Time time          Date      Provider  







     

        

  

Other:   





  

  

Other:   







Billable time:
    

               

    

H:        


L:   


Deduction (min):
      

     



Direct Patient Time   

Start     
Finish        Interval (minutes)   

Start     
Finish        Interval (minutes)   

Start     
Finish        Interval (minutes)   

Start     
Finish        Interval (minutes)   

Start     
Finish        Interval (minutes)   

Start     
Finish        Interval (minutes)   

Start     
Finish        Interval (minutes)   

Start     
Finish        Interval (minutes)   

Start     
Finish        Interval (minutes)   



Balancing:                                          plus    
Manual correction for uninsured:   minus    

Direct patient time total (min):                  Block    Start:    Finish:    Units:



Indirect Patient Time   

Start     
Finish        Interval (minutes)   

Start     
Finish        Interval (minutes)   

Start     
Finish        Interval (minutes)   

Start     
Finish        Interval (minutes)   

Start     
Finish        Interval (minutes)   

Start     
Finish        Interval (minutes)   

Start     
Finish        Interval (minutes)   

Start     
Finish        Interval (minutes)   

Start     
Finish        Interval (minutes)   



Balancing:                                      minus    
Balancing:                                      minus    

Indirect patient time total (min):              Block    Start:    Finish:    Units:



Admin Time   

Start     
Finish        Interval (minutes)       Notes:

Start     
Finish        Interval (minutes)       Notes:

Start     
Finish        Interval (minutes)       Notes:

Start     
Finish        Interval (minutes)       Notes:

Start     
Finish        Interval (minutes)       Notes:

Start     
Finish        Interval (minutes)       Notes:

Start     
Finish        Interval (minutes)       Notes:

Start     
Finish        Interval (minutes)       Notes:

Start     
Finish        Interval (minutes)       Notes:



Balancing:                                     minus    
Balancing:                                       plus    

Admin time total (min):                            Block    Start:    Finish:    Units:



Uninsured Time   

Start     
Finish        Interval (minutes)       Notes:

Start     
Finish        Interval (minutes)       Notes:

Start     
Finish        Interval (minutes)       Notes:

Start     
Finish        Interval (minutes)       Notes:

Start     
Finish        Interval (minutes)       Notes:

Start     
Finish        Interval (minutes)       Notes:

Start     
Finish        Interval (minutes)       Notes:

Start     
Finish        Interval (minutes)       Notes:

Start     
Finish        Interval (minutes)       Notes:



Uninsured time total (min):                         Block    Start:    Finish:    Units:



Hospital Time

Start     
Finish        Interval (minutes)   

Start     
Finish        Interval (minutes)   

Start     
Finish        Interval (minutes)   

Start     
Finish        Interval (minutes)   

Start     
Finish        Interval (minutes)   

Start     
Finish        Interval (minutes)   

Start     
Finish        Interval (minutes)   

Start     
Finish        Interval (minutes)   

Start     
Finish        Interval (minutes)   



Hospital time total (min):                            Block    Start:    Finish:    Units:



Longterm Care Time

Start     
Finish        Interval (minutes)   

Start     
Finish        Interval (minutes)   

Start     
Finish        Interval (minutes)   



Longterm Care time total (min):                 Block    Start:    Finish:    Units:

Notes:


Adjust       Format (hh:mm):      







Disclaimer
The use of this tool is at your own risk and clinical discretion.

Time tracker tool by David Page is licensed under CC BY-NC-SA 4.0