Billing for home health is not general billing with a different code set. Episode-based billing where the physician must certify and re-certify the plan of care inside defined windows.
Predominantly government-funded, so the state Medicaid structure and managed care penetration shape the payer mix directly.
At a glance
What drives the coding
Episode-based billing where the physician must certify and re-certify the plan of care inside defined windows.
What drives the payer behavior
Predominantly government-funded, so the state Medicaid structure and managed care penetration shape the payer mix directly.
Coding
Assigned by certified coders from your documentation.
Reporting
Denials segmented by reason, payer, and provider.
Where home health claims actually fail
- Physician did not certify the plan of care inside the window
- Face-to-face encounter not documented
- Visit frequency exceeding the plan of care
How we work it
We code from what your record documents and query you when it does not support a code, which in home health is where most of the avoidable exposure sits.
Denials are worked by cause rather than in queue order, so the same failure stops recurring instead of being re-worked every month.
We work the claims. You practice medicine.
Coding, claim submission, denial management, and A/R follow-up — with nothing left for your front desk to chase.
View pricingHow It Works
Review
We look at your current home health denials and aging.
Scope
A written scope and price before any work starts.
Transition
Coding and submission move across without a gap.
Report
Denial causes reported monthly, segmented by payer.
Home Health Medical Billing by State
Medicare contractor, Medicaid program and managed-care structure, and no-fault rules cadence differ by state. Pick yours for a state-specific guide.
Home Health — Frequently Asked Questions
Do you have coders who know home health?
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Yes. All coding is performed by certified coders, and specialty assignment is deliberate — episode-based billing where the physician must certify and re-certify the plan of care inside defined windows.
Do you guarantee we will collect more?
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No, and nobody honestly can. Payment is decided by the payer. What we commit to is the process and the six numbers we report, which you can check against your own system.
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