Unit-Based Fee Structure Tip Sheet

Overview

Aaniie supports both hourly and unit-based billing structures. While private pay and long-term care insurance services are often billed hourly, many Medicaid, VA, and government-funded programs require claims to be billed using units.

In most cases:

• 1 Unit = 15 Minutes

• 4 Units = 1 Hour

The Unit-Based Fee Structure feature automatically converts service time into units and rounds appropriately for billing purposes without affecting EVV data.

Why Use Unit-Based Fees?

Many payers require claims to be submitted using whole units rather than decimal hours.

Example

A caregiver works:

• 1 hour and 52 minutes

The payer may require billing as:

• 7 Units

rather than:

• 1.87 Hours

Unit-Based Fees automatically handle this conversion and rounding process while preserving accurate visit and EVV information.

Why Not Simply Use Hourly Billing?

Many EVV systems and payers require:

• Whole-unit billing

• Quarter-hour increments

• Limited corrections after submission

Using hourly billing can create discrepancies between scheduled time and billable units.

Unit-Based Fees are specifically designed to:

• Round correctly for claims

• Maintain EVV compliance

• Reduce claim rejections

• Simplify billing workflows

Setup Process Overview

There are four primary steps:

1. Enable Unit-Based Fees

2. Configure Fee Rate Labels

3. Assign Unit Rates

4. Convert Existing Fee Types

Step 1: Enable Unit-Based Fees

Before unit billing can be used, the feature must be enabled in Site Settings.

Note

If Unit-Based Fees are not currently available on your site, contact Aaniie Support for assistance.

Navigate To

Menu → Settings → Site Settings

Scroll to the Accounting section.

Configure Hourly Fee Rates

Specify the number of hourly fee types your agency uses.

Example

If you bill:

• Personal Care Weekday Rate

• Personal Care Weekend Rate

Enter:

2 Hourly Fee Rates

Configure Unit Fee Rates

Specify the number of unit-based fee types your agency uses.

Example

If you bill:

• VA Homemaker Services

• VA Respite Services

Enter:

2 Unit Fee Rates

Save Changes

After entering the appropriate number of fee rates:

1. Click Save

2. Refresh the page if necessary

Step 2: Edit Client Fee Rate Labels

Once Unit-Based Fees are enabled, fee labels should be configured.

Navigate To

Menu → Accounting → Edit Client Fee Rate Labels

Label Hourly Fee Types

Assign labels for any services billed hourly.

Examples:

• Private Pay Weekday

• Private Pay Weekend

• LTC Services

Label Unit Fee Types

Assign labels for services billed by units.

Examples:

• VA HHA

• VA Respite

• Medicaid Personal Care

• Medicaid Homemaker

Recommended Conversion Method

When transitioning from hourly billing:

• Leave existing hourly fees in place temporarily.

• Rename old rates to include "DO NOT USE."

• Create new unit-based fee types.

• Complete the conversion.

• Remove old rates later if desired.

This makes it easier to identify which fee structures still need conversion.

Step 3: Assign Unit Rates

After creating the unit fee types, assign the proper rates.

Rate Conversion Formula

Since:

• 1 Hour = 4 Units

The unit rate is calculated by dividing the hourly rate by 4.

Example

Hourly Rate:

$32.00/hour

Unit Rate:

$32 ÷ 4 = $8.00 per unit

Bulk Update Rates

Navigate To:

Menu → Clients → Client Management

1. Select Bulk Change Rate

2. Select the new unit fee type

3. Enter the unit rate

4. Save

5. Repeat for all unit fee types

Step 4: Convert Existing Scheduled Shifts

Once unit rates have been created, existing scheduled shifts should be updated.

Navigate To

Scheduling Dashboard

1. Select Bulk Actions

2. Choose Change Fee Type

3. Select the current hourly fee

4. Select the new unit-based fee

5. Apply the change

This updates future scheduled shifts to use the new billing structure.

Update Client Default Rates

After scheduled shifts are converted, update each client's default rate.

This is especially important for:

• Unscheduled shifts

• Mobile clock-ins

• Manual visit creation

Change Default Rate

Navigate To:

Menu → Clients → Client Management

1. Open the client profile.

2. Under Priority Info, locate Default Rate.

3. Change the default rate to the new unit-based fee.

Update Billing Code Configuration

After updating the client's default rate:

Navigate To

Client Profile → Accounting → Billing Code Config

1. Select Edit

2. Change the Unit Type to:

Shift-Rate-Based Units

3. Click Save

Common Use Cases

Medicaid Services

Many state Medicaid programs require billing in 15-minute units.

VA Programs

VA Homemaker and Respite services frequently use unit-based billing.

Managed Care Organizations

Many MCOs require claims to be submitted in units rather than hours.

EVV-Compliant Billing

Unit-Based Fees help ensure claims align with EVV requirements while reducing manual calculations.

Common Conversion Example

Before

Private Pay Rate:

• $28.00/hour

After

Unit-Based Rate:

• $7.00/unit

Because:

$28 ÷ 4 = $7

The system will automatically calculate billable units based on the visit duration and rounding rules.

Best Practices

• Create all unit fee types before converting clients.

• Keep old hourly fee labels temporarily during the transition.

• Use Bulk Change Rate whenever possible.

• Update all scheduled shifts before going live.

• Verify client default rates after conversion.

• Confirm Billing Code Config is set to Shift-Rate-Based Units.

• Test invoicing and claims before processing a full billing cycle.

Key Takeaway

Unit-Based Fees allow agencies to bill services using payer-required units instead of hourly rates. By converting hourly rates into unit rates, updating fee types, and configuring billing codes appropriately, agencies can improve EVV compliance, reduce claim errors, and simplify billing for Medicaid, VA, and other unit-based payer programs.