We delve into the intricacies of Medicare Advantage claims, focusing on the importance of prior authorizations, the differences between Medicare Advantage and traditional Medicare, and the timelines for claim payments. The discussion emphasizes the need for home health agencies to understand the requirements for pre-authorization and the implications for billing and payment processes.takeaways Prior authorizations […]

This podcast episode discusses the importance of credentialing for home health agencies looking to accept Medicare Advantage plans. It covers the steps involved in the credentialing process, the significance of submitting Notices of Admission (NOAs), and the distinctions between in-network and out-of-network status. The conversation emphasizes the necessity of credentialing for payment and the strategic […]

We delve into the complexities of accepting Medicare Advantage plans for home health agencies, focusing on the distinctions between HMO and PPO plans, reimbursement rates, and the implications of being in-network versus out-of-network. We also highlight the importance of understanding patient demographics and referral sources to make informed decisions about network participation. Medicare beneficiaries are […]

In this episode, Joey and Leo from Core Billing discuss the topic of eligibility in home health care. They explore the importance of verifying patient eligibility for Medicare and commercial insurance, the processes involved, and the implications of eligibility on patient care and billing. The conversation emphasizes the need for timely checks and the differences […]

In this episode, Joey Baum and Leo from Core Billing discuss the critical topic of revenue recovery services for home health agencies. They explore the reasons why agencies may experience discrepancies between their patient census and revenue, the importance of timely billing, and the common pitfalls that lead to unpaid claims. Home health agencies should […]

Summary In this episode of Home Health Insider Insights, we discuss the common reasons why home health agencies may experience discrepancies between their expected revenue and actual revenue. They explore how to assess revenue expectations based on patient census, the impact of patient acuity and referral sources on reimbursement, and the importance of coding and […]

Introduction: In the world of home health billing, the Notice of Admission (NOA) is a critical component. It's the first claim submitted to Medicare, marking the patient's admission into a home health agency. However, timely submission is crucial, as delays can lead to significant penalties. Let's explore the common challenges and penalties associated with late […]