We manage every step of the revenue cycle using payer-specific workflows, updated billing logic, and EMR-integrated tools.
Verify insurance coverage in real time using ANSI 270/271 before the start of care.
Initiate and track prior authorizations according to each payer's requirements.
Ensure all care plans are physician-signed and coded accurately to match billed services.
Handle Pre-Claim Review (PCR) submissions and manage UTN tracking for RCD-compliant billing.
Generate HIPAA-compliant 837I claims using accurate PDGM units and LUPA indicators.
Post 835 remits and reconcile payments with expected reimbursements.
Resolve denials based on 835 codes by correcting errors in documentation, coding, or billing.
Use both manual review and automated 276/277 workflows to follow up on unpaid claims.
Track Days in A/R, Clean Claim Rate, NOA timeliness, and A/R over 90 days to keep your revenue cycle on target.
Dastify’s home health billing solutions are built to support agencies of all sizes and specialties:
Fast onboarding, credentialing, and daily claims processing support
Automated workflows, KPI reporting, and team training
Dedicated billing teams, payer-specific escalation protocols, and audit risk controls
Our home health billing services combine technical expertise and automation to keep your agency compliant with new CMS rules, reduce denials, and maximize timely payments.
PDGM Case-Mix & Therapy Management
We automate precise case-mix assignment to the updated 432 PDGM clinical groups, including functional impairment scoring and comorbidity adjustments. Our real-time therapy tracking prevents low-utilization payment adjustments (LUPA) by applying the latest thresholds and therapy add-ons.
Face-to-Face and Telehealth Billing Compliance
We ensure accurate billing of HCPCS codes G0466–G0470 for physician face-to-face visits and G2025 for telehealth services according to current CMS guidelines. This guarantees audit-ready claims aligned with CMS requirements.
OASIS-E1 Documentation & Coding
We support OASIS-E1 assessments with certified coders and NLP automation for precise ICD-10 coding. Your documentation meets QAPI, CoPs, and HHVBP standards, helping avoid quality reporting penalties.
NOA Filing & Accounts Receivable Optimization
We provide compliance with CMS’s 1-day NOA filing rule by completing eligibility verification immediately at intake, ensuring all payer data is accurate before the NOA is submitted.
Need Help Managing RCD? We Make It Simple and Compliant
If your agency operates in an RCD state, you understand the importance of obtaining accurate documentation before billing. Review Choice Demonstration (RCD) requires agencies to submit claims for CMS approval either before or after services are delivered, depending on your selected review option.
We help your team stay compliant and avoid payment delays by managing the complete RCD process from start to finish.
Our RCD Support Services Include:
Illinois
Ohio
Texas
North Carolina
Florida
If your current system isn’t meeting your agency’s needs, we also offer a streamlined transition to our purpose-built home care agency billing software. Key features include:
AI-driven denial management to keep low denial rates.
UiPath RPA bots automating prior authorizations, status checks, and payment follow-ups.
HIPAA-compliant patient portals enable patients to access their medical records, review billing statements, and submit payments.
Regular KPI reporting with benchmarks against NAHC, VNAA, MGMA, and HCAF standards.
— Choose Your Plan
Transparent Pricing With No Hidden Fees
Starter
For Solo & Small Practices
*Based on collections
Most Popular
Growth
For Group Practices & Clinics
*Based on collections
Enterprise
Hospitals & Large Systems
Volume-based pricing
— Proven Expertise in
50+ EHR/EMR/PMS
With over a decade of experience in home health revenue cycle management, our expert team of AAPC and AHIMA-certified coders ensures accurate billing that helps you get paid faster and maximize reimbursements.
Eliminate the cost and hassle of hiring, training, and retaining billing staff by relying on our specialized home health billing team.
Our Satisfied Clients
Discover how physician groups thrive with us.
Frequently Asked Questions
Today, CMS updated how each 30-day billing period (called an episode) is classified into one of 432 clinical groups. These groups are based on the patient’s main diagnosis (using ICD-10 codes), their level of functional ability, and other health conditions (comorbidities). This recalibration changes how much your agency is paid, so accurate coding and documentation are essential to receive full payment.
LUPA stands for Low Utilization Payment Adjustment. It’s a reduced payment that applies if a patient receives fewer therapy visits than CMS’s set minimum threshold. Today, these minimum visit numbers (thresholds) have changed depending on the patient’s clinical group. If therapy visits fall below these new thresholds, the agency gets paid less. We use accurate tracking and documentation of therapy visits to help avoid losing revenue due to LUPA penalties.
Yes. Medicare allows billing telehealth visits under PDGM using specific HCPCS codes. This means agencies can get reimbursed for remote patient visits, provided they comply with the state parity laws and document the visits correctly.
Comorbidities are additional health conditions a patient has alongside their primary diagnosis. CMS recognizes that patients with more or more severe comorbidities require more care, so it increases payments through comorbidity adjustments. If your coding accurately captures these secondary diagnoses, your agency could see increase in reimbursement per episode.
Our AI-driven tools check claims for errors before submission, catching issues that often cause denials. This means over high claims are clean on the first try, denial rates stay below, and payments come in faster without extra work.
Let’s make your current year more profitable. Connect with Dastify Solutions today and see the difference expert home health billing services can make.
