature and Supervisor/Reviewer’s Supervisor/Reviewer’s ConfirmationConfirmation

• Time Study form must include:Time Study form must include:– Signature of Supervisor/Reviewer Signature of Supervisor/Reviewer

confirming that the time study confirming that the time study accurately represents the action and accurately represents the action and services performed by the participant.services performed by the participant.

– Telephone number and date. Telephone number and date.


Completion of the Time Completion of the Time Study FormStudy Form

• Record time DAILYRecord time DAILY• In increments of 15 minutesIn increments of 15 minutes• Use decimals onlyUse decimals only• When multiple activities are performed in a When multiple activities are performed in a

fifteen minute period, the activity performed fifteen minute period, the activity performed for the greater amount of time should be for the greater amount of time should be coded to that fifteen minute incrementcoded to that fifteen minute increment

• Time study hours must match the time Time study hours must match the time worked for the period worked for the period

• Signed and dated by physician/employee Signed and dated by physician/employee and supervisor/reviewer in blue inkand supervisor/reviewer in blue ink


How to Time Study for Best How to Time Study for Best ResultsResults

• Identify Activities Correctly:Identify Activities Correctly:– Ensure proper Time Study form is being Ensure proper Time Study form is being

used.used.– Ensure 100% of time for the Time Study Ensure 100% of time for the Time Study

period has been captured.period has been captured.– Ensure activities performed correlate to job Ensure activities performed correlate to job

classification / position.classification / position.– Ensure descriptions and supporting Ensure descriptions and supporting

documentation are provided as necessary. documentation are provided as necessary.


Supporting Supporting Documentation – Provision Documentation – Provision

and Retentionand RetentionProvide and retain documentation for all Provide and retain documentation for all

activities that require specificity (e.g.: activities that require specificity (e.g.: other administrative or teaching and non-other administrative or teaching and non-billable.)billable.)

Additional documentation may include:Additional documentation may include:• Flyers for Conventions / Lectures / Meetings Flyers for Conventions / Lectures / Meetings • NotesNotes• Calendar entriesCalendar entries• Mileage logsMileage logs• AgendasAgendas


Reviews and AuditsReviews and Audits


General Audit ProvisionsGeneral Audit ProvisionsBecause time studies are part of the Because time studies are part of the

reporting, cost reimbursement, and reporting, cost reimbursement, and payment process, all time study payment process, all time study forms and supporting documentation forms and supporting documentation are subject to review and audit.are subject to review and audit.

If a review or audit determines If a review or audit determines inconsistency, impropriety, or error, inconsistency, impropriety, or error, adjustments to cost or payments adjustments to cost or payments may be made.may be made.


Inconsistencies and Red Inconsistencies and Red FlagsFlags

• Activity Coding identical time each dayActivity Coding identical time each day• Individuals with the same job class Individuals with the same job class

significantly coding activity different activity significantly coding activity different activity • White-out (not allowed) –strike through if White-out (not allowed) –strike through if

necessarynecessary• Corrections not initialed or not easily Corrections not initialed or not easily

understoodunderstood• Paid Time Off not coded correctlyPaid Time Off not coded correctly• Hours worked not matching time study hoursHours worked not matching time study hours• Time study date reported in the incorrect weekTime study date reported in the incorrect week


More Red Flags….More Red Flags….• Not all physicians and/or non-physician Not all physicians and/or non-physician

practitioners completed a Time Study formpractitioners completed a Time Study form

• Work, training, teaching, and/or duty schedules Work, training, teaching, and/or duty schedules not kept in the supporting documentation filenot kept in the supporting documentation file

• Insufficient documentation to substantiate tally of Insufficient documentation to substantiate tally of time on a daily basistime on a daily basis

• Time studies not signed in blue ink by Time studies not signed in blue ink by physician/employee or supervisor/reviewerphysician/employee or supervisor/reviewer

• Activities that required specificity are unreadable Activities that required specificity are unreadable or unclearor unclear

• Inconsistent signaturesInconsistent signatures


Best Practices for Best Practices for SuccessSuccess

Supervisor/Reviewer:Supervisor/Reviewer:

Checks all time studies for accuracy.Checks all time studies for accuracy.Ensures time studies reconcile to work, Ensures time studies reconcile to work,

training, teaching, and/or duty training, teaching, and/or duty schedules.schedules.

Ensures Time Surveys always signed in Ensures Time Surveys always signed in blue ink by employee and supervisor.blue ink by employee and supervisor.

Ensures supporting documentation is Ensures supporting documentation is present when required.present when required.


More Best Practices …….More Best Practices …….

THE SUPPORTNG DOCUMENTATION FILE THE SUPPORTNG DOCUMENTATION FILE THAT INCLUDES ALL TIME STUDIES THAT INCLUDES ALL TIME STUDIES

FOR ALL PARTICIPANTS FOR ALL PARTICIPANTS MUST MUST CONTAIN:CONTAIN:

• The original time study forms and copies The original time study forms and copies of the work scheduleof the work schedule

• Secondary documentationSecondary documentation

• All training materials including training All training materials including training sign-in sheets sign-in sheets


Scheduling Successful Scheduling Successful TrainingTraining

• Establish training dates as closely to time Establish training dates as closely to time study week as possible.study week as possible.

• Indicate to participants that training is Indicate to participants that training is mandatory mandatory beforebefore initial time study week. initial time study week.

• Schedule multiple training sessions.Schedule multiple training sessions.• Schedule alternative or make-up training Schedule alternative or make-up training

sessions.sessions.• Choose locations and times of the day that Choose locations and times of the day that

are convenient and accommodating. are convenient and accommodating.


Day of TrainingDay of Training

• Know your audience, and prepare and Know your audience, and prepare and customize the training for a good “fit”.customize the training for a good “fit”.

• Provide sufficient handouts of the applicable Provide sufficient handouts of the applicable approved DHCS time study form.approved DHCS time study form.

• Allow sufficient time for “Q & A”, and re-state Allow sufficient time for “Q & A”, and re-state time study requirements and expectations.time study requirements and expectations.

• Prepare to clarify procedures that your Prepare to clarify procedures that your hospital will use to notify participants of a hospital will use to notify participants of a scheduled time study. scheduled time study.


CLOSING QUESTIONSCLOSING QUESTIONS

Documents

Department of Health Care Services Physician and Non-Physician Practitioners