Home Health Billing Services

Welcome to Medcare MSO, where our home health billing company goal is to provide all the services you need to support the revenue growth of your agency. Our experienced team is dedicated to helping your home health agency succeed. We understand the unique challenges faced by healthcare providers and provide a comprehensive suite of billing and revenue cycle management services, including the efficient submission of Medicare claims to reduce human error and improve billing efficiency.


Verifying patients’ eligibility and benefits information is a critical step in the home health billing process. Accessing detailed benefits information, especially from Medicare’s HETS database, is essential for effectively determining service requirements and billing codes.

Key Challenges Faced by Home Health Providers

Home health agencies have a lot of challenges with billing. Medical coding and billing regulations are complicated and require specialized knowledge and constant updates. Insurance reimbursement policies and rates vary significantly which makes billing even more complicated. Agencies have to systematically collect both medical documentation and demographic data to facilitate efficient patient care and billing operations, submit claims accurately and on time, and manage multiple payers and billing systems. Compliance is another important aspect that can’’t be ignored. It’’s overwhelming so home health agencies need to have a reliable and efficient home health revenue cycle management solution to navigate all this.

Essential Skills for Accurate Home Health Billing Services

Skillfully navigating insurance coverage to verify patient eligibility and obtain approvals in advance.

Actively handling accounts receivable by dealing with payers, researching unpaid claims, and fixing mistakes in claims.

Making sure all patient information is recorded accurately and claims are submitted without errors.

Efficiently solving credit balance issues by analyzing the records, identifying overpayments, and sending refund letters.

Excelling in coding and knowing how to obtain the highest allowable reimbursements.

Providing personalized reports for clear insights into the status of all financial processes.

Quickly managing billing and submitting claims, both at the end of a patient’s encounter and following up on unpaid bills.

Carefully reviewing and correctly recording payments, both electronic and manual, and accurately denoting payments from payers and patients, as well as tracking denials.

Top Benefits of Outsourcing Home Health Revenue Cycle Management

Outsourcing home health billing has many benefits that can really make a big difference in the efficiency and financial health of an agency. By using the expertise of billing companies, agencies can improve their billing processes, reduce errors and denials. This not only meets regulatory requirements but also increases cash flow and revenue cycle management. You can focus on patient care not administrative tasks. Additionally, outsourcing allows for custom-fit billing and coding services that enhance reliability and increase reimbursement rates for clients.

Instant Ramp-ups

One of the top benefits of outsourcing home health billing is the ability to scale quickly. This is key for agencies that need to respond to sudden increases in patient volume or changes in reimbursement. With the ability to ramp up or down quickly agencies can adjust to market changes without compromising patient care. This scalability means agencies can keep their bottom line healthy and still meet patient needs. Additionally, a quick turnaround time in resubmitting denied claims ensures timely reimbursements, accelerating cash flow and enhancing overall efficiency.

How MedCare MSO Strengthens Your Home Health Financial Performance

Patient Coverage and Authorization

Identifying insurance coverage can be tricky when submitting a claim. Medcare MSO has a team that specializes in determining patient eligibility and obtaining prior authorizations, saving your staff precious time and minimizing the chance of error.

Secure and Streamlined Home Health Data Management

Efficient home health billing services depends on precise data management. Our committed staff ensures that patient demographics and insurance information are accurately recorded, resulting in careful charge entry, accurate coding, and comprehensive documentation. Our system ensures error-free claim submission, maximizing your reimbursement potential. Accurate completion of the Outcome and Assessment Information Set (OASIS) is crucial to ensure compliance and effectively meet patient needs.

Coding Excellence

Home health coding demands a complete understanding of clinical documentation and adherence to specific coding standards. Medcare MSO has a highly trained team of experienced billers and coders with in-depth knowledge of industry guidelines. Our team can handle specialized coding requirements to optimize your payout. The OASIS assessment is a key patient-specific standardized tool utilized in home health care, crucial for providing quality metrics, determining reimbursement, and ensuring compliance as part of a patient’s care plan.

Billing and Claims Submission

Delays in billing and claims submission directly interfere with your cash flow. Medcare MSO provides prompt home care billing solutions, efficiently handling No-pay RAPs and End of Episode (EOE) claims through electronic and paper submissions as appropriate. Efficient billing practices are crucial for shortening the turnaround time for Medicare payments, especially given the financial pressures from the growing aging population.

Payment Posting

Our dedicated team thoroughly reviews and posts all payments, covering electronic, manual, patient, and denial posting. We offer you a transparent view of your financial transactions by minimizing errors in claim submission. Medcare MSO ensures accuracy at every step, contributing to your financial stability.

Proactive AR Management

Effective management of accounts receivable relies on proactive follow-up. Medcare MSO engages directly with payers, conducting thorough research on unpaid claims, responding to rejections, and promptly reprocessing corrected claims.

Denial Management

Identifying the causes of denials and categorizing them is important for preventing recurring issues. Medcare MSO’s denial management process includes determining the reasons for denials and retraining the biller or correcting information with the payer if there is a problem on their end.

Frequently Asked Questions

Home health billing is a complicated process of submitting claims to Medicare, Medicaid and private insurance companies for reimbursement of home health services provided to patients. The goal of home health billing is to get home health agencies paid timely and accurately for the services they provide. Effective home health billing solutions can help agencies streamline their billing process, reduce denied claims and improve cash flow. By managing the complexity of health billing, agencies can focus more on patient care and less on administrative burdens.
Home health billing solutions can streamline the billing process, reduce errors and improve cash flow. These solutions can include automated claims submission, electronic remittance advice and real-time eligibility verification. By implementing home health billing solutions, agencies can reduce the time and effort to manage their billing, so they can focus on patient care. These advanced solutions ensure claims are submitted accurately and on time, so payments are faster and fewer denials.
Quality assurance is a big part of home health billing. It’s reviewing and verifying claims, making sure all documentation is complete and up to date and identifying and addressing errors or discrepancies. By having a quality assurance process, home health agencies can reduce denied claims, improve cash flow and be compliant with regulations. This proactive approach not only improves the overall billing process but also the financial stability of the agency.
Researching unpaid claims is a critical step in the home health billing process. It’s identifying and investigating claims that haven’t been paid, determining why they weren’t paid and taking corrective action to resolve the issue. By researching unpaid claims, home health agencies can reduce lost revenue, improve cash flow and get paid timely and accurately for the services they provide. This diligent follow-up makes sure no revenue is left uncollected, so the agency is financially healthy.

Orders management is the process of managing and tracking orders for home health services. It’s receiving, processing and verifying orders and making sure all documentation is complete and up to date. By having an effective orders management process, home health agencies can reduce errors, improve cash flow and make sure patients get the care they need on time. This organized approach to orders management ensures patient services are delivered without delay, so overall care is better.

Join Medcare MSO to support the financial health of your Home Health agency. Each challenge is met with expertise, accuracy, and a commitment to your success. Our home health billing services ensure that your practice not only survives but thrives in today’s complex healthcare landscape.

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If you’d like to talk to someone now, give us a call at 800-640-6409. ​
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