When hospital administrators elect to contract with one or more staffing firms, they are likely to focus on the skills, experience, and availability of a com-pany's travelers rather than its invoicing practices. However, assumptions should not be made about this important aspect of the staffing process. Some managers opt to work within agencies' individual billing schematics, while others require adherence to their facility's internal accounting methods.

ItemizationFor the most part, agencies are likely to follow their own formats and are largely prepared to furnish—and modify—data elements to suit the unique requirements of their client facilities. "Our invoices are very straightforward in terms of the information we provide," relates Eric Broder, president and COO of FASTAFF Nursing, located in Denver, Colorado. "For instance, if a hospital wants particulars regarding the unit(s) a traveler has worked on reflected in our invoice, we use their exact terminology, not a coded or abbreviated version."

Over the past several years, many companies have adjusted their processes to conform to hospitals' individual protocols since a number of facility administrators will not accept statements that do not adhere to their in-house systems. "About 50 percent of the time, our invoices are created using an institution's unique forms, particularly for large governing groups that may cover 30 or 40 hospitals all at once," says Cheryree Eldred, vice president of Preferred Medical Placement, based in Louisburg, Kansas. "For the facilities that do not require billing furnished in their own formats, we provide essential criteria and any additional components they desire."

What type of data must be captured on a typical travel company invoice? According to Marilyn Nemerever, director of nursing finance and staffing at Swedish Medical Center (SMC)/Providence Campus in Seattle, Washington, specifics like hourly rates, mobile providers' names, and actual dates and hours practiced during a given pay period should always be included. "Bills ought to be itemized by shift and cover all of an agency's supplemental staff on one, unified statement." She adds, "It would be extremely helpful if the units to which travelers were assigned were recorded, as well. Most, but not all, of the staffing firms we deal with incorporate this information, and it is a true timesaver."

Jennifer Bradley, patient services IT system specialist with Children's Hospital Boston in Boston, Massachusetts, concurs. "Additionally, I ask the companies that contract with my facility to further simplify the process by breaking travelers' hours down into one of three categories: regular, overtime, and holiday." Other components, such as a healthcare professional's specialty, rates for floating or being on call, and shift differentials might be included on an invoice, as well, if applicable.

"In cases where all charges—including labor, housing, and transportation—are bundled together, a facility might request a breakdown of each component based on its contract stipulations," says Mr. Broder. "Though each category would be recorded separately, the amount due would still reflect all of the costs associated with each professional in question."

Suggestion Box

Both Ms. Nemerever and Ms. Bradley—who work with roughly four to six staffing agencies apiece—relate that there can, of course, be exceptions to these guidelines. If a placement agency concurrently furnishes a hospital with nurses and radiologic technologists, for example, two invoices are likely to be generated and generally preferred. "We request separate bills for RNs and techs," relates Ms. Bradley, "because they are charged to different account numbers within our organization."

Invoice frequency can vary, too. However, the standard timeframe is weekly or biweekly. "We prefer it when travel companies adjust their disbursement cycles to match ours, which is every two weeks," comments Ms. Nemerever. "Fortunately, most of the agencies with which SMC contracts have been able to honor this request. Overall, we have found that firms are happy to make any reasonable accommodations, so facility administrators should never hesitate to ask for anything that will make their jobs easier."