Discover how minimizing unbilled claims can significantly enhance cash flow for your home care agency. Implement effective strategies today.

This blog will discuss some critical features of home care software that will help home care agencies monitor, manage, and reduce unbilled services and improve revenue cycle management.

Overview

While demand for Home Care Services continues to grow, increased regulatory requirements and a labor force shortage will pose many challenges to the cash flow and bottom line of Home Health Care Agencies. Authorization, Plan of Care, and Physician Order Management will lead to potential unbilled and denied claims. Home Care Agencies are forced to do more with less just to keep from falling behind in cash flow and the bottom line.

Home Health Care Agencies should stay ahead of these challenges with the right processes and tools to survive, thrive, and grow. Even though there are many options to deal with these challenges, one option that will significantly impact cash flow and the bottom line is effective management of unbilled services, claims, and revenue. The impact of unbilled services is very significant for home care agencies. Agencies will still have to pay employees for unbilled services even while they are not reimbursed for the same services, doubling the impact on cash flow and bottom line.

Home Care Agencies must develop metrics and processes to monitor and manage unbilled services and revenue. They should use Home Care Software that provides the tools to monitor and significantly reduce or eliminate unbilled services. Reducing unbilled services will increase revenue, improve cash flow and the agency's bottom line, provide quality care, and improve patient and employee satisfaction.

Reduce Unbilled Claims and Improve Cash Flow for your Home Care Agencies

This blog will discuss some critical features of Home Care Software that will help home care agencies monitor, manage, and reduce unbilled services and improve revenue cycle management.

Key Metrics and Features to Monitor and Reduce Unbilled Services and Revenue

Home Health Care Agencies should define critical metrics to measure unbilled revenue and use the right tools to manage unbilled services.

The following are some key metrics and the home care software features that will help home health care agencies reduce or eliminate unbilled services.

Track Unbilled Services

The first step in managing a problem is defining its scope. Often, unbilled revenue stems from unfinished administrative and clinical tasks such as pending authorizations and late-time tickets. Home Health Care Agencies should identify reports to measure unbilled services and revenue and closely monitor these reports to ensure that unbilled revenue does not become too large and unmanageable.

The following are key reports to measure unbilled services and revenue.

Reports to measure services provided but not converted to revenue.
Reports to measure unbilled revenue and the reasons for the claims not being sent out.
Reports with issues holding up the claims for review and resolution.
Timely filing reports based on payers ensure claims are submitted before timely filing expires.

The management staff of home health care agencies should review these reports regularly and ensure that individual departments follow up on unfinished tasks in a timely manner.

Home Health Care Software should have the tools and reports to provide the necessary metrics to agency staff. The ability to proactively schedule these reports and deliver the results will improve the agencies' operational efficiencies.

Intake and Eligibility

Managing unbilled revenue starts at intake and continues through authorization management and billing. Collecting the correct payer information and verifying eligibility in real-time at intake will reduce the need to hold the claims back before eligibility is verified. Home Care Software should also be able to verify eligibility in a batch mode regularly to capture any changes in coverage. Recurring eligibility verification is crucial when multiple managed care organizations service Medicare and Medicaid patients.

Proactively notifying agency staff and management of coverage changes will help them resolve eligibility issues before they become timely filing issues. Home Health Care Software should also have configurable validations to identify missing keys and required fields for clean claims during intake.

Authorization Management

Effective management of Authorizations, Plan of Care, and Physician Orders will help home care agencies reduce unbilled revenue. Pending authorizations, unsigned Plans of Care, and Physician Orders will lead the agencies to hold claims back and increase unbilled revenue. Home Care Software should have tools and reports to closely monitor pending authorizations and orders and proactively take action to resolve them promptly.

Providing services beyond authorized limits will also lead to unbillable revenue. Home Care Software should have the tools to proactively notify scheduling staff when services are scheduled beyond authorized limits. Authorization utilization reports will also help agency staff to optimize authorized services and maximize revenue fully.

Home Care Software should have the tools to optimize authorized services, minimize unbillable revenue, and maximize revenue.

Timely Filing

Understanding and keeping track of payers' timely filing requirements will be critical in managing and reducing unbilled revenue. Home Care Software should have tools and reports to proactively notify agency staff when services and denied claims approach timely filing requirements.

Late Time Sheets

Home Care Agencies should also closely monitor services provided without time sheets (Electronic and Paper). Late time sheets will lead to services for which revenue is not recognized and claims not being sent in a timely manner.

Home Health Care Software should provide the tools and reports to accurately measure and manage late timesheets, including the ability to send correct claims and pay employees appropriately.

Claims

Home Care Agencies should also closely monitor the number and dollar value of claims not sent out for various reasons, such as not having an authorization number or patient policy number. Monitoring claims that are not going out on a regular basis will help home care agencies minimize unbilled revenue and missed timely filing requirements.

Home Care Software should provide configurable validations to detect potential claim issues that will result in denials proactively. The software should also provide tools and reports to proactively monitor held claims, resolve problems, and send claims promptly to reduce unbilled revenue.

Continuous Process Improvement

Effectively managing unbilled revenue is an ongoing process. Home Health Care Agencies should monitor unbilled services and revenue and continuously adjust. Agencies should partner with the right Home Health Care Software partner who will listen to your feedback and collaborate to constantly enhance software tools to improve the agencies' operational efficiency and bottom line.

Conclusion

Home Care Agencies should look for a home care software platform with tools and features to effectively manage unbilled services and revenue. Effective unbilled services and revenue management will reduce revenue leakage and improve collections, cash flow, and the agency's bottom line. The CareVoyant Home Care Software platform offers the right technology and tools to help home care agencies reduce unbilled revenue and improve cash flow and the bottom line.

About CareVoyant

CareVoyant is a leading provider of cloud-based integrated enterprise-scale home health care software that can support all home-based services under ONE Software, ONE Patient, and ONE Employee, making it a Single System of Record. We support all home based services, including Home Care, Private Duty Nursing, Private Duty Non-Medical, Home and Community Based Services (HCBS), Home Health, Pediatric Home Care, and Outpatient Therapy at Home.

CareVoyant functions – Intake, Authorization Management, Scheduling, Clinical with Mobile options, eMAR/eTAR, Electronic Visit Verification (EVV), Billing/AR, Secure Messaging, Notification, Reporting, and Dashboards – streamline workflow, meet regulatory requirements, improve quality of care, optimize reimbursement, improve operational efficiency and agency bottom line.

For more information, please visit CareVoyant.com or call us at 1-888-463-6797.