4 Stages in the Home Healthcare Billing Process
Home healthcare billing operations involve multiple stakeholders. There is the patient, the provider, the payer, and other healthcare professionals who deliver important rehabilitation services. Billers must bill patients for services provided at the HHA and submit the billing claim to payers.
Despite their significance, the number of HHAs in the US has been declining since 2013. This is because of shrinking margins, excessive denials by private payers, and low cash reserves. But interestingly, most of these challenges can be addressed to a great extent with efficient home healthcare billing processes.
So, how can one improve the efficiency of their home health billing process? To understand that, it is crucial to first identify important stages in the billing process. And so in this blog, we will discuss 4 crucial stages in billing for services provided by home health agencies.
Home Healthcare Billing in 4 Simple Steps
Billing operations can be broken down into multiple stages depending on the provider’s unique requirements. For example, if a provider experiences problems in accurately coding for medical services, they must prioritize their coding operations and perform audits to fix coding mistakes. Likewise, if an HHA is struggling with high claim submission costs, the provider should evaluate their entire process and make necessary changes to cut down costs.
Here are the top 4 stages in home healthcare billing operations:
1) Insurance verification & documentation
Verification of insurance and eligibility benefits should be the first step after patients schedule appointments. This crucial step helps in determining financial liabilities for patients, payers, and providers. It also helps understand if authorization is required for a service.
2) Charge capture
During this stage, billing staff assigns codes for services as per notes and details entered in EHR or EMR systems. Once the codes have been assigned and all relevant charges captured, claim data from this stage can be moved to EDI systems for formatting.
3) Integration with EDI systems
All medical information necessary for claim submission is captured as per the payers’ formats and standards during this stage. Submitting home healthcare billing claims via EDI helps reduce silly errors and delays associated with processing and submission.
4) Claim submission
During the submission stage, necessary information on EDI systems is transmitted to the payer. Submitting claims using EDI systems helps reduce delays and submission expenses.
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Maximize Collections with Home Healthcare Billing Services
Home healthcare billing services specialize in end-to-end billing operations for home health services. By regularly updating their knowledge bases these billing experts ensure accuracy across billing, coding, and claim submission processes.
For home health specialties, looking to avoid the challenges present in the healthcare industry in 2024, partnering with a reliable home healthcare billing service will not just reduce payroll and operational expenses but also improve accuracy and revenue collections.
To learn more about how our home healthcare billing services are supporting HHA chains in the US in maximizing collections, please contact Sunknowledge Services Inc., a HIPAA-compliant healthcare revenue cycle management organization serving US providers & payers since 2007.