Five easy steps to take now to streamline your home care billing

Five easy steps to take now to streamline your home care billing

Five easy steps to take now to streamline your home care billing

Navigating and managing the home care billing process is one of the most challenging parts of running a home care agency.  

A clearly defined, repeatable and scalable billing process is a critical part of setting up your agency for financial success.  

Here are five ways to simplify the home care billing process and improve your agency’s operational effectiveness.  

1. Evaluate your current home care billing process

Once you map the process, survey your team and interview stakeholders, you will have a more holistic picture of both time and resources required as well as where there are roadblocks and opportunities. 

Be curious and open to ask: 

  • What are you doing now? 
  • What reports and spreadsheets are you maintaining? 
  • What are your pain points? 


By pulling the thread, you can start to see where and how a centralized, end-to-end platform can help reduce time, errors and inefficiencies. 

Pavillio takes the time to understand each of its customers’ needs and process so that it can be custom configured for each agency. 

2. Know your rate of rejected and denied claims – and the reason

Problems in billing, often in the form of rejected or denied claims, range from missing simple information to mismatches in services and coding to unpayable claims not eligible for insurance or Medicaid payments.  

Manual entry can lead to inaccurate, incorrect or missing information, resulting in rejected or denied claims – negatively impacting your agency’s financial health.  

Pavillio not only has its One-Click Billing feature that allows users to efficiently manage and submit claims in a single click, but also has built-in validations to help you identify issues before a claim is submitted and denied. For example, Pavillio’s smart automation checks for valid Service Agreements, issues with unit utilization, client eligibility, and much more.  

3. Define and track your core home care billing KPIs

Ultimately, the financial success of your home and community-based services agency will depend on the ability to attract and retain clients, adhere to compliance requirements, and ensure timely payments. 

Core metrics and benchmarks key to track include: 

  • Billed Claims  
  • Denied Claims  
  • Failed Services  
  • Client Eligibility  
  • Units/Out of Units 
  • Service Agreements Pending 


Additionally, in the Pavillio platform, Pavillio has an Agency Financials feature, enabling users to see summary data for revenue and accounts receivable by Provider Number, by Payor, and by Service line.   

4. Track your time spent on billing

Lola Aune, Director of HR for Udac, Inc., reported she performs billing daily by client and leverages the Pavillio report called Claims Data. She shared that the billing process formerly required multiple days of her work but now consumes a little over an hour. 
“When I started, I spent 50% of my time on billing and payroll,” said Lola Aune, Director of Human Resources. “Now, with Pavillio, this represents  just 20% to 25% of my time per week.” 

5. Consider outsourcing your billing

Even with the right home care operations platforms, your agency may need additional help to focus on delivering care. 

That’s why Pavillio has a dedicated billing team so growing agencies can outsource their billing to a trusted partner. 

For example, Imaan Hassan, CEO, and founder of Prestige Health Care LLC, founded her agency approximately one year ago.  

She decided to outsource her agency billing to the Pavillio Billing Services team as her agency grows to help her free up more time for professional development and securing new clients.  

In fact, the time she saved with using Pavillio and outsourcing her home care billing has enabled her to go back to school. By advancing her care certifications and degree, she will not only be able to continue to grow her agency and serve more clients, but also deliver even more high-quality care. 

Are you ready to get started? 

Contact us at [email protected] to learn more about how we can help and how quickly and easily our team can get started. 


Learn more about how Pavillio stands out from the rest in our new guide.

Want a look at our monthly Billing Services dashboard? 

Pavillio Billing Services Monthly Dashboard

Pavillio Billing Services Monthly Dashboard