01
Home Health PDGM Billing
30-Day episode billing with diagnosis coding, comorbidity capture, functional scoring review, and timely RAP/NOA submission to avoid LUPA downcoding and payment delays.
Home Health Billing Services
Home Health Billing Services by Revex Square is where you go when your home health, home care or hospice agency focuses on caring for patients in their homes. You don’t want to spend your days tracking LUPA thresholds, hospice election dates or Electronic Visit Verification logs across three payer systems. Your workday often ends with a 30-day PDGM episode still open an HCBS Medicaid waiver claim waiting for an EVV match and a hospice recertification deadline you nearly missed. That’s when Home Health Billing Services from Revex Square step
Home-based care agencies get paid faster, more cleanly and more predictably when they work with a home health billing company that truly understands PDGM, OASIS-E, hospice levels of care and Medicaid HCBS billing. Not a generalist team using office-visit billing logic for home-based care. No long meetings. No confusing reports packed with jargon. Just a partner who knows home health billing inside and out whether you run home health private duty home care, hospice or home infusion.
Imagine finishing your week knowing that every OASIS assessment supports the payment group, every hospice election and recertification is properly documented every EVV visit matches its claim and every claim is already moving through the payment stream instead of sitting in a denial queue. That is the peace we bring to home-based care agencies every day.
Schedule Free Consultation
Home Health Billing Service Specifications
Complete billing & RCM overview for home-based care providers
Home Health Billing Service Specifications
Service Type
Home Health, Home Care, Hospice, and Home Infusion Billing & Revenue Cycle Management
Provider
Revex Square, Full-Service Medical Billing Company
Agencies Served
Service Areas Covered
Coding/Compliance Systems
HIPPS Coding, ICD-10-CM, PDGM Grouping Logic
— Notice of Election (NOE) and Hospice Cap Tracking, 21st Century Cures Act EVV Requirements
Service Price
As low as 2.75% of your monthly collections
— no hidden fees
Software Compatibility
Availability
Nationwide in the United States, including multi-state agencies with state-specific EVV and Medicaid waiver rules
Compliance
HIPAA-Compliant, encrypted, auditable, and secure
Key Metrics
99%
Clean Claim Rate
<25
Days in A/R
<6%
Denial Rate
48hr
Claim Turnaround
Contact Number
+1 737-227-1587
Business Hours
Mon – Fri: 6 AM – 9 PM (CST)
Want to increase your home health collections? Get a free demonstration.
Schedule a Free DemoBilling Support Built Around Home Healthcare
We handle the billing so you can focus on your patients.
05+ Years in Medical Billing
Half a decade of specialized medical billing experience helping healthcare practices improve collections and revenue.
99% Clean Claim Rate
Our experienced billing team handles claims with precision, helping reduce errors, rejections, and payment delays.
Faster Payments
We follow every claim from submission through payment, helping your practice receive revenue faster and maintain a healthier cash flow.
Work With a Home Health Billing Specialist
Our team understands PDGM grouping, hospice election rules, HCBS waiver billing and the unique challenges of home-based care revenue cycle management.
Our Home Health Billing Process
We simplify every step of your revenue cycle so your agency can focus on serving patients.
01
Patient Eligibility
We verify insurance eligibility before care begins. For Medicaid HCBS clients, we also verify authorized service hours to help prevent billing issues.
02
Charge Capture & Visit Verification
Our team captures every billable visit and reconciles it against EVV data so visits that are missing from the EVV system do not become unbillable.
03
Coding & Episode Review
Certified coders assign HIPPS and ICD-10 codes based on OASIS documentation and review PDGM grouping for accuracy. We also track hospice level-of-care changes and HCBS service-plan updates.
04
Claim Submission
Clean claims are submitted electronically to Medicare, Medicaid, and commercial payers, with RAP/NOA, hospice NOE, and HCBS claims routed according to their specific timing and documentation requirements.
05
Payment & A/R Follow-Up
We monitor payments, track episode and election-period deadlines, follow up on unpaid claims, and actively manage denials and outstanding accounts.
Accurate Home Health Coding
Every HIPPS code, diagnosis, and supporting OASIS or care-plan document is carefully reviewed to reduce coding errors, claim rejections, and lost revenue.
Faster Reimbursement
Our streamlined billing workflow helps move claims efficiently through the revenue cycle and improves your cash flow.
Home Health Billing Services We Provide
Comprehensive revenue cycle solutions designed for home-based care, including the billing and compliance gaps most billing companies skip.
02
OASIS-E Documentation Review
Our specialists review OASIS assessments against documentation before submission since a single miscoded item in wound status, functional limitation, or skilled need can shift an episode into a lower-paying group.
03
Hospice Billing
Hospice runs on a different model than home health: per-diem levels of care, Notice of Election (NOE) filing, physician certification and recertification deadlines, and aggregate hospice cap tracking. We manage this separately from home health billing rather than forcing it into the same workflow.
04
Medicaid Waiver Billing
Home and Community-Based Services billing runs on units and hours rather than episodes, with state-specific waiver rules that vary significantly from standard Medicare home health. We track authorizations and service-plan limits so units are not billed beyond what is approved.
05
Home Infusion Therapy Billing
Home infusion billing combines drug costs, per-diem nursing services, and supply billing, often split across pharmacy and nursing benefit categories with payer-specific rules. We keep these components billed to the appropriate benefit rather than bundled incorrectly.
06
EVV Compliance & Claim Matching
The 21st Century Cures Act requires Electronic Visit Verification for applicable Medicaid care and home health services. We reconcile EVV visit data against billed claims before submission to help prevent EVV-related claim denials.
07
Private Duty & Non-Medical Home Care Billing
For agencies billing long-term care insurance or state programs for non-skilled personal care, we manage hourly billing, authorization tracking, and invoicing separately from clinical episode billing.
08
Denial Management
Our team identifies the root causes of denials, corrects billing issues, and follows up with payers to recover lost revenue, including denials tied to LUPA thresholds, EVV mismatches, and hospice election errors.
09
Accounts Receivable Management
We monitor accounts, prioritize aging balances, and actively follow up with payers to accelerate reimbursement and improve cash flow.
10
Multi-State & Multi-Branch RCM Reporting
For agencies operating across multiple states, we consolidate collections, denial trends, and A/R performance while tracking each state's distinct EVV and Medicaid waiver requirements.
Need a Home Health RCM Solution?
Let Revex Square handle your billing while you focus on serving patients.
HOME-BASED CARE EXPERTISE ACROSS EVERY MODEL
Home Health Billing Solutions Tailored to Your Agency
Every home-based care agency is different. A Medicare-certified home health agency running 30-day PDGM episodes has different billing needs than a hospice agency tracking election periods and the annual cap, an HCBS provider billing authorized hours under a state Medicaid waiver, or a home infusion provider splitting drug and nursing charges across benefit categories.
Revex Square provides specialized home health billing solutions designed around a category of billing that runs on rules general medical billing companies often only half understand: episode-based PDGM payment, hospice per-diem and cap rules, HCBS authorization limits, and EVV visit verification that most other specialties never deal with.
✓
Specialty-Specific Coding
Accurate HIPPS, ICD-10, and hospice/HCBS coding matched precisely to OASIS documentation, care plans, and authorized service levels.
✓
Payer Expertise
Experienced handling of Medicare, Medicaid HCBS waivers, and commercial payers, each with its own episode, election, or authorization rules.
✓
Complete Revenue Cycle
From eligibility and EVV reconciliation to coding, claims, denials, and A/R follow-up, covering the full path from visit to final reimbursement.
Performance Snapshot
Home Health RCM
Clean Claims
99%
Denial Rate
<8%
Days in A/R
<25
✓
Faster Payments
Streamlined RCM
99%
Clean Claims
Faster
Payments
<25
Days in A/R
WHY REVEX SQUARE
Talk to a Home Health Billing Specialist
→
Why Choose Revex Square Among Home Health Billing Companies?
Your agency deserves more than a general medical billing company. You need a revenue cycle partner that understands the complexities of home-based care billing.
✓
Home-Based Care Expertise
Our billing professionals understand PDGM grouping, hospice election and cap rules, HCBS authorization tracking, and EVV compliance — the requirements that make home-based care billing fundamentally different from office-visit billing.
✓
Transparent Pricing
Simple, transparent pricing with no unnecessary hidden fees, allowing you to understand exactly what you are paying for.
✓
Dedicated Billing Team
Work with experienced billing specialists who become an extension of your agency and remain focused on your financial performance.
✓
Complete Revenue Cycle Management
From patient registration and eligibility verification to coding, claims, denials, and A/R follow-up, we manage the complete cycle.
Turn Your Home Health Billing Challenges Into Results
From claim denials to EVV mismatches, Revex Square helps identify the problems affecting your revenue and provides practical solutions.
High Claim Denials
Denial rates rise quickly when OASIS documentation, hospice election paperwork, or EVV data aren't managed carefully. We identify denial patterns, correct billing errors, and follow up with payers to recover revenue.
Solution
Denial Management
Slow Insurance Payments
Our team actively tracks outstanding claims and follows up with insurance companies to accelerate reimbursement.
Solution
A/R Follow-Up
LUPA Downcoding
Falling below the visit threshold for a payment group can quietly cut episode reimbursement without triggering an outright denial.
Solution
PDGM Episode & Visit Utilization Review
EVV Claim Mismatches
A visit that isn't properly captured or matched in the EVV system is one of the most common reasons an otherwise clean HCBS or home health claim still gets denied.
Solution
EVV Compliance & Claim Matching
Hospice Cap and Election Errors
Missing a recertification deadline or exceeding the aggregate hospice cap creates compliance and repayment risk that's entirely preventable with proper tracking.
Solution
Hospice Billing & Cap Monitoring
Scaling Across Multiple States
Agencies expanding into new states face different EVV vendors, Medicaid waiver rules, and payer requirements in each one.
Solution
Multi-State RCM Reporting
Stop Leaving Revenue on the Table
Let our home health billing experts identify opportunities to improve your revenue cycle.
GOT QUESTIONS?
Frequently Asked Questions About Home Health Billing
Get answers to the questions most frequently asked about home health billing, reimbursement, PDGM, LUPA, EVV, and billing costs.
Home health billing covers skilled medical services, while home care billing typically covers non-skilled personal care and support services.
PDGM determines Medicare home health reimbursement based on clinical, functional, and patient-specific factors documented in the patient's care record.
A LUPA applies when visits fall below the required threshold, changing reimbursement from an episode payment to a lower per-visit payment.
Electronic Visit Verification confirms required visit details for applicable services, helping agencies avoid billing errors and claim denials.
Our home health billing services start as low as 2.75% of monthly collections, depending on your agency's services, visit volume, and billing requirements.