EHP LLC, a home health provider, partnered with MedCare MSO in early 2023 after documentation gaps and coding errors were preventing them from collecting payment for services delivered to patients.
We overhauled clinical documentation, corrected coding practices, and automated claims processing. The results? EHP LLC grew collections from $5,000 to $50,000 monthly within 12 months while reducing denials by 87%.
Collection Ratio
Monthly Collections
EHP LLC had a billing mess on their hands. Documentation wasn’t getting finished, coding was all over the place, and they couldn’t collect on services they’d already provided. Claims kept getting denied. Payments weren’t coming in. Monthly collections had dropped to $5,000. The clinical team was doing solid work with patients, but the billing side was completely falling apart.
EHP LLC kept billing the wrong insurance company. Primary coverage was active but claims went to secondary. Medicare Advantage plans got treated like traditional Medicare. Authorization requirements showed up after the patient had already been seen. Coverage mistakes meant reworking claims from scratch, and by then timely filing deadlines were approaching.
Here’s where it got really bad: everything was manual. Staff spent whole days preparing claim batches with no way to catch errors before submission. Problems only surfaced after claims were already out the door and rejected. The backlog kept piling up while the team scrambled just to keep up with volume.
The clinical staff wasn’t completing OASIS assessments. Physician certification forms showed up without signatures. Plan of care documentation was too vague to prove medical necessity. Payers would review the claims and deny them because the charts didn’t back up what was being billed, even when the care was completely appropriate.
Home health episodes were getting coded wrong. Hospice levels of care weren’t differentiated properly in the system. Primary care E/M codes didn’t match what was actually documented. Diagnosis codes weren’t establishing medical necessity. Legitimate services were getting rejected because of coding problems.
When EHP LLC came to us in early 2023, we saw the problems right away: bad training, no quality checks, and manual processes that couldn’t scale. We rebuilt their revenue cycle piece by piece. The clinical team kept seeing patients while we fixed the billing operation behind the scenes.
We replaced the manual process with Maximus billing software set up specifically for home health and hospice. Claims got scrubbed automatically against payer rules before they left. The system flagged missing documentation before claims were even submitted, not after they got rejected.
First thing we did was train the clinical staff on what payers actually need to see in the charts. We ran hands-on workshops using real claim scenarios from their practice. Nurses learned exactly what OASIS questions had to be answered and why physician signatures mattered for getting paid.
We built front-end verification into their intake process. Real-time eligibility checks became standard before services got scheduled. Authorization requirements were tracked up front instead of discovered after the fact. Coverage problems got caught before anyone showed up at a patient’s home.
We put certified coders on every claim before it went out. Each rejected claim became a teaching moment, we’d pull it apart, figure out what went wrong, and make sure the same mistake didn’t happen again. The billing staff learned proper coding through actual examples from their own claims.
The partnership between EHP LLC and MedCare MSO delivered transformational results. Over 12 months, the practice went from barely surviving at $5,000 monthly collections to thriving at $50,000 monthly collections. Documentation became tight, coding became accurate, and claims moved through the system cleanly and efficiently.
| Metric | Before MedCare MSO | After Implementation | Impact |
|---|---|---|---|
| Monthly Collections | $5,000 | $50,000 | 900% Increase |
| First-Pass Resolution Rate | 45% | 95% | 111% Improvement |
| Denial Rate | 38% | 5% | 87% Reduction |
| Days in A/R | 68 days | 28 days | 59% Reduction |
| Claim Submission Time | 18 days | 3 days | 83% Faster |
| Collection Ratio | 52% | 95% | 83% Improvement |
| Manual Processing Hours | 120 hours/week | 25 hours/week | 79% Reduction |
| Revenue Per Patient | $127 | $385 | 203% Increase |
By outsourcing your billing services to us, you can expect revenue growth of up to 20%
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