Healthcare Contractor Invoice & EVV Hour Automation

CUSTOMER

A healthcare services organization managing Personal Care Assistant (PCA) and Private Duty Nursing (PDN) services through independent contractors.

The organization manages contractor invoices, EVV-based service hours, approvals, and payment submissions to the Florida State Nurse Registry.

CHALLENGE

The organization was managing the contractor invoicing process manually.

Key challenges included:

• Axxess EVV reports had to be exported and cleaned manually.
• PCA and PDN records had to be separated.
• Invoices were created manually for each contractor.
• Contractors often preferred text messages over email, with many preferring Spanish.
• Staff had to contact contractors to confirm invoice receipt and follow up on signatures.
• Rejected invoices required manual correction and resubmission.
• Staff had to track how many invoices were sent versus how many were returned.
• Missing approvals created payment delays.
• Signed invoices had to be organized and submitted to the Florida State Nurse Registry.
• Client service hours also needed tighter control, especially for PCA services.
• Managers needed the ability to handle late approvals, hour adjustments, and other exceptions.

COGNIC’S SOLUTION

Cognic designed a custom web-based invoice management and approval system to automate the complete workflow from Axxess data through contractor approval and final payment submission.

Automated Axxess Data Processing

The system accepts the Axxess Excel export uploaded by the operations team. The system validates the uploaded file, reads EVV visit information, identifies contractor and service information, separates PCA and PDN records, groups records by contractor and pay period, and uses approved hours, rates, dates, and service details to prepare invoices.

Automated Invoice Creation

The system generates contractor invoices using the approved invoice template. Each invoice includes relevant information such as contractor name, invoice number, pay period, service dates, client information, hours worked, hourly rate, total amount, and signature information. Invoices are organized under the required PCA and PDN folder structure.

Mobile Contractor Approval

Contractors receive a text message with a secure link to their invoice. The mobile interface allows contractors to review invoice details, approve the invoice, reject the invoice, provide a rejection reason, complete the required signature process, and choose between English or Spanish. This removes the need for contractors to work through a complicated application.

Rejection and Correction Workflow

If a contractor rejects an invoice, the system records the reason and alerts the appropriate operations team member. The manager can review the rejection, correct the invoice, add correction notes, generate the revised version, send the invoice back to the contractor, and continue the approval process. Each version and action is recorded for traceability.

Digital Signature Workflow

The solution uses Zoho Sign for electronic signatures. The workflow records the contractor approval and required internal approval before the invoice moves to the final payment stage.

Automated Reminders

The system tracks outstanding invoices and sends reminders to contractors who have not completed approval. The workflow also supports deadline alerts, including the Wednesday 1:00 PM processing cutoff. Operations staff receive alerts when expected approvals are missing.

Invoice Reconciliation

The system tracks the number of invoices sent versus the number returned (e.g., 64 invoices sent, 60 invoices approved, 4 invoices pending). The system highlights the outstanding invoices so the team knows where follow-up is required.

Client Hours Management

A Client Management module was added to control authorized service hours. For PCA services, each client has monthly authorized hours. Each client can have multiple tasks, such as companion care, personal support, or other approved PCA tasks. The system tracks authorized monthly hours, approved hours used, remaining hours, task-level usage, and overall client usage. Hours are deducted only after an invoice receives approval. For PDN services, the hour-management feature is optional and remains turned off by default per client.

Hour Alerts and Controls

The system provides alerts when remaining hours reach 16, 8, or 0 hours. Contractors and the PCA Manager receive applicable alerts. Client notifications have their own ON/OFF setting. When hours reach zero, the system applies a hard stop and requires manager approval before additional processing.

Manual Overrides

Managers and administrators have controls to handle exceptions such as late invoice approvals, hour adjustments, cross-month corrections, allocation changes, and other approved exceptions. All manual changes are recorded in the audit trail.

Secure Document Management

Invoices and supporting documents are stored in the Microsoft OneDrive/SharePoint environment. The solution follows the required folder structure for PCA and PDN invoices and supports the required document retention period.

Reporting and Audit Trail

The system maintains a complete history of invoice activity. The audit trail records actions such as file upload, invoice creation, invoice sent, contractor approval, contractor rejection, invoice correction, resubmission, signature completion, and final submission. The system also prepares the required payment summary information for submission to the Florida State Nurse Registry.

BUSINESS BENEFITS

• Reduced manual invoice preparation.
• Faster contractor approval and less phone and email follow-up.
• Easier Spanish-language communication with contractors.
• Better visibility into pending invoices.
• Faster correction of rejected invoices.
• Better control over authorized client hours.
• Early alerts before authorized hours are exhausted.
• Reduced risk of paying against incorrect or unapproved hours.
• Clear audit history for every invoice.
• Better organization of PCA and PDN records.
• Faster preparation for payment submission.
• Improved control over the overall biweekly invoicing process.

TECHNOLOGY USED

• React for the web interface
• Node.js backend APIs
• Database for contractors, clients, invoices, tasks, hours, approvals, and audit records
• Axxess Excel export for source data
• Zoho Sign for electronic signatures
• SMS integration for contractor notifications
• Microsoft OneDrive/SharePoint for document storage
• Secure cloud hosting
• English and Spanish mobile approval interface