How to improve home care billing and payments

by | Feb 26, 2024 | Billing, Client Success Stories, Home Care, News

How to improve home care billing and payments

Keeping your your finger on the pulse of your agency’s claims revenue

There are many moving parts to home care billing, claims management, and care coordination for home and community-based services agencies to manage. 

With the volume of need and complexity agency leaders and owners manage, the fear of dropping any single part is real and can have a significant impact on the ability to deliver care. 

That’s why agencies not only need a partner who understands the complexities and requirements of home care billing, but also one that can make home care billing services easier and simpler, including helping to reduce and eliminate claims denials. And one who gives you a clear and accurate picture of your overall claims revenue cycle. 

Identifying and resolving issues with claims – before denial, ensuring faster, predictable payments for you 

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, even for those with extensive experience, 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. 

Our goal is to eliminate denials by identifying the issues before you submit a claim – and help you get paid faster. 

That’s why we also have a dedicated team of Billing Services experts who work as an extension of your team so that you and your team can focus on the why – providing quality care to those who need it most. 

Strengthening your agency’s financial health by managing your agency’s claims revenue cycle 

In the spirit of delivering maximum impact in all areas of the work we do, Pavillio launched a new monthly report to help its Billing Services customers better track claims revenue and keep a pulse on the health of the agency. 

Each month, the Billing Services team now meets with its customers to review and discuss issues that need attention, helping to reduce issues preventing prompt payment. 

Core metrics and benchmarks we 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. 

How one home care agency owner is now going back to school with her new free time thanks to Pavillio’s Billing Services 

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. 

Resources

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