Home health billing is a necessary yet challenging process for healthcare practices. Managing insurance claims is rewarding only when you know effective ways to deal with errors, delays, and denials. Wanting to run a successful home healthcare practice is a fair aim, but many times it leads to burnout.
You can avoid this situation and take your home healthcare practice towards better administrative functioning and satisfactory revenue flow. To achieve these goals, you must start by understanding the billing process and then move forward to taking appropriate action.
This blog is your guide for everything you need to know about home health billing and a medical billing services company in New York. We will also talk about different ways you can avoid the hassle of billing and still attain your revenue goals.
But first, let’s get the answer to the most important question, which is:
Can You Be Considered a Home Healthcare Provider?
Home health is a specific type of medical specialty, and there are various types of physicians and care providers who are a part of it. So, if you want revenue under home health billing, then you must know if you fall under this category.
Home care providers offer medical assistance directly to patients in their homes, and they include:
- Registered Nurses (RNs)
- Licensed Practical Nurses (LPNs)
- Home Health Aides (HHAs)
- Physical Therapists (PTs)
- Occupational Therapists (OTs)
- Speech-Language Pathologists (SLPs)
- Medical Social Workers (MSWs)
- Physicians (who can make home visits)
- Dietitians/Nutritionists
- Respiratory therapists (who provide breathing support or oxygen therapy at home)
- Palliative and Hospice Care Teams
What Is Home Health Billing?
The process of acquiring revenue for rendered home care from insurance companies is known as home health billing. It is similar to any other type of medical billing process but is performed only for home care practices.
The medical billing process has various steps starting from the time a patient enters your facility until the time you receive payment. In theory, the steps sound simple, like registering patients, checking their insurance coverage, documenting their information, filing claims, and submitting them to the insurance company.
However, the real struggle begins when you start performing these steps. Every day with a multitude of patients showing up at your practice, things can get unorganized and cause issues.
When Do the Home Health Billing Steps Become a Challenge?
Completing every step in medical billing requires skill, expertise, and experience, especially in steps like verification, documentation, and medical coding.
When you don’t employ qualified professionals to handle your administrative process, you will start seeing its effect on the steps. With an increase in the daily patient inflow, the manual errors will also increase.
Not utilizing technology to your advantage leaves the billing process incomplete and leads to errors during coding.
Let’s look at these complexities in detail and identify improvement areas!
Insurance Eligibility Verification
To get paid for your services, the patient must have the necessary insurance coverage. As home health is very specific, not all patients will have covered benefits for home care. However, if you fail to check it before offering medical services, then later you may not receive adequate revenue.
To reduce errors during this step, you can opt for eligibility authorization services and kick-start your billing process with efficiency.
Documentation of Patient Data
After the patient has received medical care, the billing process progresses to documentation of patient information. Recording this data is important for the coding process and claim filing. A room for mistakes and missing details will result in claim denials and improper revenue.
It becomes crucial to avoid these mistakes and carry out documentation perfectly.
Medical Coding for Home Care
Medical coding is the only step that leads to the maximum number of denials. The reason behind this is a lack of coding skills and knowledge for home healthcare. Under-coding, over-coding, unbundling, and duplicate coding are common error types.
To improve the coding process, you must hire certified professionals with experience in home health billing and utilize the latest technology.
Claim Submission to Payers
After proper claim filing, it’s time for submission of claims to the insurance provider. This step may seem normal and easy, but there is a catch to it. If you delay submissions and miss the deadline, then your claims are most likely to turn into denials.
Staying prompt with the submission of claims doesn’t seem difficult, but when you have the pressure to handle multiple patients, it’s normal to slip through your mind. To make sure such errors don’t occur in your practice, you can partner with a medical billing company in New York.
Denial Management & Follow-Up
After every step is taken, then comes the role of denial management and revenue recovery. Claim denials are a common part of home health billing, but it is vital to reduce them. So, the role of denial resolution is to identify the reason behind denials and refile those claims to recover revenue. Another thing that denial management does is review the whole billing process and improve error-prone zones.
This way healthcare providers can upgrade their revenue cycle management and streamline the operational flow.
Regulatory Standards & Compliance
While talking about medical billing, healthcare providers often overlook the constant need to stay up to date with changing guidelines. Taking these changes lightly is not the best course of action for home health medical billing. One more compliance standard you must not miss in any situation is HIPAA.
Complying with HIPAA prevents you from losing revenue, legal actions, and reputational damage.
What’s the Solution? - Medical Billing Services Company in New York
There are a lot of layers of home health medical billing, and ensuring accuracy in each of these layers is essential to achieve profits. Trying to provide medical care to patients and doing billing at the same time requires much effort. Also, the chances of mistakes increase, leading to reimbursement losses.
Medical billing services will help you say goodbye to all these billing complexities and welcome complete reimbursement. With their assistance, you will have zero administrative burden and payment in your bank account at the right time.
Eminence RCM is an outstanding medical billing services company in New York. We offer a comprehensive range of home health billing made specially to meet your needs. Our team has qualified individuals who take every billing matter seriously and improve your revenue cycle management.
We comply with HIPAA and make use of advanced technology to ensure streamlined processes are free from any discrepancies. With us, you get a chance to forget the billing stress and focus solely on offering exceptional patient services.
Outsource medical billing from Eminence RCM and get a full team of certified team members who will maximize your revenue!
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