Payroll and Time Reporting for Travel Nurses

As the balance of travel nursing tilts toward VMS and MSP services, the process of payroll, billing, and time reporting changes as well. Some for the better, but the proficiency and efficiency of the process rely upon a comprehension of the technology and use of timekeeping Staffing and the relationship between the facilities and the VMS/MSP providing the service.

Sadly, the nurse and the agency are often caught in the middle of this struggle and often never consulted before knee-jerk policy changes that affect livelihoods. For instance, a facility may decide matters of policy to parallel their level of convenience. For instance:

“Our hospital sends Kronos reports after all of our internal time has been processed, and that will take place on Thursdays. Agencies are not allowed to call us either to ask that we resend the reports.”

That is an actual policy of a hospital to which we provide travel nurses. The problem is, we pay weekly like most agencies and to send time reports four days after the work week has concluded means that our nurses don’t get paid. Add in the rigidity of ‘don’t ever call us’, and it is a breeding ground for discontent among the travelers and often we are the targets of misdirected anger.

This article will give travelers a glimpse of how the process has gone awry and its origination.

Reverse Billing

Reverse billing means we never have to send an invoice, and instead, the VMS or MSP automatically sends us payment according to the schedule that the nurse works. Sounds easy – and it is easy for many facilities and VMS platforms. TotalMed Staffing provides travel nurses for the fictitious Giant Healthcare, and they have been a very reliable and predictable partner when it comes to reverse billing and time reporting. My only conclusion is that Giant Healthcare enjoys a good working relationship with the facilities they support, and together they have a very good understanding of timekeeping processes and the technology the use to record and report time. Thus, we reliably receive the time reports from the facility/Giant Healthcare for the hours our nurses work by Tuesday, and they are most often accurate.

Other facilities and VMS’ do not enjoy the same relationship, or worse, do not have a clear understanding or cooperation between VMS and facility. For instance, a network of facilities will not send time reports but twice per month – which would be fine if we paid our nurses twice per month. The VMS has not been able to help the facility understand that their insistence in sending bi-weekly reports presents a significant business problem to the VMS, the providers (agencies), and ultimately the nurses.

To compound the problem, the VMS estimates the hours that the nurse works, sends a “pre-report” from which we are expected to pay the nurses, then often alters the report the next week. It has made a simple process a labor intensive one. Because we are the interface for the nurses, agencies are often perceived as the barrier or the problem, when it is most often the facility or VMS/MSP that is creating the complexity.

Time and Attendance Staffing

Kronos and Cerner offer time and attendance Staffing that track the time a nurse (or any clinician) works. From the time they report for the start of the shift, break, and leave for the day, the system captures every swipe or punch. Used properly, the system works well. In fact, there are interfaces that would allow agencies to capture the time data to make the process even simpler for the facility – but unfortunately, very few hospitals support this integration.

There also seems to be a void of subject matter experts at the facilities. In our experience, it is often the staffing office personnel who have been drafted as the timekeeping system managers, and the technology can be as complex as it is useful – these office managers frequently see the system as a “time printing system” when it does so much more than that.

Payroll Correction Forms

When a swipe or a punch does not happen as planned (missing badge, broken Kronos machine… whatever), the nurse is asked to submit a Payroll Correction Form, which may have some other name depending upon the facility, but this form is intended to temporarily replace the automated system with the manual system.

This form, once signed/authorized by the nurse manager, is submitted to the staffing office for them to manually enter into their time and attendance system (like Kronos). Sometimes this happens right away, sometimes rigid staffing office policies delay the entry for up to two weeks.

Payment Terms

While payment terms would seem out of place in this article, they are relevant. Most VMS/MSP today have windows in which time may be reported for payment or in which a payment may be disputed. For instance, if Florence Nightingale, RN worked on January 1st, 2nd, and 3rd, and we were paid for those shifts 50 days later, we have only 9 days to dispute any incongruities. For instance, let’s say that Ms. Nightingale worked 36 hours, but the VMS paid us for 30. If we do not catch it and dispute it in 9 days, that money is unrecoverable.

Payment terms and windows in which agencies may dispute payments have guided many of the time reporting policies. If we can’t bill for it, we can’t pay it – and this policy is commonplace among agencies today.

Bottom Line

1. The best policy is to ALWAYS use your badge or the time keeping system to report hours. If you forget your badge, (kindly) insist that the staffing office enter your time as you wait.
2. Check your hours in the staffing office before the work week concludes. For instance, if you worked Monday through Thursday, you should visit the staffing office at the conclusion of your Thursday shift and make sure your hours match those in the report.
3. Work closely with your agency. It is our policy to check in with our travelers each week, not only to make sure the assignment is running smoothly, but to also ask about hours, RTO, etc. The relationship is SO important to ensuring paychecks are accurate each week.

TotalMed Staffing

valleyrocks.com

info@valleyrocks.com

916.779.1616

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