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OASIS review and PDGM coding
Certified coders calibrated to your case mix and clinical pathways.
Industry · Home Health
PDGM throughput without the documentation backlog.
Home health agencies operate inside one of the most operationally punishing reimbursement frameworks in healthcare. PDGM, OASIS, RAP timelines, and LUPA exposure mean a single intake or coding miss can cascade into weeks of delayed cash.
Operational pain
Where the operation breaks down.
01
OASIS and coding bottlenecks
Clinical reviewers backed up; QA queues delaying claim submission past payer windows.
02
LUPA and case-mix exposure
Visit utilization out of step with HIPPS coding; reimbursement leaving the building.
03
Eligibility and intake delays
Slow benefit verification pushing starts of care and inflating front-end denials.
Reimbursement complexity
The payer landscape, plainly.
PDGM 30-day periods, RAP submission timing, NOA penalties, MA plan diversity, and an expanding mix of Medicare Advantage authorizations create a payer landscape where operational discipline determines margin.
Staffing reality
You cannot hire your way through this.
Coders, intake coordinators, and A/R specialists are the hardest roles to keep staffed in home health. We augment your team with experienced post-acute resources who plug into your EMR, not generic billing labor.
How we support home health operations
What an engagement actually delivers.
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Eligibility and benefit verification
Within two hours of referral receipt, including MA plan rules.
03
Denial management and A/R follow-up
Segmented by payer, with root-cause feedback into intake and coding.
Operational outcomes
What stabilization looks like for home health.
Outcomes vary by baseline and segment. The numbers below are representative of mature home health engagements after six months.
Discuss Home Health OperationsHome Health Engagement Benchmarks
Days in A/R
34Median, post-stabilization
Clean-Claim Rate
96%First-pass acceptance
Denial Overturn
88%Inside the appeal window
Aggregate engagement performance. Individual results vary by segment and baseline.
Other segments we serve
Ready to stabilize your revenue operations?
Connect with our operational advisory team to evaluate your current intake-to-cash workflow and identify leakage points.
Request an Operational Assessment
Confidential Operational Reviews · Post-Acute Specialists Only