AI‑Powered Hospice Billing Services for Better Cash Flow

Our billing experts start by verifying patient eligibility and insurance coverage right away. Using real-time systems, such as ANSI X12 270/271 transactions, we quickly and accurately confirm Medicare or private insurance coverage. This process verifies key patient details, like Medicare number and admission date, to prevent delays later.

Our team files the NOE using the CMS-1450 (UB-04) form, monitors its status, and quickly fixes any errors. We also manage appeals for any NOE-related denials to ensure that your hospice avoids per-diem losses and remains compliant with CMS rules.

During the final week of a patient’s life, we bill for the Service Intensity Add-On (SIA). We also ensure proper inclusion of HCPCS G0337 for face-to-face encounters and telehealth codes (G2025), which remain valid through September 30, 2025.

For veteran patients receiving hospice care, we handle VA hospice billing with precision. Our team verifies eligibility under the Veterans Health Administration (VHA), submits all required VA-specific forms, applies billing codes that differ from Medicare, and ensures claims are processed efficiently.

We check T-Status eligibility for all Medicare patients to ensure they qualify for hospice care under Part A. If an ADR is issued, we respond promptly with full documentation, including physician certifications and patient narratives.

We file monthly claims in order, making sure each one is processed before submitting the next. Using EDI (837I, 835, 276/277) and automated bots, we spot denials within 24 hours and resolve them quickly to keep your cash flow on track.

We handle payment posting using automated processing of ERA files (835s) to ensure accuracy and flag any underpayments. With data-driven tools, we keep Days in A/R under 30, supporting faster reimbursements and a smoother revenue cycle.

When a patient revokes election or ends hospice care, we file the Notice of Termination or Revocation (NOTR) within five days using the correct TOB 8XB form. This ensures Medicare processes the final bill efficiently and prevents any coverage gaps.

We track each patient’s hospice cap year from October 1 to September 30. If the cap is exceeded, we report it using occurrence code 27. Our system also uses predictive monitoring to forecast cap overages, allowing you to take action before it affects CMS reimbursements.

We make sure you stay compliant with HIS v3.01 and CAHPS survey rules to avoid the 2% payment penalty. We handle submissions on time and keep your CAHPS participation above 50 cases. We also prepare your documentation to meet 42 CFR 418 standards and monitor OIG PEPPER flags so nothing slips through the cracks.

For providers participating in the VBID pilot (Extended through 2025–2030), we handle all aspects of Medicare Advantage (MA) carve-in billing. It includes encounter data, credentialing, and billing reconciliation. Our team ensures full coverage for hospice services under Medicare Advantage, with accurate wrap-around rates and streamlined claims management.

We ensure that your NOE and NOTR filings are completed on time using smart automation. Our AI tools spot potential denials and coding errors before they become problems. Plus, our dashboards give you a clear view of cash flow, compliance, and claim status at a glance.

Our billing system simplifies hospice care costs with upfront estimates and one-click payment tools for families.

Workflow-integrated billing processes tailored to your hospice size, EMR, and payer mix

Scalable fee models aligned with claim volume and reimbursement structure

Accelerated collections through optimized charge capture, coding accuracy, and denial prevention

Deliver hospice BI reports covering unbilled claims, aged A/R, Medicare cap, denials, compliance, tracking, reconciliation, and payer mix.

Work with certified RCM professionals specialized in Medicare and Medicaid hospice billing.

Systematic follow-up and appeals to resolve aged claims and reduce outstanding AR by up to 40%.