Home Health Billing Services for Medicare-Certified Agencies

Who our home health billing service is for

Our home health billing service is built for Medicare-certified home health agencies, from a single branch to multi-branch organizations, that bill Medicare, Medicare Advantage and Medicaid on institutional claims. Your clinicians run the visits and the OASIS; we run the billing calendar around them.

Hand your billing to us when:

• the person who filed Notices of Admission left, and admissions are slipping past the five-day window;
• period claims keep coming back unmatched to an OASIS or held on unsigned orders;
• Medicare Advantage and Medicaid claims sit unworked while A/R ages past 90 days.

Physician practices that certify home health patients are covered by our primary care billing for certifying physicians.

What we take over and what your agency keeps

We take over the home health claim cycle from the eligibility check before admission to the posted remittance, for Medicare, Medicare Advantage and Medicaid. We check every code against your clinician's documentation and never change a code without the clinician's sign-off. Your clinicians keep the OASIS, the visits and the clinical decisions; the figure below shows how we run one period of care.

Read the workflow as text

1. Check eligibility first — Identifier and any open period at another agency checked before admission. Owner: Our billing team.
2. File the NOA — Filed from your start-of-care date; acceptance confirmed and proof kept. Owner: Our billing team.
3. Track orders and F2F — Unsigned orders and encounter dates tracked by certifying physician. Owner: Your staff, our team.
4. Match claim to OASIS — Accepted assessment and completion date confirmed before the claim is released. Owner: Your clinicians, our team.
5. Submit and post — Period claim submitted; paid case-mix code, LUPA and proration checked. Owner: Our billing team.
6. Report monthly — Late NOAs, returned claims and LUPA periods, with written definitions. Owner: Our billing team.

Where home health revenue slips, and how we catch it

A missing admission notice, unmatched assessment or unsigned order can hold a whole billing period. We track each admission and period claim through the checks below.

At admission and start of care

• A Notice of Admission accepted late. We track each admission notice through acceptance, keep the confirmation and escalate a rejected or unaccepted notice to your agency. A submission record alone does not close the task.
• A face-to-face encounter outside its window. We compare the encounter documentation with the start-of-care record and return gaps to your clinical team before the period claim is released.

When the period claim goes out

• A claim with no accepted OASIS. We match the assessment identifiers and acceptance record to the period claim, then work rejections back to the underlying OASIS mismatch.
• One unsigned order holding the period. We keep unsigned orders visible on a hold list and identify the clinician or agency contact needed to release each period.
• LUPA and partial periods paid short. We compare the visit record and period dates with the remittance, then investigate a payment mismatch with the documented period rather than treating every reduction as an error.
• Medicaid visits without verification. We match the visit information needed for billing to your EVV records and return missing verification to your agency; your team continues operating its EVV system.

If your organization also runs a supplier line, see our DME supplier billing.

What home health billing costs your agency

An agency is paid per 30-day period of care, not per clinician, so instead of a rate-card row by practice size you get a written quote built from your period volume and payer mix. The fee base, cap and contract below match our published rate card. Ask for your agency's quote.

How we take over your agency's billing

Open admissions carry the first risk in a home health switch: an NOA nobody files during the handover cuts that period's payment, and an unbilled period ages toward Medicare's 12-month filing limit, which counts from the Through date on a span claim. We start with five things from you:

1. The signed service agreement and business associate agreement (BAA).
2. Logins to your home health software and clearinghouse, plus your Medicare claim-entry access.
3. A list of open admissions, NOAs on file and periods not yet billed.
4. Your unsigned-orders report and a claim-level aging export, which we sort by deadline.
5. For Medicaid patients, access to your state's EVV records.

Go-live, when your first claims go out, comes within 5 business days of access; any unbilled backlog follows within 10 business days of access. Clock starts with your signed agreement, signed BAA and working system logins; it extends day for day while we wait on access. Every inherited claim within 30 days of a filing, corrected-claim or appeal deadline is worked within 5 business days of access. Starts at access; covers up to 250 claims (more gets a day-1 deadline schedule); worked means submitted, corrected, appealed or returned with the fix.

Request the files on our handoff list for switching billing companies from your outgoing company. Inherited claims past 90 days can go to A/R Recovery: 15% of the insurance payments that post after we work them, $0 on claims that never pay. Fee only on insurance payments posting after our logged action; patient payments 0%; full-service clients stay under the 9.0% fee cap. Not ready to switch? Start with The Free A/R Deadline Map: Every unpaid claim over 90 days, sorted by the date it expires. Clock starts with your claim-level aging export and signed BAA; above 10 requests in a week, we confirm your date within 1 business day.

Monthly reporting, service standards and our two guarantees

Your agency gets two written guarantees, with the terms of each printed next to it.

• On-Our-Watch Guarantee: If a claim misses a filing, corrected-claim or appeal deadline while it is on our watch, we pay you what it would have paid. Claims we get complete 10+ business days before the deadline; contracted rate less any copay you collected, paid automatically within 30 days of final denial; capped $10,000/month; your holds excluded.
• Clock-or-Credit Guarantee: From go-live, every new claim goes out within 1 business day of complete charge data, and every denial is worked within 2 business days of posting — or $25 comes off your invoice for each late one. Mon–Fri ET business days by your system's timestamps; worked: resubmitted, appealed or returned with the fix; auto-credited; capped at monthly fee; clearinghouse outages excluded.

Neither guarantee makes Medicare pay a period whose OASIS, face-to-face encounter or signed orders are missing. Those records stay with your clinicians and certifying physicians, which is why our calendar checks each one before the period claim goes out.

The clocks your agency can audit us on

Each standard in the table is measured by timestamps in your own systems, so your administrator can check it without asking us. Our monthly report defines clean claims, A/R days and net collection rate in writing, then breaks out late NOAs, returned claims and LUPA periods by payer. Returned and denied claims follow our denial management workflow.

We publish client results only with written permission. Until we have them, judge us by the guarantees and the free Deadline Map.

Admission notices have their own handoff deadlines. Confirm the notice handoff, weekend coverage and any notice-specific guarantee in the written scope; the claim guarantees above do not establish those terms.

Your software, Medicare access and data security

We work inside your existing practice-management system and clearinghouse; tell us which ones and we confirm in writing within 1 business day. See the systems we work in. Medicare NOAs and claims go out under your agency's own Medicare access, and Medicaid claims are matched to your state's EVV records before submission. A signed BAA comes before any access to patient data. Every payment goes straight to your practice's own bank account. We never receive, deposit or endorse your payments; we invoice you once a month.

Common questions

How much do your home health billing services cost?

Each agency gets a written quote from its period volume and payer mix, on the same terms as our rate card: a percentage of insurance payments, 0% of patient payments, $0 setup. Month to month. Leave with 30 days' written notice. No termination fee. See medical billing pricing for the minimum and cap.

How should we choose a home health billing company?

Put five questions to each company in writing: who files the NOA and keeps proof of acceptance, who confirms the OASIS match before release, who checks LUPA and prorated payments, what the fee is, and who pays when a claim misses its filing limit. This page answers all five, and our checklist for comparing billing companies covers the contract terms.

Is there a long-term contract or a cancellation fee?

Neither. Leave with 30 days' notice and no termination fee. Want a run-out? We keep working the claims we submitted for 90 days at your plan rate. Decline it and we charge nothing on payments that post after you leave. Notice by email; optional run-out covers claims we submitted before your exit date, at your plan rate; handover file within 10 business days of exit.

How fast can you take over our agency's billing?

Go-live, when your first claims go out, comes within 5 business days of access; any unbilled backlog follows within 10 business days of access. Clock starts with your signed agreement, signed BAA and working system logins; it extends day for day while we wait on access. The five things we need from your agency are under how we take over.

Do you file our Notices of Admission and track the five-day window?

Yes. You send the start-of-care date on the day of the first visit; we file the NOA, confirm the Medicare contractor accepted it and keep the proof, so a returned NOA can be corrected and an exception requested when one applies.

Can you handle our Medicare Advantage and Medicaid home health claims?

Yes. We bill each Medicare Advantage plan from its enrollment date, including a patient who elects a plan mid-period, and we bill Medicaid home health claims against your state's electronic visit verification records.

Which home health software do you work in?

We work inside your existing practice-management system and clearinghouse; tell us which ones and we confirm in writing within 1 business day. See EHR and practice-management compatibility.