Home Health and Hospice Medical Billing Built for Episode-Based Care
ClainetRCM delivers revenue cycle management built for home health agencies and hospice programs. Stop losing revenue to late notices, assessment errors, and face to face documentation gaps.
Certified specialists file admission notices inside the required window and reconcile every episode so no period is billed late or incomplete
Why Home Health and Hospice Billing Demands a Specialist
Home health and hospice are governed by deadlines rather than denials. A notice filed a day late reduces payment for the entire period, and an assessment error changes the payment group for the whole episode.
Admission and Election Notice Deadlines
Notices of admission and election must be filed within a strict window. Late filing reduces payment for every day of delay and is not appealable.
Assessment Accuracy
The patient assessment drives the payment group for the entire period. Errors and inconsistencies change reimbursement and invite review.
Face to Face Encounter Requirements
Certification requires a documented face to face encounter within defined timeframes, tied to the reason for care. Missing it invalidates the claim.
Visit Thresholds and Episode Structure
Periods with visits below the threshold are paid per visit rather than as a full period. Tracking visit counts protects episode revenue.
Complete Home Health and Hospice RCM Solutions
From charge capture to final payment posting, ClainetRCM manages every step of your home health and hospice revenue cycle so you can focus on patient outcomes.
Home Health and Hospice Medical Billing
Complete billing management built specifically for home health agencies, hospice programs, and in-home care providers.
- Charge entry and claim scrubbing
- Electronic and paper claim submission
- ERA/EOB posting and reconciliation
- Denial management and appeals
- Patient statement and balance collections
Home Health and Hospice Medical Coding
Certified coders with deep home health and hospice coding expertise capture every procedure at the correct, compliant level.
- Primary diagnosis selection driving the payment group
- Assessment review for accuracy and consistency
- Admission and election notice preparation and timing
- Face to face encounter documentation verification
- Visit threshold monitoring and episode reconciliation
Healthcare Credentialing
Fast payer enrollment and re-credentialing so you never miss a payment because of a lapsed credential.
- Insurance enrollment and re-credentialing
- CAQH profile management
- Medicare and Medicaid enrollment
- Payer contracting and fee schedule review
- Ongoing status tracking and follow-up
Virtual Medical Assistant
Dedicated remote assistants to absorb your front-desk workload so your staff stays focused on patients.
- Prior authorizations and referrals
- Appointment scheduling and reminders
- Insurance eligibility verification
- Patient follow-up calls
- EHR data entry and documentation support
Accounts Receivable Management
Dedicated AR follow-up to recover outstanding claims and pull down aging balances across every payer.
- Aging AR review and prioritization
- Payer follow-up and escalation
- Patient balance collections
- Write-off and adjustment analysis
- Monthly AR performance reporting
Revenue Cycle Audit
A thorough audit of your home health and hospice billing to surface revenue leakage and compliance risk before it escalates.
- Billing workflow assessment
- Coding accuracy and payer policy audit
- Denial pattern analysis
- Payer contract review
- Custom revenue improvement roadmap
Home Health and Hospice Billing Challenges We Solve Every Day
Home health and hospice agencies face billing obstacles that generic billing companies consistently get wrong. We know them all, and we fix them.
Late Admission Notices
Payment reduced for every day a notice is filed late, with no appeal available. We file inside the window every time.
Assessment Errors
Inaccurate assessments change the payment group for the whole period. We review for accuracy and internal consistency before submission.
Missing Face to Face Documentation
Claims invalidated because the required encounter was not documented or not tied to the reason for care. We verify before billing.
Visit Threshold Shortfalls
Periods paid per visit instead of as a full period because visit counts fell short. We monitor counts during the period, not after.
Certification and Order Gaps
Missing or unsigned physician orders and certifications invalidate otherwise correct claims. We track signatures actively.
Recertification Timing Errors
Recertifications completed late break the continuity of billing. We manage the calendar so periods do not lapse.
Slow Reimbursements
Episode claims stall when documentation is incomplete. We work them until each period is fully resolved.
Audit and Review Exposure
Home health and hospice face heavy medical review. We keep documentation aligned so reviews do not become recoupments.
Get Started in 5 Simple Steps
Onboarding with ClainetRCM is fast and seamless. Most home health and hospice practices go live within one week with no disruption to daily operations.
Free Consultation
We analyze your current billing setup and identify home health and hospice revenue gaps at zero cost.
Custom Onboarding
We integrate with your EHR and PM system and configure home health and hospice billing workflows.
Team Assignment
A dedicated billing team with real home health and hospice experience is assigned immediately.
Claims Submission
Clean, policy-compliant claims submitted within 48 hours with real-time tracking.
Revenue Growth
Watch collections climb with transparent monthly performance reporting.
What We Commit To on Every Home Health and Hospice Claim
These are the standards we control and hold ourselves to, written into every engagement.
From charge capture to claim submission, on every working day
Business days to onboard your home health and hospice practice end to end
Between full accounts receivable reviews, every single cycle
Starting rate on monthly collections. No setup fee, no contract
Home Health and Hospice Billing for Every Practice Size
Whether you run a single-county home health agency or a multi-site hospice program, ClainetRCM keeps every episode compliant and paid.
Independent Agencies
Smaller home health agencies that need deadline discipline and assessment review without a large back office.
Hospice and Palliative Programs
Hospice organizations managing election notices, levels of care, and interdisciplinary documentation requirements.
Health System Home Care
Health system home care divisions requiring enterprise reporting, audit readiness, and multi-site consistency.
Frequently Asked Questions
Because the payment reduction applies to every day between the start of care and the day the notice is actually filed, and it is not appealable. An agency that files a few days late across many admissions loses a meaningful percentage of revenue with no denial ever appearing on a report. We treat the notice deadline as the hardest deadline in the revenue cycle and file inside the window every time.
We review assessments for accuracy and internal consistency before they drive the payment group for the period. Inconsistencies between the assessment, the plan of care, and the clinical documentation both change reimbursement and attract medical review. Catching them before submission is far cheaper than correcting them after a review finds them.
Certification requires a documented encounter with a qualifying practitioner within a defined window around the start of care, and the documentation must connect the encounter to the primary reason home care is needed. A generic visit note that does not tie to that reason will not satisfy a reviewer, so we verify the linkage rather than just confirming an encounter occurred.
We monitor visit counts during the period rather than discovering a shortfall after billing. Periods with visits below the threshold are paid per visit instead of as a full period, which is a substantial difference. Knowing mid-period lets the clinical team make an informed decision about whether additional visits are clinically appropriate.
ClainetRCM integrates with the platforms home health and hospice practices already use, including Homecare Homebase, WellSky, Axxess, MatrixCare, Netsmart, and Alora. We adapt to your existing technology rather than forcing a migration, so onboarding does not disrupt your clinical workflow.
Pricing starts at 2.29% of monthly collections, so we are only paid when your practice is paid. There are no setup fees, no long-term contracts, and no hidden charges. Book a free consultation for a quote based on your volume and payer mix.
Ready to Grow Your Home Health and Hospice Revenue?
Talk to a home health billing specialist about your notice timing, your assessments, and your episode reconciliation.
Request Your Free Audit TodayLet's Grow Your Home Health and Hospice Practice
No obligation. Our home health and hospice billing specialists will review your current setup and identify exactly where you are losing revenue.
Why Consult With ClainetRCM?
In a single free session, our home health and hospice RCM experts will uncover hidden billing gaps and give you a clear roadmap to increase collections starting immediately.
Free Revenue Audit
We review your billing performance and identify gaps at zero cost to you.
Dedicated Home Health and Hospice Billing Expert
You will speak directly with a specialist who understands home health and hospice billing deeply.
100% Confidential
All information shared is protected by HIPAA and never shared with third parties.
Fast Onboarding
Practices go live within 7 to 14 business days of signing on.
No Long-Term Contracts
Pricing starts at 2.29% of collections. No setup fee, no lock-in.