Home Health Medical Billing & RCM
Home health billing that keeps OASIS coding, PDGM, and Medicare episode claims accurate for stronger revenue and faster reimbursement.
Revenue cycle management for home health
Home health billing runs on precision, from OASIS-driven coding to PDGM episode management and strict Medicare submission timelines. A single documentation or coding gap can delay an entire episode's payment and disrupt agency cash flow.
ClaimSphere RCM delivers end-to-end home health billing designed around the regulatory realities of the industry. We streamline eligibility, coding, and claim submission so your agency gets paid accurately and on time, without the administrative burden.
Home Health billing, done right
OASIS-Based Coding
Accurate diagnosis coding aligned with OASIS data to optimize case mix and support quality metrics.
PDGM Episode Management
Proper period grouping, admission source, and clinical grouping to maximize appropriate PDGM reimbursement.
Medicare Claim Submission
Timely NOA and end-of-period claim submission that keeps episodes compliant and cash flowing.
Eligibility & Authorization
Verification of Medicare and payer eligibility plus authorizations before care begins.
AR & Denial Management
Active accounts receivable follow-up and claim corrections to resolve errors and recover payment.
Why home health practices choose us
- Coders trained in OASIS, PDGM, and home health regulations
- Accurate demographic and insurance entry that prevents downstream errors
- Timely NOA and episode claim submission for faster Medicare payment
- Proactive eligibility and authorization to reduce workload and denials
- Transparent reporting on every episode and outstanding claim
Frequently Asked Questions
How does PDGM affect our home health reimbursement?
Under PDGM, payment is driven by 30-day periods and factors like admission source, timing, and clinical grouping rather than therapy volume. We code and group each period accurately so your agency captures the reimbursement it has earned under the model.
Do you handle Notice of Admission submissions?
Yes. We submit the Notice of Admission within the required timeframe to avoid the payment penalties that accrue for late filing. Staying ahead of these deadlines protects your agency's cash flow across every episode.
How do you keep OASIS coding compliant?
Our coders align diagnosis coding with OASIS assessment data to support both accurate case-mix weighting and quality reporting. This consistency reduces audit risk while ensuring your reimbursement reflects the true acuity of your patients.
Specialized billing for home health practices
Get a free assessment of your revenue cycle from coders who know your specialty inside out.
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