Hospice billing includes bundled payments, per-diem logic, and Medicare rules that change every fiscal year. Our hospice billing software keeps itself updated on every NOE, CTI, and HOPE assessment so your claims go out clean.
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Trusted by 1000+ providers
Faster NOE Processing
Faster Reimbursements
Fewer Denials
MedCare MSO’s hospice billing software is built for every stage of the revenue cycle, from election to final payments so that your claims are always compliant, deadlines are met, and reimbursements are on time.
The Notice of Election requires 5 calendar days of admission to be filed and if not, the downstream claims are blocked. Our software auto-generates and submits the NOE, flags errors before submission, and tracks filing status in real-time so your revenue cycle stays steady.
Hospice claims are billed across four Medicare levels including RHC, CHC, GIP, and IRC, each having their own documentation requirements. MedCare MSO’s hospice billing software validates the selection against clinical records so that the claim generated is compliant.
All claims are scrubbed by hospice-specific logic before they get to the clearinghouse, ensuring that the CTI narrative is complete, election statement is valid, revenue code is accurate, and payer-specific rules are adhered to. Errors are identified for correction before clean claims go out; clean claims go out the same day.
Denied claims are identified at the point of return, classified by root cause, and directed through a streamlined, hospice specific appeal process. All denials are addressed and not just resubmitted with audit-ready clinical documentation, from CTI documentation gaps to face-to-face encounter deficiencies.
Access tracking collections, denial rates, AR aging, per-diem reimbursement capture and aggregate cap utilization on one real-time dashboard. Role based access allows all stakeholders, from billing employees to agency owners, to see these revenue gaps and stop them from being unaware of the revenue loss.
HOPE will supersede HIS in October 2025 and add 4 structured assessment timepoints and Symptom Follow-up Visits within 2 calendar days of a trigger. Our platform monitors all your windows throughout your patient population and raises a flag on staff before any window becomes a compliance risk.
Every feature of our software is purpose-built for the compliance requirements and assure timely reimbursements for your hospice care. It covers every requirement of the Medicare hospice benefit and keeps your revenue cycle steady.
End-to-end hospice billing and NOE filing, HOPE compliance monitoring, and per diem claim billing and aggregate cap monitoring.
Hospital-affiliated hospices software, one place for GIP documentation, cost report alignment and multi-department billing.
One platform, with one report and no duplicate data entry: Separate PDGM and hospice per-diem billing workflows.
Manages GIP and IRC documentation, Medicare crossover claims, and facility-specific billing rules, all automated in the hospice platform.
Standardized billing processes, aggregate cap monitoring per agency, and consolidated denial tracking for all locations in your network.
Built to safeguard your hospice billing accuracy and funding, audit-ready documentation, clean claim submission, and real-time compliance tracking.
MedCare MSO is designed to interface with every major podiatry EHR and practice management system using the HL7, FHIR, X12 and secure REST API frameworks. There's no manual re-entry required into the billing queue, no migration of the system required, and clinical documentation, imaging records and treatment notes flow into the queue.
Every rule set, workflow, and compliance protocol is purpose-built for hospice billing and not repurposed from a general billing software.
Monitors HOPE guidelines, aggregate cap thresholds, and NOW submission windows in real time to flag claim errors before submission.
Whether you need billing workflows, reporting, denial tracking, AR assessment, or claim analysis, our hospice billing software has it all.
Most hospice agencies are fully onboarded and operational in the first week. However, patient data, payer enrollments, and workflow configurations can differ, so did the onboarding time.
Yes, MedCare MSO’s hospice billing software supports the Medicare hospice four levels of care. The software uses AI for validating every level-of-care selection against the clinical documentation before the claim is generated to make sure it is supported and audit-defensible.
The software tracks recertification windows from the third benefit period onward and escalates missed 2F2 encounter tasks through automation. If there is a gap, the software flags it immediately and generates the documentation workflows required. This is to support readmission and protect reimbursements.
Yes, the software identifies MA plan patients at admission and routes claims through the accurate billing pathway. The pathway can either be Medicare FFS or the elected MA plan, based on the patient’s enrollment status.
Our hospice billing software has an aggregate cap dashboard that calculates real-time cap utilization on a per-agency basis across the entire network. If there are any issues in it, early warning alerts are triggered before the thresholds are approached.
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