Billing, Coding & Clinical Documentation Review
Outsourced expert services to streamline your back office, improve reimbursement and maximize cash flow
HEALTHCAREfirst’s RCM, coding, clinical documentation review services and CAHPS Survey program are now integrated with MatrixCare, expanding our suite of solutions and services for home health and hospice providers.
Through decades of industry experience with superior customer service and expert guidance, we work hand-in-hand with our partners to understand their needs and deliver customized solutions that drive success.
Our partners thrive through superior patient care, enhanced efficiencies, improved quality and integrity of medical records and optimized reimbursement. That’s why thousands of home health and hospice providers trust us every day to get their work done and continue to grow and thrive in their communities.
Focus on delivering exceptional patient care while we manage the financial intricacies, helping to ensure your agency’s long-term success in the evolving healthcare landscape.
Our service solutions include:
- Billing
- Coding
- Clinical documentation review (OASIS & 485/POC)
- Eligibility & authorization
- AR recovery
- QAPI program
Billing
Your billing process is one of the greatest opportunities to streamline operations, accelerate reimbursement, and improve overall profitability. All too often however, agencies find themselves struggling with cash flow as a result of billing issues. And with the ever-changing regulatory environment and soaring popularity of Medicare Advantage plans , it’s increasingly complicated.
Our mission is to alleviate the headaches associated with billing and collect what you are owed for the services you provide. We have extensive experience working with agencies of all sizes on a variety of EMR solutions.
Our home health billing experts have the knowledge, training, and experience needed to process claims accurately and quickly. As a result, you will likely experience fewer billing errors, faster turnaround time, and improved cash flow.
To discover the many benefits of outsourcing your RCM, visit our new home at MatrixCare.com.
Coding
As the home health and hospice industries continue to usher in new complexities and regulations, you should take a renewed look at the way your agency approaches revenue cycle management (RCM). It’s critical to submit accurate claims with the proper diagnosis codes in the correct sequence. Inaccurate coding can slow reimbursement, drain administrative resources, and result in lost revenue.
And without specialized knowledge, expertise, and a solid foundation to support the coding process, you could be increasing your agency’s exposure to risk. However, our certified coders can help your agency achieve success, no matter what EMR you use.
When you work with us, you get more than just coding services… you get a team of experts dedicated to your success and a customized plan built to your agency’s unique needs. Our well-tested, proven processes are geared to promote optimal cash flow – allowing you to invest back into the business so your agency and your team can succeed and thrive. Our customers have the confidence that while they focus on providing quality patient care, our experts are laser-focused on the accuracy and speed of their coding.
To learn more about how our coding program can benefit your bottom line, visit our new home at MatrixCare.com.
Clinical documentation review
As clinical documentation (OASIS and 485/POC) responsibilities become more complex, you should be looking for cost effective ways to alleviate the burdens on your agency, so you can continue to focus on your mission of providing quality, patient-centered care and compassionate caregiver experiences. Our certified experts have the knowledge and experience necessary to help you overcome documentation challenges and set your agency on a course for success.
A solid clinical documentation review process is essential to making sure that you get paid fully for the services you provide. If you don’t have a solid process in place and are worried about the additional manpower that may be required for it, let us help you. Our expert team will help you reduce your agency’s risk of errors, maximize reimbursement and help to provide precise, patient-specific and error-free documentation.
To see how our OASIS and 485/POC review services can benefit your agency, visit our new home at MatrixCare.com.
AR recovery
Are you dealing with a lot of unpaid claims or aged accounts? Our team of billing recovery experts is experienced in addressing the lost revenue that could be impeding your cash flow and finding the root cause so the issues don’t reoccur.
Our team will manage your unpaid claims and aged accounts so that you are properly compensated for the services provided by your agency. An often labor intensive and lengthy process, most agencies don’t have the time and dedicated, trained staff to take on recovery. Outsourcing to our team allows your agency to focus on day-to-day operations and quality clinical care, while we handle the problem payors.
We will review and resubmit all unpaid claims, notify your agency of any clinical documentation and/or coding errors on the rejected claims and fix them for resubmission. We also provide comprehensive and transparent tracking of our progress and appeals status so you can see the real-time effect of our work on your bottom line.
To learn more about our AR Recovery services, visit our new home at MatrixCare.com.
Eligibility & authorization
There’s a lot at stake for home health and hospice agencies when it comes to billing, coding and documentation review. Errors and omissions can lead to delayed, denied or rejected claims that can decrease reimbursement. In addition, ongoing regulatory changes make it difficult for overstretched clinicians to keep current with new guidance — increasing the risk of errors and incomplete documentation.
And many agencies are struggling to maintain their cash flow. Denials only compound those issues. As your payor mix changes and staffing shortages continue to mount, it’s easy to see how rejected claims can begin to stack up, slowing down your cash flow and impacting your bottom line. Detecting and resolving issues are critical to the success of an agency.
Most billing errors occur during the intake process, including entering incorrect patient or payor information, adding invalid diagnosis codes or authorization, and ordering services not covered by the payor. Let us help you tackle your billing challenges – saving you valuable time, helping to ensure accuracy from the beginning and enhancing your bottom line.
To learn more about our eligibility and auth services, visit our new home at MatrixCare.com.
QAPI program
Our comprehensive Quality Assurance and Performance Improvement (QAPI) program can help agencies enhance performance and improve compliance through actionable insights into critical areas like infection control and adverse event management. By performing an assessment, creating an action plan, implementing the plan, monitoring progress, and refining outcomes, our program can help your agency address existing challenges while successfully improving patient outcomes and safety.
Whether you’re a home health or hospice agency, we work with you to help revolutionize your agency’s approach to quality assurance and performance improvement.
To learn more about our QAPI program, visit our new home at MatrixCare.com.
Key benefits of outsourced RCM helps you:
- Accelerate reimbursement and maximize cash flow
- Reduce the risk of denials and minimize write-offs
- Maintain consistent billing and coding output with dedicated, trained, and certified staff
- Handle problem payors, regulatory updates, and Medicare Advantage plans with expertise
- Ensure a seamless transition for your preferred EHR platform
Partnering with you for better healthcare
Trust the experts at HEALTHCAREfirst to help you accelerate reimbursement, maximize cash flow, reduce risk of denials and go beyond compliance for CAHPS surveys.