Home Health Billing: What Are the Basics?

home health billing

Helping patients is your agency’s top concern. However, receiving payments from insurance companies for your skilled services becomes an unnecessary hassle. That’s because while some payers provide you with the appropriate funds to assist your patients, others save money by not covering given claims. 

At PracticeForces in Clearwater, FL, we understand fighting for claim approvals is one of the major causes of burned-out physicians. If claim rejections are becoming a recurring event from insurance companies playing hardball, examine the home health billing process and give us a call. Our trained staff lowers first-pass rejection rates from an average of 25% to below 5%, so make the changes you need now!

Creating a Claim

When assisting patients, it’s not uncommon to encounter insurance providers, such as Medicaid and Medicare, that you’ve dealt with before. In these cases, creating home health billing claims should be a breeze for your at-home nursing, physical therapy, or social work sessions. 

While all payers have their formulas for filing and approving claims, your electronic medical records (EMRs) already reflect the appropriate revenue codes and claim types for insurance companies with which you have experience. Therefore, your company already knows how to bill the payer without fear of claim rejections. 

If you’re incorporating a new insurance company into your system, your practice’s health billers must understand the specifics of its billing claims. Among other things, this includes correctly cataloging:

  • The line of business (LOB)
  • HCPCS and revenue codes 
  • Submitter, provider, and payer IDs

Sometimes, receiving information from payers is difficult, causing claim rejections, but use denials to acknowledge and remedy missing information. 

Managing Your Claims

Revenue cycle management (RCM) is the next step in home health billing, where a clearinghouse tracks billing and payments. This hub seeks out each claim’s appropriate payer portals, saving you time manually logging into the portals. It also:

  • Outlines all paid transactions
  • Shows claims denied by payers
  • Helps you manage rejections so you may reapply
  • Organizes claims so you can filter through them effortlessly 
  • Looks over claims for errors before sending them 

Outsourcing to coding and billing partners is also an option where you allow an out-of-house team specializing in the billing process to heighten productivity and encourage consistency while focusing on the patients. 

Dealing With Claim Denials 

Claim denials during home health billing are bound to happen. However, don’t keep resubmitting what you have. Instead, follow up with the insurance companies for necessary claim changes.

We also advise you to build powerful connections with all agencies, insurance companies, clearinghouses, outsourced partners, and electric medical companies with whom you work. 

It Takes an A+ BBB-rated Company To Make One!

While you help others, we help healthcare providers like you. Our home health billing team answers all your questions, from “What is a clearinghouse?” to “How will your team grow my company?”

At PracticeForces in Clearwater, FL, we have almost 20 years of experience maximizing profits and dealing with stingy payers to lessen claim denial percentages. Call (727) 499-0351 to discuss our A+ services further today!

Parul Garg, CEO and co-founder of PracticeForces, has significantly contributed to the growth of over 1,000 U.S. medical practices through her expertise in medical billing and coding since the company’s inception in 2003. With a background in Computer Science and an MBA in Human Resources, her leadership and AAPC-certified coding skills have been pivotal in managing the company’s operations effectively.

Related Posts


Do you want to streamline your reimbursements?

Subscribe for actionable tips and insights to grow your medical practice >

Call Now Button