4 steps to count what after-hours notes cost your practice
Count each clinician's after-hours notes, the hours they take, the days from visit to claim, and the visits those hours equal.
Co-founder, JotPsych
Your after-hours notes are the notes your clinicians finish after their last visit of the day, at the office or at home. You'll need two weeks of daily note counts, last month's claims, and one question for each clinician.
| Count | How | Period |
|---|---|---|
| After-hours notes | Notes from that day's visits still unsigned when each clinician's last visit ends | Each day for two weeks |
| Hours | Each clinician's own count of hours spent on after-hours notes | Per week |
| Days to claim | Days from visit to claim, for visits with notes signed after the last visit and for the rest | Last month's claims |
| Visits | Each clinician's weekly hours on after-hours notes, divided by the length of a standard visit | Per week |
Each count comes from your own schedule, claims, and clinicians. The counts show which clinician spends the most hours on after-hours notes, and whether those notes delay your claims.
- Count the after-hours notes. Each day for two weeks, count the notes from that day's visits still unsigned when each clinician's last visit ends. In your EHR's list of unsigned notes, skip any note from an earlier day, so you count each note once. Write the count down by clinician.
- Count the hours the after-hours notes take. Ask each of your clinicians how many hours a week those notes take, counting the time at the office after the last visit and the time at home. Ask for a number of hours, not a feeling. Write each answer beside your note count for that clinician.
- Compare the days from visit to claim. Pull your claims from last month. Compare visits whose notes were signed after the clinician's last visit that day with the rest, and check your longest count against each payer's timely filing limit. UnitedHealthcare, for one, tells you to “file your claim within your timely filing limits or it may be denied.”
- Count how many visits those hours equal. Divide each clinician's weekly hours on after-hours notes by the length of your standard visit. The National Council for Mental Wellbeing surveyed mental health and substance use workers in 2023. Of the 587 who give care and have admin tasks, 68% agreed that admin time takes away from time with clients.
From the National Council for Mental Wellbeing's survey, run by The Harris Poll, which asked each worker to agree or disagree. Your clinicians' weekly hours on after-hours notes show what admin time costs your practice.
Compare your clinicians' counts, and start with the clinician who has the most after-hours notes. Ask that clinician what's slowing those notes down.
Run the four counts again after a month of JotPsych drafting each note from the visit your clinician records.
Book 15 minutes- National Council for Mental Wellbeing, Industry Workforce Shortages Research, prepared by The Harris Poll, March 16, 2023: an online survey of 750 mental health and substance use employees, February 3 to 19, 2023; the 68% counts the 587 who provide care to patients and have administrative tasks.
- UnitedHealthcare, 2026 Care Provider Administrative Guide, effective April 1, 2026: Chapter 10, timely filing.