TPE Audit Guide: How Home Health Providers Cut Claim Denials Through the Audit Process
Is your agency ready for a Medicare Targeted Probe and Educate (TPE) audit? A TPE audit reviews 20 to 40 claims per round to determine whether your documentation supports the care you billed. Preparing early can help reduce claim denials, protect cash flow and limit the staff time needed to respond to documentation requests. Key […]
Revenue Cycle Management Best Practices That Improve Cash Flow in Home Health Agencies
Your revenue cycle performance depends on how consistently you execute every stage of care. Layered QA, clear ownership and defined workflow controls reduce delays in your payment. Key Takeaways A claim can’t move forward when referral details, authorizations or physician orders are incomplete. Preventive QA, concurrent QA and pre-bill QA each stop different problems before […]
How to Improve Patient Outcomes Through OASIS Documentation in Home Health Agencies
Every OASIS assessment should inform how you care for the patient. When OASIS documentation reflects the patient’s condition and guides the care plan, your home health agency can provide better patient care and accurate reimbursement. Key Takeaways Accurate OASIS documentation gives every discipline the same clinical baseline. All significant assessment findings should appear in the […]
How Can LUPA in Home Healthcare Be Avoided?
One missed visit, a delayed note or an unresolved cancellation can leave a patient below the assigned LUPA threshold and change a full payment period to per-visit reimbursement. Preventing LUPA in home health depends on how your agency manages the process from intake through billing. Key Takeaways Many preventable LUPA cases happen because intake, clinical, […]
What Does It Mean to Be OASIS Certified? A Guide for Home Health Agencies
CMS relies on OASIS data for home health quality reporting. OASIS certification shows that a clinician knows the assessment rules, but only ongoing review, training and clinical oversight confirm that those rules are applied consistently. Key Takeaways Certification works best when agencies reinforce it through ongoing QA, training and clinical oversight. QA review verifies that […]
The Most Common Healthcare Revenue Cycle Management Bottlenecks in Home Health
According to a 2024 CMS report, insufficient documentation contributes to up to 51.4% of home health claim denials. Many of these issues begin with the OASIS assessment and plan of care, long before coding or QA reviews the chart. Timely completion and submission of these documents are key indicators of revenue cycle performance. Consistent staff […]
The Hidden QA Layer Missing From Most Medical Billing and Coding Teams
MDaudit’s 2025 provider data found that outpatient coding-related denials rose 26% in 2025, from errors in diagnosis coding, modifier usage and incomplete documentation. Home health agencies see these same three issues affect their denials, delayed payments and lost staff hours. Key Takeaways Complete documentation reduces coding errors before they affect the billing process. A structured […]
How to Solve Nursing Short Staffing: Practical Steps for Home Health Employers
The U.S. Bureau of Labor Statistics projects 189,100 registered nurse openings per year through 2034, more than most home health agencies can hire. If intake, authorization and documentation work fall behind, your current nurses have to work through these on top of patient care. Key Takeaways Hiring solves only part of the nursing shortage; retention solves […]
How to Build a Resilient Home Health Care Team?
Can your agency still deliver care when your next key hire walks out? According to the 2024 Activated Insights Benchmarking Report, direct care staff turnover in home health hits 79.2% annually. Low pay, inconsistent schedules and administrative load push that number up. Agencies that plan for turnover create a stronger culture, retain more talent and […]
Electronic Medical Records (EMR) Hours: Guide for Home Health Agencies
Your RN wraps up her last visit at 4 pm. She’s home by 5. But her laptop stays open until 8. Three hours of charting after a full day with patients. Those hours burn out your clinicians and hit your billing, claims and compliance. Here’s where your EMR hours go, how much they cost you […]