Late or rejected NOA
A rejected Notice of Admission quietly erases days from the first period. We submit NOAs within the admission window, work the rejection report the same day and resubmit with corrected HICN, dates and admission source.
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Home health billing services
Home health billing runs on PDGM: each 30-day period pays a case-mix rate built from the OASIS assessment, the primary diagnosis and the referral source. Whether the claim pays depends on a timely Notice of Admission, a valid face-to-face encounter, a signed plan of care and visit counts that clear the LUPA threshold.
What makes home health billing different
Agency billing has its own claim type, its own rate logic and its own list of documents Medicare will ask for.
- Every 30-day period is billed on type of bill 32X with a HIPPS code generated from the OASIS, so a late or inaccurate OASIS changes the payment group before the claim is ever built.
- The Notice of Admission must be accepted within five calendar days of the start of care; each late day reduces the payment for the first period, which makes NOA tracking a daily task rather than a monthly one.
- Visits are reported with G-codes by discipline, including G0299 and G0300 for RN and LPN nursing, G0151 through G0153 for PT, OT and SLP, and G0156 for aide services, each with 15-minute units.
- The face-to-face encounter, the certifying physician's signed plan of care and the recertification estimate must all be on file before billing; the physician's own G0180 and G0179 claims depend on the same documents.
Denials we see most in home health
Every denial gets a root cause, a fix and a feedback loop, so the same denial stops coming back.
Face-to-face and certification gaps
ADRs and medical review pull the claim when the encounter note is missing, unsigned or undated. We verify the physician documentation before the first period bills and chase signatures through the portal.
LUPA and PEP adjustments
Periods that fall under the LUPA threshold or end in a transfer pay per visit instead of per period. We flag at-risk periods before they close so clinical staff can schedule and document appropriately.
How Core MB bills for home health
Core MB bills home health as a period-based workflow: OASIS lock, NOA acceptance, plan of care signatures and visit reconciliation are tracked per patient so the final claim goes out complete. Credentialing for new agency providers and clinicians runs in the same client portal. Credentialing for new providers runs in the same system, tracked live in your client portal.
- NOA submission and acceptance tracking within the five-day window, with same-day rework of rejections.
- OASIS-to-HIPPS review before each period bills, including primary diagnosis acceptability under PDGM.
- Visit reconciliation by discipline against the plan of care, with LUPA threshold alerts before period close.
Everything in the service
Agencies get the full revenue cycle from Core MB, from eligibility and period billing through ADR response and recertification tracking, with reporting that shows where each period stands.
- Insurance verification and eligibility checks
- Charge entry and specialty-specific coding review
- Claim scrubbing and electronic submission
- Payer follow-up on every open claim
- Denial management and appeals
- Payment posting and reconciliation
- Accounts receivable recovery
- Patient statements and balance support
- Monthly reporting you can read in five minutes
- Provider credentialing and payer enrollment
Home health billing questions
What happens if our Notice of Admission is filed late?
Medicare reduces payment for the first 30-day period by a daily amount for each day the NOA is late, and a rejected NOA counts as not filed until it is accepted. We monitor NOA status every business day and resubmit corrections immediately so the admission window is protected.
Why do Medicare Advantage plans keep asking for authorization on every period?
Most MA plans treat home health as an authorized benefit and require a new authorization for each certification period, often with visit limits by discipline. We request and track those authorizations alongside the plan of care so visits are not delivered outside an approved window.
How do you handle a patient who transfers to another agency mid-period?
A transfer creates a partial episode payment adjustment for the discharging agency and a new admission for the receiving one. We bill the discharge with the correct patient status and occurrence codes and ensure the receiving period starts with its own NOA and OASIS.
How do we get started with Core MB for home health billing?
Send us your agency details, active census and monthly period volume through the quote form and we will reply with a written proposal. Transitions run alongside your current billing so no period is dropped, and credentialing for new agency clinicians and providers can start at the same time.
Get every 30-day period billed complete and on time
Tell us about your agency and we will show how Core MB manages NOAs, OASIS-driven billing and recertifications so revenue keeps pace with care delivered.