It’s a day at the races, the horses jostle at the starting gate and the crowd is flushed with anticipation. The flag drops, the gates swing open, the horses vie for first place, and your first pick sails through the finish line.
It may not seem like it, but horse racing is a lot like the homecare billing process. And just like Seabiscuit, being the fastest one on the track has a lot more to do with what you do behind the scenes than what you do on the day of the race. If you want your billing claims to make it to the finish line, and for your agency to get paid faster, it’s important to follow these best practices.
The success of your billing claims has a lot to do with how prepared you are before you ever press “submit”.
When you first register a patient for your services, you must confirm that you have all their information in your system and understand how they’ll be paying for their homecare. The payer they’ll be using, whether Medicaid, a Managed Care Organization (MCO), private pay, or one of the many other options like Veterans programs, will influence how you can bill for services completed. Your team must determine the responsible party for covering care expenses.
Once you’ve identified the payer, you need to check that the client’s prior authorization is valid. This should happen before a caregiver ever walks through the client’s front door. Validating this information will help prevent denials and lost money down the line.
If your agency uses Business Intelligence reports, you can regularly check the status of your patient authorizations. The dashboard allows you to easily filter for expiring authorizations, allowing you to update the authorizations before they become a problem.
As part of the CURES Act, Medicaid-financed homecare visits must be electronically verified for the type, date, and location of service performed, the individual receiving the service, the caregiver or aide performing the service, and the time service begins and ends.
Accurately documenting those items and the plan of care information is critical for ensuring that your billing claims will not be denied. HHAeXchange’s Electronic Visit Verification (EVV) is seamlessly integrated into the HHAeXchange Platform, creating more efficient billing workflows and preventing errors that can occur due to manual visit documentation. As soon as a caregiver clocks in and clocks out with EVV (whether they use the mobile app, interactive voice response (IVR), or fob device), that necessary documentation appears in HHAeXchange.
While the horse is putting in the hard work, it’s the jockey who guides the horse down the right path. Great billing software can be your jockey, preventing you from making errors, and getting you into the right position so you can take advantage of faster invoice generation and claims submission. Here’s how the HHAeXchange billing solution helps homecare agencies submit cleaner claims, faster.
With any race, you need proper pacing, so you don’t lose your momentum. With homecare billing, you need consistent billing cycles. Having dependable cash flow will ensure your caregivers are paid on time, your agency’s bills are paid, and that you can keep your agency running without disruptions.
It’s the last lap of the race, which means it’s time to collect what’s rightfully yours. If you submit your claims to a payer, it’s time to work on any denials you may have received and resubmit those after fixing any administrative or authorization-related errors. Now, if you are using a billing solution, hopefully there are little to no denials, making this part of the process simple.
If your clients are private pay, you should consider implementing a systematic follow-up process for any unpaid invoices. This requires that you communicate with clients about outstanding payments while preserving the relationship. This communication should always be professional. You can keep it simple by informing them about their balance and asking how they would like to pay for services.
You’ve done it! You have crossed the finish line and successfully completed the billing journey. You have gotten your payments quickly, which means you can pay your caregivers on time, helping to prevent any unnecessary turnover, and keep your agency running smoothly.
Getting paid quickly requires systematic processes, organization, and leaning on helpful billing tools. If you are interested in learning more about how the HHAeXchange billing solution helps prevent errors, and helps providers achieve a 99.9% first-pass acceptance rate, contact us today!
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