Home Health and Hospice billing and accounts receivable
Soft Home Global works home health accounts receivable, denials, eligibility and prior authorization as a full time seat inside your own system, from $1,700 per seat per month. The denials below are the ones that cost home health and hospice practices the most, and they are what a seat is trained to attack first.
Home health and hospice are paid in episodes and periods, not per visit, and almost everything that goes wrong is a certification or a date that was not obtained in time.
Where the money leaks in home health and hospice
These are the recurring denial reasons in this specialty. They are not exotic. They are the ordinary ones that go unworked because the person who could fix them is at the front desk answering a phone.
- Face-to-face encounter not documented inside the certification window
- Plan of care not signed by the certifying physician before billing
- Notice of election or benefit period dates wrong, so the whole period denies
- Services billed during a period covered by another provider's election
- Physician certification and recertification dates outside the permitted range
What a seat does about it
One trained person works your queue from the difficult end. Every call is logged with the payer reference number and the outcome, so an appeal can quote what was said rather than start again. Denials are categorised, which is how the same reason stops coming back next month. On Friday you get it in writing.
The roles that matter most in this specialty are AR calling and denials at $1,700, prior authorization at $1,900, and certified coding at $2,500.
Questions
What are the most common home health and hospice denials?
Face-to-face encounter not documented inside the certification window. Plan of care not signed by the certifying physician before billing. Notice of election or benefit period dates wrong, so the whole period denies.
Do you have people who know home health and hospice?
Not a bench of home health and hospice specialists sitting idle — we would rather say so. A seat is trained on your specialty, your payer mix and your system for about a week, and stays on your account rather than rotating.
What does it cost?
An AR caller working denials is $1,700 per seat per month. Prior authorization is $1,900. A certified coder is $2,500. Full time, US hours, one month minimum.
Next step
Put one seat on your home health and hospice AR
Twenty minutes is enough to work out whether the denials above are the ones costing you money. If they are not, I will say so.
Or write to ops@softhomeglobal.com