Level of Care (LOC) Setup

The Kipu EMR allows facilities to customize the Levels of Care (LOCs) offered by their organization. There are two ways to assign LOCs: 

• Authorized (UR) Level of Care: Assign a Level of Care to the patient when adding an insurance authorization to the Concurrent Reviews section of the patient facesheet.  
• Clinical Level Of Care: Providers can assign a Level of Care to the patient when completing an Evaluation. 

Why would I need to assign two different LOCs?

Clinical Levels of Care are typically used to document a LOC for non-insurance patients instead of adding an insurance authorization. However, Clinical LOCs can also be used when the patient's Authorized (UR) LOC is not what will be provided to the patient. This typically occurs when the insurance doesn't authorize the needed LOC (typically authorizing a lower LOC), but your organization chooses to provide the needed treatment in the form of a higher LOC.

By assigning both LOCs, your organization can better manage patient treatment.

Integrated Billing Users
Levels for Care for users with an integrated billing solution (Avea or CMD) are crucial for successful billing and require a different level of configuration than what is described here. Click here for more information on managing LOCs for Integrated Billing users. 

Additionally, authorizations (concurrent reviews) must be added to the patient chart following a specific set of required fields. Click here for more information.  

Configure Levels of Care

Super Admins can complete the LOC setup.

The system will check the Standard LOC field and LOC Type and verify that both are present and have been correctly associated. The table below indicates the Standard LOC and the corresponding LOC type. 

Standard Level of Care	LOC Type
Outpatient	Outpatient (OP)
Outpatient detoxification	Outpatient (OP)
Outpatient methadone/buprenorphine or naltrexone treatment (OTP)	Outpatient (OP)
Outpatient buprenorphine or naltrexone treatment (OBOT)	Outpatient (OP)
Intensive outpatient treatment	Attendance Based (PHP/IOP)
Partial hospitalization/day treatment	Attendance Based (PHP/IOP)
Short-term residential	Inpatient (Detox/Res)
Long-term residential	Inpatient (Detox/Res)
Residential detoxification	Inpatient (Detox/Res)
Hospital inpatient/24-hour hospital inpatient	Inpatient (Detox/Res)
Hospital inpatient detoxification	Inpatient (Detox/Res)

Level of Care Setup

Configure the Levels of Care offered by your organization in the Patient Settings tab. Companies with a master instance can offer a different set of LOCs for each location, as needed. 

1. Click on your initials and select Settings.
2. From the Patients tab, locate the Levels of Care section.
3. Click Add item to add a new LOC.
4. Name the LOC and click on the Standard LOC drop-down to pick an option. This field matches a location's existing, customized LOCs to standard LOCs sourced from the SAMSHA list. This step allows facilities to maintain highly individualized levels of care without sacrificing accuracy in reporting and performance. Both these fields are required.
5. Choose the LOC type from the drop-down options.
6. Facilities with a master instance have a Locations drop-down. Use this list to select which locations offer this level of care.
7. Click Update to save. 

Important: This setup process is completely different for users with an integrated billing solution. If you are integrated with Avea or CollaborateMD, review these Level of Care configuration instructions.  

Insurance Verification Form

If your organization uses the standard Insurance Verification form to manage your Verification of Benefits process, you can add the Levels of Care (as configured above) as checkboxes to this form. Check out this article for full instructions.

Instance Settings

You can enable the patient's LOC(s) to display in the patient header. 

1. Click on your initials and select Settings. 
2. Open the Instance tab. 
3. Locate the Show level of care setting. Tip: Use Ctrl + F (Windows) or Cmd + F (Mac) and enter your search terms to quickly locate the setting.
4. From the drop-down, determine how you want to display the LOC on the facesheet:
   • Hide LOC: Do not display LOC on the facesheet.
   • Show clinical LOC: Only display the LOC documented by the provider on the patient evaluation.
   • Show UR LOC: Only display the LOC documented in the authorization from the Concurrent Reviews section of the patient facesheet. 
   • Show clinical and UR LOC: Display both documented LOCs (if present)
5. Click Submit at the bottom of the page. 
6. Any selected LOCs will display on the facesheet once added to the patient chart.

Configure Evaluations for Clinical LOC

Let's review how to add the patient.level_of_care_clinical field to an Evaluation. This allows providers to document the patient's clinical LOC. Super Admins and users with the Manage Templates or Manage Templates - Consents and Evaluations feature added to their profile can create and edit evaluations.

The most common evaluation the LOC field is added to is the Manage Clinical Level of Care form. 

1. Click on Templates and open the Evaluation tab.
2. Create a new form or edit an existing evaluation. If you need more information on creating Evaluations, click here.
3. To add a new field, scroll to the end of the form and click Add item.
4. Complete the Name, Label, and any other desired formatting fields.
5. Select patient.level_of_care_clinical from the Field type drop-down.
6. You can also add the patient.level_of_care_ur field to view the patient's current Authorized (UR) LOC. The provider will be able to view or change the UR LOC using this evaluation. 
7. Click Update to save.
8. This is how each field will appear to the provider when completing the evaluation.

Assign UR and Clinical Levels of Care

Click here for instructions on assigning the Authorized (UR) LOC or Clinical LOC to the patient chart.