Discover ParaMed’s innovative home health billing management solutions, carefully designed to enhance revenue generation, simplify operational workflows, improve efficiency, and support long term financial success for healthcare providers.
ParaMed Home Health Team
OASIS & Medicare Home Health Specialist
Home health billing under Medicare PDGM requires OASIS accuracy, RAP submission discipline, and episode management expertise that most RCM firms simply do not have. ParaMed handles every component of your home health revenue cycle with specialists who know PDGM inside out.
Home Health Billing Challenges — Solved
PDGM changed everything about how home health revenue is earned and managed. Agencies that do not bill it correctly lose 15 to 25% of potential revenue every episode.
Inaccurate OASIS scoring directly lowers your PDGM HIPPS code weight, reducing reimbursement for every episode in ways that compound invisibly across your full census. Most agencies do not know how much they are losing until an audit reveals the gap.
Every OASIS is reviewed by a certified OASIS specialist before submission. We verify functional and clinical scoring accuracy, cross-referencing the clinical notes and visit documentation to ensure your HIPPS code reflects the true patient complexity and captures maximum reimbursement.
Low Utilization Payment Adjustment triggers when visit counts fall below the episode threshold, replacing the full episode rate with a per-visit rate that can cut agency revenue by 30 to 50% for that patient in that period.
We track every patient against their episode visit threshold in real time, alerting your clinical coordinators when a patient is approaching LUPA risk so visits can be scheduled appropriately — protecting full episode reimbursement every time.
Delayed Request for Anticipated Payment submissions push your earliest receivable to the back of the episode, creating cash flow gaps that compound across a growing patient census and create payroll risk for rapidly growing agencies.
Our process triggers RAP submission automatically within 5 days of the start of care assessment. We track every patient from admission intake and ensure no episode enters without a timely RAP on file, stabilizing your cash flow regardless of census size.
Missing or incomplete physician certification orders and face-to-face encounter documentation are the number one cause of home health claim denials. Chasing documentation after the fact is expensive and time-consuming, and often results in permanent write-offs.
We verify physician orders and face-to-face documentation before every claim is submitted. Missing documents are flagged and collected from referring providers before the claim queue, not after a denial arrives with a 30-day appeal window already running.
Fully Integrated in 7 Days
We connect to your home health EMR, set up OASIS review workflows, and begin managing RAP submission and episode tracking from week one.
We review your OASIS scoring patterns, LUPA frequency, RAP submission lag, and denial breakdown to calculate exactly what your current billing is costing you.
Direct integration with your home health EMR — Axxess, Kinnser, WellSky, Homecare Homebase, or others — without disrupting clinical workflows.
A named home health billing specialist with PDGM-specific expertise assigned to your account from day one.
OASIS review in place, RAP timing normalized, LUPA risk alerts active, and denial rates dropping within the first full billing cycle.
What is Included in Your Home Health RCM
Every billing function your home health agency needs, from OASIS review through final claim adjudication.
Certified OASIS review before every Start of Care, Resumption of Care, and Recertification submission, ensuring HIPPS accuracy and maximum PDGM reimbursement.
Timely RAP submission within 5 days of SOC and final claim submission at episode close, with automated tracking of every episode through the full billing cycle.
Real-time per-patient LUPA threshold tracking with clinical team alerts when visit counts approach the threshold — protecting full episode reimbursement.
We collect, verify, and track all physician certification orders and face-to-face documentation before claim submission, eliminating documentation-related denials.
Full HIPAA-secure home health billing operations with encrypted PHI handling, BAA agreements, and audit-ready documentation at all times.
Episode revenue reporting, LUPA frequency, OASIS accuracy rates, denial breakdown, A/R aging, and cash flow tracking delivered every month.
Systematic denial tracking with root-cause analysis and timely appeals, including ADR response preparation with clinical documentation coordination.
Complete billing management for dual-eligible Medicare-Medicaid patients plus private duty and commercial payer claims for non-Medicare home health services.
A named account manager with home health PDGM expertise who knows your census, payer mix, and operational model — one contact for everything billing-related.
Our home health billing specialists review your OASIS scoring accuracy, LUPA frequency, RAP submission lag, and denial patterns — and deliver a specific monthly revenue recovery estimate within 48 hours.
No commitment. No sales pressure. A real home health billing specialist reviews your account and delivers findings within 48 hours.
Takes 2 minutes. Revenue findings in 48 hours.
A ParaMed home health billing specialist will review your account and reach out within 48 hours. Check your inbox.
Frequently Asked Questions
Ready to fix your Home Health Agency billing?
Get a free, no-obligation home health billing audit. We deliver specific revenue findings within 48 hours of receiving your information.
Trusted by practices across the US — feedback from providers who rely on ParaMed for smarter medical billing.
