8 Tips for Properly Billing for Managed Care in Home Health

The process for managed care can be difficult to handle. When managing the office for home health care, you have a lot of responsibility and data to keep track of. If you do not have a handle on a proper billing process, you can quickly find yourself way over your head. This is why home health agencies often seek the assistance of billing companies. By doing so, many have seen up to a 30% increase in revenue.

You may decide you could benefit from assistance, and we want to help. But first, take into consideration these best practices to properly bill for managed care in home health.

1. Make sure that the patient is eligible to receive treatment from you. The last thing you want to discover is that the services you have provided are not covered by the patient’s insurance. Make sure that eligibility checks are one of the first things done when registering a patient or it is very possible you will not be reimbursed.

2. Follow up with the insurance company to ensure that the plan covers home health. Some plans do not cover home health or custodial care. Though the insurance company may have covered a patient of yours in the past, your current patient might have a different plan that does not include your services.

3. Determine what the patient owes, including their deductibles and copayments. Home health agencies need to collect both of these. If you do not calculate these amounts, you will not be receiving the full amount that is owed to you.

4. Do all of your billing electronically through a clearinghouse. If you carry out your billing through paper documents, you are putting yourself at high risk for the loss of important data. Electronic billing allows everything to move quicker and keeps all of your patient’s information in one secure place.

5. Be aware of deadlines. Your claims need to be filed on time or your agency could completely miss their chance to get paid. Each claim should be prioritized based on its filing deadline to avoid the risk of letting one fall through the cracks.

6. Monitor submitted claims for approval. After a claim is submitted electronically through your clearinghouse, your billing team should check on it the following day to ensure that it was not rejected and needs to be adjusted and submitted again.

7. Follow up on rejected claims. Once it is determined that the claim has been rejected, be sure to have someone on your billing staff figure out why. Often times the rejection was due to a minuscule error that can be easily fixed. The sooner the issue is resolved, the more likely it will not be put onto the back burner and subsequently lost in the mix.

8. Outsource your billing. By engaging a team of experts who know exactly how to carry out home health-managed claims with a track record of success, you can feel confident that your finances are being handled properly. Billing companies are well worth the investment because you are only charged a small percent of the revenue they recover on your behalf.

In Conclusion

At the end of the day, you want to have a system that ensures that your patients receive the treatment they deserve and that your company is reimbursed for it. If you are finding that your office is having a difficult time keeping track of claims, you may be in need of some extra assistance. Contact us here for more information on medical billing.