Medivanced’s Home Care Billing Services are specifically tailored to meet the unique billing needs of home health agencies (HHAs), hospices, and private duty home care providers. We understand the complexities of reimbursement models for services delivered in a patient’s residence, including skilled nursing, therapy services, home health aide visits, and personal care. Our expert team ensures that your agency receives accurate and timely reimbursement from payers like Medicare, Medicaid, and commercial insurers. We manage the entire billing process, allowing your clinical staff to focus on providing essential care to patients in their homes while we handle the financial aspects
Medivanced manages the complete credentialing and enrollment process for home care agencies and their individual providers. From application preparation for Medicare/Medicaid certifications (including state licensing requirements) to consistent follow-ups and necessary renewals, we ensure your agency is credentialed and authorized to bill all major government and commercial payers. We stay current with all payer regulations and compliance standards, such as the OASIS requirements for home health, to ensure your agency can receive payments without delay. Once approved, we seamlessly integrate your provider numbers with our billing operations for efficient claims submission and uninterrupted cash flow.
Our certified coders specialize in home care billing and coding, applying the most up-to-date ICD-10 codes (especially primary diagnoses that justify home care), CPT, and HCPCS codes for all home care services. Whether it’s billing under the Patient-Driven Groupings Model (PDGM) for Medicare Home Health, utilizing Hospice per diem rates, or coding for specific durable medical equipment (DME) and supplies, we ensure every detail of the care delivered is accurately captured and billed according to payer-specific rules. By meticulously adhering to documentation standards and visit frequency rules, we reduce claim denials and maximize appropriate reimbursement for each episode of care.
Medivanced provides end-to-end Revenue Cycle Management (RCM) for home care providers, covering every step from verifying patient eligibility and benefits upon referral to managing the final payment posting. Our proactive approach identifies potential revenue leaks (e.g., missed visits, inadequate documentation), improves charge capture, and tracks key performance indicators (KPIs) such as Low Utilization Payment Adjustment (LUPA) rates, denial rates, and collection efficiency. We help stabilize your agency’s cash flow, ensuring its financial health remains robust while you focus on delivering high-quality, continuous care at home.
Our denial management specialists work tirelessly to recover denied or underpaid claims common in the home care sector. We actively monitor rejected claims, identify the root causes of denials (e.g., lack of pre-authorization, missed deadlines for Notice of Admission (NOA), or documentation not supporting skilled need), and implement rapid corrective measures. We efficiently resolve issues related to incorrect coding, missing clinical documentation (like the 485/Plan of Care), or complex payer-specific guidelines to quickly recover lost revenue. We also provide detailed denial reports, offering valuable insights to help your agency improve compliance and reduce future denials, particularly those related to the strict PDGM rules.
Outsourcing billing allows your skilled nurses, therapists, and aides to concentrate entirely on providing essential care in the patient's home.
Outsourcing billing allows your skilled nurses, therapists, and aides to concentrate entirely on providing essential care in the patient's home.
Significantly reduce the costs associated with hiring, training, and retaining an in-house billing team with specialized home care knowledge.
We expertly handle all the regulatory and procedural complexities of home care billing, freeing up your administrative staff.
Our specialized coders ensure highly accurate claim submission, reducing the risk of payment delays, audits, and compliance issues.
Medivanced strictly adheres to HIPAA, Medicare's PDGM rules, OASIS submission guidelines, and all state Medicaid regulations.
We possess deep, current knowledge of the nuanced reimbursement models for home health and hospice services.
Our services can easily scale to meet the fluctuating demands of a growing home health agency or a multi-site hospice organization.
We use state-of-the-art billing software and integrate seamlessly with most Electronic Health Record (EHR) and Electronic Visit Verification (EVV) systems.
Transparent and accurate billing practices contribute to higher patient and family satisfaction with your agency.
Our fully compliant systems ensure that all protected health information (PHI) is handled with the highest security standards.
Through rigorous quality checks and proactive claim monitoring, we drastically lower denial rates, ensuring predictable cash flow.
Our expert RCM strategies help optimize coding, improve documentation compliance, and ultimately increase the profitability of your home care operations.
Medivanced integrates smoothly with all major home care EHR/EMR systems (e.g., WellSky, Homecare Homebase), automating eligibility checks, claim submissions, and payment postings. Our Accounts Receivable (AR) team is proficient in managing the unique payment cycles of Medicare Home Health, carefully monitoring aging reports, actively following up on outstanding claims, and ensuring timely reconciliation of payments. We provide detailed AR reports that highlight payer trends, underpayments, and opportunities to optimize the management of your home care agency’s revenue cycle.
Medivanced provides real-time dashboards and detailed financial reports specific to home care, including KPIs like LUPA frequency, final claims submission timelines, reimbursement rates by PDGM grouping, and denial trends. These data-driven insights enable your leadership to make informed decisions that enhance operational efficiency, ensure compliance with Medicare guidelines, and improve financial stability.
Our Home Care Billing Services are expertly tailored to the needs of the industry, covering:
We ensure strict adherence to all complex documentation and regulatory requirements to maximize reimbursement across all home care service lines.
We offer responsive, round-the-clock support for any urgent billing concerns, claim submission issues, or critical payer inquiries. Available via phone, email, or our secure client portal, we are committed to supporting your agency’s financial operations whenever needed..
Medivanced offers continuous education and training for your administrative and clinical teams on the latest updates to PDGM documentation, coding for home care, state Medicaid requirements, and best practices for compliance. This training helps minimi
Each home care agency is assigned a dedicated Account Manager who serves as a primary point of contact, tracks performance against targets, and ensures effective communication between your agency and our billing team. Your account manager will proactively collaborate with you to address any issues and streamline the entire claims and collection process.
Home Care Billing Services manage the complex revenue cycle for services delivered in a patient’s home, including Medicare Home Health (PDGM), Hospice, and private duty care, focusing on compliance with strict clinical and procedural documentation rules.
We can typically begin within 2–4 weeks, depending on the time it takes for credentialing and EHR integration.
No, Medivanced integrates seamlessly with all major EHR and EMR platforms without requiring any changes to your current system.
Our certified team conducts multi-level audits, compliance reviews, and uses automated quality assurance processes to ensure 99% accuracy in billing.
We offer flexible pricing options—either percentage-based or flat-rate per claim—tailored to your podiatry practice’s structure and size
