Late Notice of Election
Days between election and NOE acceptance go unpaid. We file NOEs on the day of election where possible, confirm acceptance and document any exception request when the delay was outside the hospice's control.
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Hospice and palliative care billing services
Hospice billing pays a daily rate by level of care, so the claim is only as good as the Notice of Election, the election periods and the certification behind it. Routine home care, continuous home care, respite and general inpatient days each carry their own revenue code, documentation standard and audit exposure.
What makes hospice billing different
Per-diem benefit billing rewards clean election records and punishes paperwork delays, which is unlike any physician specialty.
- The Notice of Election must be filed and accepted within five calendar days of the election date; days before a late NOE is accepted are not payable, so NOE tracking sits at the front of the workflow.
- Each day is billed on type of bill 81X or 82X with the level-of-care revenue code, 0651 for routine home care, 0652 for continuous home care, 0655 for inpatient respite and 0656 for general inpatient.
- Routine home care pays a higher rate for the first sixty days of an election and a lower rate afterward, and the service intensity add-on for the last seven days of life requires G0299 and G0155 with units.
- A face-to-face encounter is required before the third benefit period and every period after it, and each certification needs the physician narrative; attending physician services bill with modifier GV, unrelated care with GW.
Denials we see most in hospice
Every denial gets a root cause, a fix and a feedback loop, so the same denial stops coming back.
Certification and face-to-face defects
Missing narratives, unsigned recertifications or no face-to-face before the third period trigger denials on review. We audit each certification packet against the benefit period calendar before claims release.
GIP and continuous care scrutiny
General inpatient and continuous home care days are reviewed for whether the symptom burden justified the level. We confirm hourly nursing documentation for continuous care and the GIP need before billing those codes.
How Core MB bills for hospice
Core MB manages hospice as a calendar: election dates, benefit periods, certification deadlines and face-to-face requirements are tracked per patient so each monthly claim reflects the right level of care and rate. Credentialing for hospice physicians and nurse practitioners runs in the same client portal. Credentialing for new providers runs in the same system, tracked live in your client portal.
- Same-day NOE filing and acceptance confirmation, with election period tracking per patient.
- Level-of-care reconciliation against clinical notes before each monthly claim, including continuous care hours.
- Service intensity add-on capture and hospice physician billing under revenue code 0657 with GV and GW applied correctly.
Everything in the service
Hospices get complete revenue cycle coverage from Core MB, from election processing and monthly claims through cap monitoring, appeals and reporting, with credentialing available in the same system.
- 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
Hospice billing questions
When do we use modifier GV versus GW on physician claims?
GV identifies the attending physician who is not employed by or under arrangement with the hospice, billing Part B for care related to the terminal illness. GW identifies services unrelated to the terminal condition. Hospice-employed physicians bill through the hospice claim instead, and we assign each case accordingly.
Why are our general inpatient days being denied on review?
GIP requires documentation that pain or symptom management could not be delivered in another setting, with daily notes showing the intervention and a plan to step down. We review the GIP packet before billing revenue code 0656 and prepare the record for any additional documentation request.
What if a patient revokes hospice and then re-elects a month later?
A revocation ends the current benefit period and the remaining days in that period are forfeited. Re-election starts the next period in sequence, which may require a face-to-face encounter and a fresh NOE. We track the sequence so the new election bills correctly from day one.
How do we get started with Core MB for hospice billing?
Share your hospice size, average daily census and current billing setup through the quote form and we will send a written proposal. Transitions run alongside your current billing so no election or claim is missed, and credentialing for hospice physicians and nurse practitioners can start at the same time.
More in facilities and ancillary care
Hospice billing that keeps pace with every election
Tell us about your census and we will show how Core MB handles NOEs, levels of care and certifications so your team can focus on patients and families.