Expert Home Health Billing Services That Maximize Reimbursements
When searching for reliable Home Health Billing Services, Synergy HCLS delivers specialized revenue cycle management for HHAs—navigating complex PDGM rules, ensuring flawless OASIS-E documentation, tracking Notice of Admissions (NOA), and proactively managing LUPA thresholds. We ensure your team can focus on in-home patient care instead of complex Medicare regulations.
Did You Know? Real Challenges in Home Health Billing
Where Home Health Agencies frequently lose revenue every single month.
Home Health Billing Built Around Strict Medicare Rules
Every home health claim depends on precise PDGM coding, flawless OASIS submissions, and aggressive deadline management. Our Home Health Billing Services control all these factors.
PDGM Coding & OASIS-E Review
Ensuring primary diagnosis codes perfectly align with OASIS data to generate the correct HIPPS code, maximizing your clinical grouping reimbursement.
Notice of Admission (NOA) Tracking
Relentless tracking and submission of NOAs within the 5-day Medicare window to completely eliminate late-filing financial penalties.
LUPA Management & Optimization
Proactive monitoring of 30-day payment periods to ensure minimum visit thresholds are met, preventing full episodes from dropping to per-visit LUPA rates.
ADR Management & Appeals
Handling Additional Documentation Requests from MACs efficiently, assembling Face-to-Face (F2F) and Plan of Care data to win complex appeals.
End-to-End Home Health Billing Services
We capture every billable episode, ensure proper regulatory compliance, and keep claims flowing—so you get paid for the complete care your field staff provides.
Intake & Eligibility Verification
Rigorous upfront verification of Medicare, Medicaid, and Commercial benefits, including authorization requirements for therapy visits.
OASIS & ICD-10 Coding
Expert review by certified coders to ensure the primary diagnosis falls into a valid PDGM clinical group to avoid Return to Provider (RTP) status.
NOA Submissions
Automated tracking to ensure the Notice of Admission (TOB 32A) is accepted by Medicare within 5 days of the Start of Care.
End of Episode (EOE) Claims
Submitting final claims (TOB 329) with all required visit data, ensuring F2F and Plan of Care signatures are on file.
LUPA Alerting
Daily reporting on 30-day billing periods that are 1-2 visits away from the LUPA threshold, allowing clinical managers to adjust schedules.
Commercial & Medicare Advantage
Handling the nuanced authorization and per-visit billing requirements for Managed Care and VA payer networks.
Addressing Real Challenges with Home Health Billing Services
Late NOA Penalties
Failing to submit the NOA within 5 days results in a 20% daily revenue loss. We use automated tracking to ensure 100% compliance.
PDGM Coding Errors
Symptom codes used as primary diagnoses result in rejected claims. We ensure codes match a valid clinical group.
High LUPA Rates
Missing a visit threshold by just one visit slashes episode reimbursement. We proactively alert your clinical directors.
Missing F2F Documentation
Medicare audits aggressively target missing Face-to-Face encounter notes. We audit charts before the final claim drops.
Commercial Payer Auth Rules
Medicare Advantage plans require frequent re-authorizations. We manage the portal submissions so care is never interrupted.
Staff Burnout on Admin Work
Agency owners and nurses spend too much time chasing doctor signatures instead of growing the census.
Comprehensive Home Health Billing Expertise
Home Health Billing Software Experience
We Also Provide the Following Services to
Home Health Agencies
Frequently Asked Questions
Trusted by Home Health Agencies Nationwide
See how we’ve helped HHAs eliminate NOA penalties and optimize their revenue cycles.
"Synergy’s team completely eliminated our late NOA penalties. Their automated tracking ensures we never miss that crucial 5-day window. Our cash flow has stabilized immensely."
"Switching to a home health-specific billing team changed everything. Their PDGM coding expertise and OASIS reviews have significantly increased our episode reimbursements."
"Our days in A/R dropped from 48 to under 28 days within the first three months. Their proactive alerts on LUPA thresholds allow our clinical team to manage visits perfectly."
"Their meticulous handling of ADRs and Medicare appeals has saved our agency from costly compliance audits. Highly recommend their services to any growing HHA."
"Synergy’s team completely eliminated our late NOA penalties. Their automated tracking ensures we never miss that crucial 5-day window. Our cash flow has stabilized immensely."
"Switching to a home health-specific billing team changed everything. Their PDGM coding expertise and OASIS reviews have significantly increased our episode reimbursements."
"Our days in A/R dropped from 48 to under 28 days within the first three months. Their proactive alerts on LUPA thresholds allow our clinical team to manage visits perfectly."
"Their meticulous handling of ADRs and Medicare appeals has saved our agency from costly compliance audits. Highly recommend their services to any growing HHA."
Stop Losing Revenue to
Complex PDGM Rules
Let our specialty billing team streamline your operations, secure your NOAs, and collect the maximum reimbursements your home health agency deserves.
Get Your Free Billing Audit