Common Hospice Billing Problems & Their Solutions

Any mistakes made during your hospice billing cycle can keep you from maximizing your hospice collections. Learn how to avoid late Notice of Elections (NOEs), how to prevent errors on your hospice claims, and how to keep your staff up to date on the most current guidelines for hospice billing.

Missed Deadlines

Notice of Elections must be submitted and processed within five business days following admission, and before any hospice claims can be filed. With the common working files changes implemented July 2, 2018, many hospices are experiencing NOE errors that are negatively impacting their collections. Does your agency understand the changes made by Medicare in July and how they affect sequential billing?

Errors on Claims

Any errors on filed claims can result in the claim being rejected. These errors can be costly and keep you from receiving payment. Because of sequential billing rules, rejected claims can hold up months of collections. Work with your business internally to identify common billing problems and prevent errors from occurring in future billing cycles. Meet with your team to establish compliance standards, review changes within the rules of hospice billing, and set up preventative measures to avoid billing mistakes. Setting up these internal standards can help your billing processes run smoothly.

Outdated Information

The rules of hospice billing are constantly changing – is your agency staying up to date? Updates and changes directly impact your claims processing. Don’t let these changes keep you from receiving your full revenue. Stay informed on policy changes to prevent mistakes and to avoid losing time during your billing cycle. A staff that is knowledgeable about the constant changes and updates of hospice regulations will help to improve your billing accuracy and maximize your collections.

 

Avoid the problems that come with hospice billing. At Advanced Hospice Management, we reduce wasted time and error so that you can get more of your money, faster. Let Advanced Hospice Management take care of your billing needs, ensuring timely, error-free billing so that you can receive your maximum collections. Contact us today for a free review of your hospice billing processes.

3 Ways To Increase Hospice Collections

There are several factors that can keep you from receiving your maximum level of hospice collections. Here are our three steps to help you increase your collections and promote a smoother billing process.

1. Manage your results.

It is important to regularly review and track your results from each billing cycle. If you are seeing progress in each billing cycle, make note of what is working to benefit your collection rate. If you are seeing issues, develop methods to help improve your next billing cycle. This is a process that should be practiced monthly with your staff to target new issues as they arise and ensure the best results from your hospice collections.

2. Set up best practices for billing efficiency.

Setting up best practices for your agency’s billing can help to ensure that your billing is compliant and on time. Making sure that your staff is well versed in the processes of hospice billing will ensure a smoother and more efficient billing cycle, resulting in maximum collections. Know how to deal with payments that are past due or with payers who routinely deny clean claims. Educating your staff will not only help them to navigate difficult areas of the hospice billing cycle, but it will help to limit errors and increase collections.

3. Outsource your hospice billing.

It is a difficult task to file hospice claims, stay on top of billing schedules, and minimize billing errors, all while navigating the ever-changing rules of hospice billing. Utilize a hospice management service to ensure that your hospice billing processes are conducted in the most accurate and efficient means possible. Outsourcing can take the stress of hospice billing off your shoulders so that you can focus on providing your patients with the best care possible.

 

We at Advanced Hospice Management are trained in the best practices of hospice billing to collect more of your money faster. We provide you with professional, reliable service to minimize billing issues and maximize your collections. For a free review of your hospice billing processes, contact us today.

5 Things To Know About Hospice Medicaid Claims

While Medicaid provides coverage to working families, it is also one of the most prevalent forms of financial aid for nursing homes and hospice care facilities. Here are five facts about Medicaid that you might not know.

Coverage has evolved.

Over the past fifty years, Medicaid’s coverage has expanded from children and the disabled to including lower-income individuals and families. With the help of the federal government’s financial matching, Medicaid provides coverage for low-income enrollees who would typically struggle with meeting requirements to be insured.

Those enrolled may receive care through privately managed care plans.

Many Medicaid enrollees receive their care from privately managed care plans contracted with state Medicaid programs to coordinate care efficiently, saving Medicaid dollars.

Medicaid managed care and coverage can change, depending on the patient care.

Hospice care may be covered only by traditional Medicaid in some states, while in others coverage depends on where care is delivered. Patients at home may be covered by managed care, while patients in long-term care facilities may be covered by traditional Medicaid. All states are different and these coverage determinations are constantly evolving.

Medicaid authorization requirements can be tricky.

Medicaid and Managed Care authorization requirements vary by plan. They can also vary by level and location of care. In some states, coverage can change from managed care to traditional Medicaid when a patient enters a nursing home.  The coverage change requires other providers, such as hospices, to obtain new treatment authorizations based on the updated coverage.

It is best practice to confirm eligibility on all Medicaid and Managed care patients monthly.

Because coverage can change month to month, it is most important that hospices verify plan coverage each month for all Medicaid and Managed care patients under their care. Monthly verification can prevent lost coverage days due to no authorization. Monthly verification can also prevent delays in payments by confirming claims are submitted to the correct payers the first time.

Stay on top of your Medicare and Medicaid billing. Let Advanced Hospice Management help you with all of your hospice billing needs. Contact us today!

How To Improve Your Hospice Billing

Staying on top of your billing can help you avoid non-covered service days and give you confidence that your claims will hold up under audit scrutiny. Here are just a few ways to improve your hospice billing processes.

Establish compliance standards internally.

Setting up compliance standards with your team will help to keep your billing and revenue cycle running smoothly. Regular internal auditing of these standards can allow you to quickly catch mistakes and find solutions to keep your billing accurate and timely. It is important to analyze the performance of your agency’s processes to ensure all claims are compliant. By identifying billing problems and patterns, you can find the best course of action to correct mistakes and set up preventative measures to save you time while avoiding costly errors on your hospice billing.

Keep your staff up-to-date on billing regulations.

It is important that your staff is updated on all rules regarding hospice billing to lower the risk of billing errors. A well-educated staff will be able to identify billing problems, track denied claims, and avoid improper payments to make sure that your business receives your maximum collections. You should have confidence that all Medicare, Medicaid, and Commercial Insurance claims are filed correctly, all billing requirements are met, and all claims are compliant.

Let a hospice billing service streamline the process.

Professional billing services can help ensure that all of your hospice claims are properly billed, resulting in accurate reimbursement for the care you provide to patients.  At Advanced Hospice Management, we provide you with a team of highly trained, expert billers who use best practices to submit clean, compliant claims. The result? We collect more of your money, faster.

For the best solutions to all of your hospice billing needs, contact Advanced Hospice Management today.

7 Things To Know About Hospice Medicare Claims

1. The Medicare Hospice Benefit is paid under Medicare Part A, the hospitalization benefit.

When electing hospice, the patient forfeits their Medicare Part B, or outpatient insurance, for all care related to the terminal condition. Patients also forgo the use of their Medicare Part D prescription drug benefit when electing hospice, for all medications used to treat the terminal condition and related conditions.

2. Hospices are required to notify Medicare of every hospice election within five calendar days.

This means you must file a clean Notice of Election for every patient who elects the hospice benefit with your agency. You must also file NOTRS within five days for all patients who revoke their Medicare Hospice Benefit or discharge from your services. Sounds simple, right?  The process of filing the NOE/NOTR is simple enough, but there are many outside factors that can affect the timeliness of the election- previous hospice elections, improper transfers, and incomplete billing by past hospices call all block your NOE/NOTR from processing and subsequently prevent your claims from paying timely.

3. Open MSP policies can prevent Medicare from paying your claims.

When checking eligibility for Medicare patients, it’s imperative that you know how to read the MSP page and what action to take based on the information found there. Do you know the difference between the types of policies you may find here? Do you know who to call to determine if that MSP policy is truly primary? What if the policy is out of date and should be closed? Not knowing how to interpret and act on the MSP page information cannot only delay claims, but many times cost you the entire reimbursement amount if you don’t act quickly.

4. Medicare requires hospices to bill sequentially.

If one monthly claim does not pay for any of the reasons listed above (or any one of dozens of other reasons), your subsequent claims will not process or pay. Months of claims can sit unprocessed and unpaid as the result of one error on one claim.

5. Hospice claims must be filed and processed within one year of the dates of service.

Again, when claims do not process timely, subsequent claims can stack up, unpaid. Timely filing can become a problem quickly if errors are not corrected promptly and outstanding claims are not worked consistently.

6. The rules are always changing.

The hospice billing update that took place July 2, 2018 was one of the most significant changes to the hospice billing process since CR8877, yet many billers are unfamiliar with the update and how it impacts claims processing. The Medicare Administrative Contractors are having issues processing some claims as a result of the changes, and those issues are ongoing. Are you aware of those processing issues and how they are affecting your revenue?

7. Outsourcing your hospice billing will improve accuracy and collections.

Would you like a solution to all of the above? Outsourcing hospice billing to a robust team of highly trained and experienced professionals will improve your revenue and reduce your AR, giving you more predictable cash flow. There is a distinct advantage to having a billing team who is continuously trained not only on billing but on best practices driven by regulatory and compliance rules.

Please contact Advanced Hospice Management for more information about how we can collect more of your money, faster

What Is Hospice Revenue Cycle Management?

RCM

Hospice Revenue Cycle Management (RCM) is the management of the process through which hospice providers ultimately receive compensation for their services. It is essential that each stage of the process, pre-billing, billing, and post-billing – are managed well.

The RCM process for hospice services begins when a patient is referred to your company, and it concludes when their account balance is zero. It can be broken into three segments: pre-billing, billing, and post-billing.

RCM Pre-billing

Patient demographics, insurance coverage information, and copayment or deductible amounts are determined during the pre-billing stage to connect the patient’s needs to the services performed. Patients and their families will consult with the hospice to find out what services they require and plan payment processes accordingly.

RCM Billing

The billing stage of hospice RCM handles Medicare, Medicaid, and Commercial claim types. Claims must be adequately documented for eligible patients to receive full reimbursement. Complete claims containing all required data is essential in determining and eventually receiving revenue.

RCM Post-billing

Rejection and denial tracking and appeals, cash application, and result monitoring fall under the post-billing stage of hospice RCM. A robust system of claims corrections, appeals, and disputes is key to collecting your revenue. Management and oversight of that system to ensure reconsiderations are filed timely and result in prompt payment is imperative in a successful collections process. Because of their superior knowledge and experience in the intricacies of claims follow up, professional billing services can play an integral part in maximizing your collections.

Now that you know the stages of hospice RCM, how do you ensure that your cycle is successful? Keep the MAD method in mind to increase your revenue through organization and team accountability.

M – Measurement

You want to ensure that the measurements you take are accurate and purposeful for your company. These may include your claims, rejections, or denials as well as financial measurements such as cash collections and credit balances.

A – Accountability

It is important that the right members of your team are paired with the best role that they can fulfill. Keeping a leader accountable to at least one metric of the process will make for the smoothest and most effective RCM.

D – Discipline

An organized team will ensure that your RCM functions properly and efficiently. Setting up a defined set of practices and evaluating them with your team will not only establish a proficient workflow but also bring coherency to their individual processes.

Knowing the three billing stages of hospice RCM and using organizational methods with your team, such as the MAD method, can help to ensure that your Revenue Cycle Management functions as smoothly and effectively as possible.

For assistance with your hospice billing needs, contact Advanced Hospice Management today.

5 Things To Know As a Hospice Startup

What are essential points to consider when opening a hospice service? Before starting up, it is crucial to have a plan that is designed to ensure the smoothest path to opening. Outline a business and marketing plan, seek out the best channels of promotion, find a strong staff to carry your company, and know the best practices for collecting funds and billing your claims.

Writing a Business and Marketing Plan Is Essential

Efficient planning helps you throughout your funding, hiring, and promotional stages. These business and marketing plans should explain the mission and vision statements of your program as well as identify your available resources, list your competition, and establish your company’s goals.

Promote Your Hospice Through Networking and Public Awareness

Building relationships with your medical and religious communities are essential. These connections provide a loyal base for referrals to your hospice services. Educating the public through online and local appearances will not only promote your services but also establish your business as a knowledgeable, trustworthy company.

A Smart Staff is a Successful Staff

Choose your staff wisely. This team includes many different skill sets including doctors, administrative staff, and volunteers. Your personnel should be experienced and show a level of independence to perform their daily tasks efficiently. Confidence in the quality of your workers translates into smooth operations.

Financial Support Comes In Many Forms

Donations, Medicare reimbursement, and charitable foundation grants are a few methods of gaining financial support. Nonprofit hospices are permitted to solicit and receive charitable donations while for-profits may only receive donations. Once you establish as a nonprofit or for-profit hospice, you can define the best methods of financial support for your company.

Find the Best Billing Solutions For Your Company

Many factors can affect the profitability of your company. Late filings, an undereducated staff, or low collection rates lead to lower returns. Finding professional, efficient billing solutions can ensure that you collect the full amount of revenue that your agency earns.

 

Many elements go into starting a Hospice, but proper planning can ensure a smooth startup. Advanced Hospice Management helps you with your billing, accounting, receivables, and hospice regulatory solutions. Contact us today to learn more.

Press Release: Industry Leaders Join Forces and Cast Compelling Vision of Hospice Service Excellence

Industry Leaders Join Forces and Cast Compelling Vision of Hospice Service Excellence

‘Who You Gonna Call?’ Introducing the Consortium of Hospice Excellence

Today, a select group of hospice service providers have announced the formation of the Consortium of Hospice Excellence. The purpose of the Consortium will be to provide a single point of contact for hospice leaders to find excellence in hospice accounting, marketing, recruiting and billing—with more services to come. Combined, the members of the Consortium represent over 340 Hospices across the United States. The management of the combined members of the Consortium represents over 280 years of experience in hospice.

Each Consortium member operates almost entirely within in the hospice industry. The current members include:

Blackmor, CPA – the top hospice-only accounting firm providing outsourced turnkey accounting.

Hospice Advisors – the leading provider of hospice coaching, consulting and training.

Hospice and Home Care Staffing Specialists – the largest hospice-specific recruiting and placement company.

Advanced Hospice Management – the premier hospice-only billing company that works with any hospice software.

The members of the Consortium decided to join together because of their shared beliefs: chief among these is a commitment to excellence in service, customer experience, and dedication to going above and beyond to help customers focus on the mission of compassionate care.

“As a trusted advisor to hospices across the country, I get questions all the time about which trusted vendors and service providers we would recommend. In the past, I’ve been hesitant, so I’ve been vetting service providers in other complimentary fields. I wanted to be able to answer with a strong positive referral based on marketplace reputation, shared values, and the commitment to deliver” noted Aaron Blackmor, Founder and CEO of Blackmor CPA. “I fully expect the value of our combined services to be greater than the sum of its parts.”

“The Consortium of Hospice Excellence is comprised of accomplished hospice experts with a long history of success”, noted Michael Onett, Founder and CEO of Hospice and Home Care Staffing Specialists. “A hospice must be as error-free as possible while ensuring refined operations. Each member of the consortium has a proven track record of having mastery of their respective fields so their clients can focus on their area of expertise: hospice care for the patient and the families.”

The Consortium aims to empower hospices’ operations while delivering value well in excess of the investment. Members’ shared purpose includes: 1) increasing hospice census, 2) maximizing revenue and collections, 3) delivering on-time, transparent financial reporting, and 4) providing the best staffing and HR support available.

To learn more about the Consortium of Hospice Excellence contact one of the members below.

Advanced Hospice Management (hospicemgmt.thinkjcw.com) is the largest independent hospice billing solution in the country, integrating with every software platform available for hospice and with the highest collection rates in the industry. Advanced Hospice Management’s geographical and personnel redundancies mean zero turnover, constant availability, and increased peace of mind for hospice executives. Contact at (888) 334-5909 or [email protected].

Blackmor CPA (www.BlackmorCPA.comis one the leading hospice-specific accounting firms in the country, offering outsourced accounting and financial reporting, financial health assessments, and a host of services including coaching and mentoring of the finance team and interim c-suite support. The average Blackmor CPA client is more than twice as profitable from operations as the median hospice while saving 0.5% of net revenue over internal staffing based on current national benchmarking assessmentsContact at (828) 233-1180 or [email protected].

Hospice and Home Care Staffing Specialists  (www.HospiceRecruiters.comis the most experienced hospice recruiting firm in the nation, providing recruiting services to hospices across the country since 1995. Hospice & Home Care Staffing Specialists is able to recruit appropriate candidates that are highly qualified specifically for the competency needed in hospice and home health: Executive Leadership, Clinical Management, Account Representatives, and more. Hospice & Home Care Staffing Specialists also provides start-up and reorganizational consulting services. These consulting services transform clients by stressing three main points: formulating or identifying strategic differentiators, recruitment of appropriate staff, and staff performance development. Contact at (202) 225-6856 or [email protected].

Hospice Advisors  (www.HospiceAadvisors.com) is the leading provider of hospice coaching, consulting and training. For over 30 years Hospice Advisors has focused on creating a culture of growth, financial improvement and dealing with compliance and regulatory challenges. Hospice Advisors provides workshops, video training sessions, development planning and innovative program development. Hospice Advisors works with clients ranging from national chains to small independent agencies, in both the for-profit and non-profit sectors. Contact at (734) 658-6162 or [email protected].

OUR PROMISE

A team of experts
who are always there when care matters most

Our team is here to stay. No vacations or time off – we are always there when you need us. Our goal is to make your hospice operations cost-effective, stable, and robust.

CONTACT US TODAY!

Our team of highly-trained and driven professionals are ready to help you with with reliable and dependable start to finish billing solutions. We will be the support structure for your hospice so you can deliver the best care to your patients.

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3 Ways To Streamline Your Hospice Billing

hospice payment processing

3 Ways to Streamline Your Hospice Billing

In hospice, serving patients and their loved ones by providing compassionate and professional end-of-life care must always be a top priority. But a strong revenue stream is what makes it possible to fulfill this mission. Unfortunately, the tedious and complex process of hospice billing means many organizations struggle to remain profitable.

Workflow that is not fully optimized to protect reimbursement can have a number of negative results:

  • Frustrated and overburdened administrative staff
  • A backlog of un-filed claims
  • Missed deadlines for NOEs
  • A high percentage of claims rejected for errors
  • A rise in the cost of billing
  • A decline in the rate of collections

Any of these factors can cause your revenue cycle to suffer. Understanding where bottlenecks, errors, and breakdowns occur in your hospice billing process is the first step in resolving these issues. Here are three areas where updating your workflow can lead to significant improvement in getting claims paid on time and in full.

#1: Coordinate NOE Processing Across Your Organization

Since hospice billing is sequential, any missed steps can throw a wrench into the process. The first hospice claim cannot be filed until after the Notice of Election (NOE) is processed (and any error on the NOE can cause it to be returned or rejected). Mistakes can happen during intake or during the completion and submission of the NOE.

Take time to review the most common reasons for rejected NOEs at your facility to see where the problem is occurring. For example, the correct identification of the provider, the beneficiary’s signature (or the signature of their representative), and the effective date of election are all areas where a mistake can cause problems.

Front office staff may need a refresher on how to complete all required fields correctly, and back office staff should double-check for missing information prior to submitting NOEs.

#2: Submit Claims in Batches Electronically

Everyone knows electronic claims submission is much faster than manual claims processing—and submitting billing in batches is a convenient way to increase productivity. For example, if you are handling this in-house, back-end staff can have a dedicated time set aside to handle this important process without distractions or “context switching” which can lead to errors and omissions.

Bear in mind that once-a-month batch processing is only suitable for submitting claims for billing. NOEs can be submitted electronically in batches, but this should be done daily or as NOEs are created to avoid missing the critical 5-day deadline. Also, Medicare instructs us to file NOEs separately from claims rather than in the same batch to avoid confusion

#3: Make Verification Part of the Workflow for Hospice Billing

Chasing down unpaid balances is a hassle. It can become a real cash-flow problem when you suddenly find that a whole batch of claims did not make it through the submissions process. But even a delay on a claim here or there adds up over time. If there is a problem with any part of the submission process, it is better to find out sooner rather than later.

Do not assume that either paper forms or electronic submissions will always make it through. Verifying receipt of claims should be a separate step built into your billing process.

Advanced Hospice Management can help you implement best practices across your organization and reduce the burden on your staff. Our team has the tools and experience to handle everything from claims submission and verification to payment processing and billing compliance. Contact us to learn more.

OUR PROMISE

A team of experts
who are always there when care matters most

Our team is here to stay. No vacations or time off – we are always there when you need us. Our goal is to make your hospice operations cost-effective, stable, and robust.

CONTACT US TODAY!

Our team of highly-trained and driven professionals are ready to help you with with reliable and dependable start to finish billing solutions. We will be the support structure for your hospice so you can deliver the best care to your patients.

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Press Release: Strategic Alliance Provides Full-Spectrum of Financial Expertise in One Place

Press Release: Strategic Alliance Provides Full-Spectrum of Financial Expertise in One Place

Blackmor CPA and Advanced Hospice Management Form Strategic Alliance for Turnkey Hospice Finance and Billing Solutions

Two hospice industry titans – Blackmor CPA and Advanced Hospice Management – have converged into one joint venture to combine world class accounting and billing/collection services for the hospice industry.

This joint venture will allow independent hospices from the startup phase to 500+ ADC achieve the same level of financial and billing sophistication as their larger health system competitors – all while keeping costs competitive. While large hospice conglomerates can build large billing and accounting departments spread out over thousands of patients to keep overhead low while building in redundancy to manage fluctuations in ADC, smaller hospices can’t attract and retain the same level of talent or achieve similar economies of scale – until now. The combination of Blackmor CPA and Advanced Hospice Management gives independent hospices that competitive edge: combining cost-efficiency with the ability to manage fast growth ADC.

“I searched the entire industry to find a billing solution whose values and customer service commitments matched our own. I found that Advanced Hospice Management has the highest levels of collection in the industry, hands down, achieving 95% to 98% collection rates consistently across all of its clients,” noted Aaron Blackmor, Founder & CEO of Blackmor CPA. “What impressed me even further was the fact that Advanced Hospice Management works on a ‘success fee basis,’ so they only get paid when the client gets paid. They are clearly incentivized to collect as much as possible and as quickly as possible for their clients.”

This alliance will form a collaboration with combined clients across the entire United States, including Hawaii, the Virgin Islands and Puerto Rico. “The depth of billing and accounting know-how that this strategic alliance will create is almost unheard of in the hospice space,” noted Delaine Henry, CEO of Advanced Hospice Management. “We found early on that Blackmor shares our vision of excellence in the quality of service that they provide, as well as their dedication to customer service. Both companies believe in working every day to earn our customers’ loyalty and trust. Fast and accurate billing collection is very important – so is producing accurate financials and the ability to properly manage financial performance. This is just some of what Blackmor brings to the table for its customers.”

To learn more about this joint venture contact Advanced Hospice Management at (888) 334-5909 or [email protected], or contact Blackmor CPA at (828) 233-1180 or [email protected].

Advance Hospice Management is the largest independent hospice billing solution in the country, integrating with every software platform available for hospice and with the highest collection rates in the industry. Advanced Hospice Management’s geographical and personnel redundancies means zero turnover, constant availability, and increased peace of mind for hospice executives.

Blackmor CPA is one the leading hospice-specific accounting firms in the country, offering outsourced accounting and financial reporting, financial health assessments, and a host of services including coaching and mentoring of the finance team and interim c-suite support. The average Blackmor CPA client is more than twice as profitable from operations as the median hospice while saving 0.5% of net revenue over internal staffing based on current national benchmarking assessments.

OUR PROMISE

A team of experts
who are always there when care matters most

Our team is here to stay. No vacations or time off – we are always there when you need us. Our goal is to make your hospice operations cost-effective, stable, and robust.

CONTACT US TODAY!

Our team of highly-trained and driven professionals are ready to help you with with reliable and dependable start to finish billing solutions. We will be the support structure for your hospice so you can deliver the best care to your patients.

  • This field is for validation purposes and should be left unchanged.

WE ARE CONSTANTLY PUBLISHING THE LATEST NEWS AND UPDATES REGARDING HOSPICE REGULATIONS

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