Home Health Billing Services

Billing that keeps up
with your agency

Home health claims usually fail for small reasons: a late Notice of Admission, an assessment that was never accepted, an order still missing a signature. We catch those before billing, so the period gets paid the first time.

96%avg. net collection rate across TruCare clients

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What a quarter with TruCare changes

96%

avg. net collection rate across TruCare clients

>95%

clean claim rate, accepted on first submission

−38%

days in A/R, so late periods stop compounding

6–20%

revenue growth inside the first 90 days

Figures reflect TruCare revenue cycle client results, trailing twelve months.

The home health billing services agencies stop switching away from

4.8

Based on 180+ client reviews

Verified client reviews

Mar 07, 2026

Day 2, every admission

We used to file the NOA whenever someone got to it, and we ate the reduction most months. It goes out on day 2 now. That alone paid for the service.

Dana R., agency owner

2 weeks ago

They emptied the RTP file

There were claims in return-to-provider status from two quarters back. They sorted them by reason code and told us which were assessments and which were missing signatures.

M. Okafor, billing manager

Jan 09, 2026

We see the LUPA coming

Before, a period under the threshold was a surprise on the remittance. Now the scheduler hears about it while there are still days left in the period.

Priya N., director of nursing

Dec 18, 2025

A second state with no gap

We opened a branch across the state line, and the Medicaid enrollment was completed before our first referral. Our last vendor spent four months on one payer.

Sam Whitfield, administrator

Nov 30, 2025

I stopped asking for reports

Unbilled periods by branch, denials by payer, days to final claim. It is all on one screen, and I quit chasing my office manager for a spreadsheet.

L. Castellanos, multi-site owner

What we do for your agency

View all services

We get you enrolled, and keep you enrolled

We file your Medicare enrollment forms and keep your provider records current. Open a branch or add a service, and we sign you up with the Medicaid and Medicare Advantage plans too. We also watch your renewal and accreditation dates, so nothing expires without warning.

Medicare enrollmentPECOS upkeepCHOW and revalidation

Nothing else in healthcare bills like a 30-day period.

An office visit is billed the day it happens. A home health period is billed after 30 days of care by four disciplines, on a payment amount that was decided at admission by a diagnosis, an assessment score, and where the patient came from. By the time the claim goes out, the revenue is already set.

That is why general billing vendors struggle here. They are good at claims. Home health is won earlier, in coding the referral correctly, filing the admission on time, getting the assessment accepted, and chasing signatures while the patient is still on service.

Our home health billers do nothing but home health all day. They know the five-day clock starts the day after the start of care. They know a claim bounces when the assessment is still sitting in a validation report. They know a period one visit short of its threshold pays per visit, not per period. Nobody learns that from a general outpatient queue.

Six places home health revenue leaks, and what we close

The five-day clock, watched for you

A late Notice of Admission costs a thirtieth of the period for every day it is late, and the reduction can reach the periods behind it. Ours go out in order, and the first visit.

A HIPPS code you could defend in a review

Admission source, timing, clinical group, functional level, and comorbidity are each traced back to something in the chart, so the grouping holds when someone asks where it came from.

LUPA seen while you can still act

Visit counts run against that group’s threshold during the period, not after it closes, and your scheduler hears about a short period while there is still time in it.

No claim before the assessment lands

We confirm the OASIS is accepted on the validation report, then bill. This one check removes a leading reason home health claims are returned unprocessed.

Signatures chased while the patient is on service

Unsigned orders and missing face-to-face documentation are pulled at the start of the period, not found at the end when the physician has moved on.

Numbers by branch, not by guess

Unbilled periods, days to final claim, days in A/R, return-to-provider volume by reason code, LUPA rate, and denials by payer, split by branch and by clinician. The same data that shows up later in HHVBP, HHCAHPS, and your Star Rating on Care Compare.

Rated on the platforms that matter

Ratings shown are collected from verified client reviews.

Our service offerings

We bill everyhome health service you provide

Skilled nursing

Wound care, injections, catheters, IV therapy, teaching a new diagnosis. This is the visit most home health periods are built around, and it determines how the period is grouped and paid.

Physical, occupational, and speech therapy

Therapy visits have to be billed under the right discipline, with the right code, and with the visit time recorded properly. Get any of those wrong, and the claim comes back.

Home health aide visits

Bathing, dressing, and daily care alongside skilled visits. Aide visits count toward the period's visit total, so they affect what the period pays.

Medical social work

Social workers visit patients dealing with housing, money, or caregiver problems. A small part of the census, and the one most often left off the claim.

Personal care and homemaker services

Non-skilled care billed by the hour or by the unit, usually to Medicaid. Electronic visit verification decides whether these claims get paid, so every visit record has to match the claim.

Private duty nursing

Nursing is by the shift rather than by the visit, often for hours at a time. We check the hours worked against the hours approved, so nobody works a 12-hour shift on an 8-hour approval.

Pediatric home health

Children on nursing or therapy at home, usually through Medicaid or a waiver program. Different rules, different approvals, and paperwork that has to be renewed often.

High-acuity care at home

Patients on IV infusion, ventilators, or complex wound care. These cost more to deliver, so the diagnoses and supplies have to be coded correctly, or you lose money every period.

Home health billing that fits your agency

Billers who only do home health

Your claims are handled by certified billers who work on home health every day. They know what Medicare sends back and why, and they are not juggling claims from other kinds of practices.

Your EHR stays exactly where it is

We work on top of the system your clinicians chart in and pull visits, orders, and assessments through to the claim. No migration weekend, no second login for the field.

Enrollment that keeps pace with growth

Add a discipline, a branch, or a state and TruCred runs the applications while billing keeps going, so new referrals turn into billable admissions instead of held charts.

Why home health claims come back, and how we keep them from leaving

Most home health money is not denied. It is returned. The claim never reaches adjudication; it lands in a file waiting for someone to notice, and the period sits unpaid while everyone assumes it was billed. Agencies discover the backlog at month-end.

Every rejection gets tagged to a cause, and the cause becomes a rule the next claim is checked against. Fix it once and it stops being a monthly event.

Still rebilling the same periods every month?

We will read your last 90 days of returned claims and tell you what the pattern is

Request a billing audit

Here is what we catch first:

The admission was opened late

A Notice of Admission filed on day 6, or rejected and quietly left there, reduces the period payment by a thirtieth for every day, and a long delay reaches the next period too. We file early and track it to acceptance.

The assessment never cleared iQIES

A period claim with no matching accepted assessment is returned rather than paid. We check the validation report first, which is why our claims do not queue up behind an unaccepted OASIS.

The primary diagnosis cannot carry a period

Some diagnoses cannot be a principal diagnosis under PDGM, and the claim comes back ungrouped. Coding is reviewed against the referral and the assessment so the clinical group is set correctly the first time.

The record does not prove the patient qualified

The patient was not on the payer you billed

A Medicare Advantage enrollment nobody checked, a Medicaid plan carve-out, or another agency’s episode still open. Coverage is verified at the start of care and again at recertification.

The period came in under its visit threshold

Below the threshold for its case-mix group, the period pays per visit instead of in full. One canceled visit can do it, which is why counts are watched while the period is still open.

A short list of codes decides what your period is worth

Home health does not run on a long procedure list. It runs on a handful of bill types, revenue codes, discipline codes, and diagnoses, and nearly every dollar an agency loses is lost inside that handful. A diagnosis in the wrong slot. A comorbidity never coded. Visit time rounded to the half hour.

Our coders live in these charts. They know which entries drive the grouping, which fields the claims system compares against the assessment, and which quiet ones decide whether a claim pays or comes home.

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The codes on every home health claim.

32A32932D

Opening, billing, and undoing an admission

The 32A opens the admission and stops the five-day clock. Each 30-day period bills on a 329. When an admission has to be corrected, a 32D cancels it cleanly instead of leaving a duplicate for someone to argue with later.

Your EHR stays. Everything else gets easier.

Nothing about your clinical day changes. TruCare connects to Axxess, HealthCare Synergy, and the other platforms agencies chart in, so visits, orders, assessments, and schedules come across on their own and billing happens on top of them. No migration weekend, no export project, no asking a field nurse to learn a second screen.

What changes is what gets caught. The system watches the few things that stop a period from getting paid: a waiting Notice of Admission, an unaccepted assessment, a period one visit short, a claim that came back. Your billers get told about the problems instead of hunting for them.

Check for your EHR

Deep integrations with all EHRs

TruCare connects seamlessly with your existing workflows — no switching required.

Six things that moved under home health agencies this year

The rate went down again

The CY 2026 final rule nets out around a 1.3 percent aggregate decrease, after a 2.4 percent update was pulled back by a permanent behavior adjustment and a one-year temporary cut. A thinner margin per period means a returned claim hurts more than it did in 2023.

The weights were recut

Case-mix weights, functional levels, comorbidity subgroups, and LUPA thresholds were all recalibrated for 2026. A visit pattern that cleared the threshold last year does not automatically clear it now.

Assessments moved to OASIS-E2

OASIS-E2 took effect on April 1, 2026, and the old manual entry screen in iQIES went away at the same time. Assessment problems surface later in the process, when a claim is already waiting on them.

Review demonstration states stayed in review

Agencies billing Illinois, Ohio, Texas, North Carolina, Florida, and Oklahoma still pick between pre-claim review and post-payment review, and the minimal-review option is gone. Documentation quality now sets your cash cycle.

More admissions arrive on Medicare Advantage

Plans that authorize visit-by-visit and pay-per-visit keep taking a share. Running an MA admission through a traditional Medicare workflow produces denials that look like billing errors but start at intake.

Electronic visit verification got stricter

EVV has been required since the 21st Century Cures Act, but enforcement keeps hardening. In more states, a home care claim with no matching record in the state aggregator, Sandata or HHAeXchange in most of them, is denied outright rather than pended. Claim and visit have to agree on service, date, and units.

How we keep policy change out of your A/R

We read the rules so your administrator does not have to. Annual rule changes, threshold updates, assessment versions, and payer policy each become a check a claim has to pass before it leaves.

When something moves, it moves in our edits, not in your return-to-provider file three weeks later. Eligibility, NOA timing, assessment status, visit counts, and enrollment are all tested against current policy at submission.

After submission, we follow the claim through the clearinghouse and the acknowledgment, fix what bounces, and appeal inside the filing window. Posting and follow-up continue past adjudication, so reduced payments and partial pays get worked rather than written off.

The result is fewer surprises, fewer write-offs from missed deadlines, and a straight answer to what each payer owes you today.

In-house vs. outsourced

One biller at a desk, or a team that only bills home health

An in-house biller knows your patients, your referral sources, and your physicians. A specialist team knows the rules and has seen the same reason code 500 times. Both approaches work. Both have a bill that arrives somewhere: in margin, in unbilled periods, or in your own evenings.

Here is the honest comparison on the things owners actually weigh:

The question	In-house billing	With TruCare
Who watches the 5-day NOA clock	Whoever notices the admission that week	A daily queue, filed on the order and first visit, tracked to acceptance
Depth in PDGM	One person’s knowledge of grouping, thresholds, and reason codes	Billers and coders on home health caseloads full time, across every MAC
When an assessment stalls	Found when the claim comes back	Caught on the validation report, before the period is billed
Documentation requests	Land on whoever is free, often late in the response window	Packets assembled and filed inside the window as routine work
Unbilled periods	Surface at month end, if someone runs the report	On a live list, aged, by branch
Rule changes	Read on a webinar, applied when there is time	Turned into claim edits the week they take effect
Cost shape	Salary, benefits, training, software, clearinghouse, desk	A fee tied to what you collect, so cost follows census
Absence and turnover	One resignation stops submissions for weeks	Billing continues through absences; coverage is our problem
Tooling	You buy it, learn it, and connect it to your EHR yourself	Platform, clearinghouse, and EHR integration included
What the owner sees	A spreadsheet someone built last quarter	Days to final claim, LUPA rate, denials by payer, live
The owner’s evenings	Spent closing periods	Spent on referrals, hiring, and the agency

Run the comparison on your own numbersFree 90-day review of denials and aging A/R, no commitment.

Hover a state to see coverage

Where we serve

Fifty states, three MAC jurisdictions, one view of your A/R

We bill for single-site agencies, multi-branch groups, operators inside review demonstration states, and home care companies billing Medicaid units. The rules are not the same in any two states, so they are handled state by state and plan by plan rather than from one template. Growing across a state line is the moment most owners find that out.

Multi-state Medicaid enrollment

MAC jurisdictions

Review demonstration support

Visit verification setup

Clearinghouse connections

A named account contact

Who we bill every day

Traditional Medicare

NOAs, PDGM period claims, three home health MAC jurisdictions

Medicare Advantage

Episodic and per-visit contracts, visit authorization, plan-specific rules

Medicaid and managed Medicaid

State plan home health, MCO plans, waiver programs

BCBS and Anthem

Home health policy that varies plan by plan

Centene family

Molina, WellCare, Amerigroup

Everything else on the census

VA Community Care, long-term care insurance, private pay

We bill whatever your agency is contracted with. If you are not contracted yet, TruCred handles the enrollment.

Home health billing saver guide

An agency collecting $1.2 million saves up to $43,180 a year by outsourcing to TruCare

	In-house billing	With TruCare	Annual saving
Dedicated billing staff	$73,060	$0	$73,060
Billing software and clearinghouse	Varies	Included	—
Training, turnover, and coverage	Varies	Included	—
TruCare fee (from 2.49% of collections)	—	$29,880	—
Total annual cost	$73,060	$29,880	$43,180

Example: an agency collecting $1.2 million a year with one full-time biller, at TruCare’s starting rate of 2.49%. Biller cost uses the BLS May 2025 median wage for medical records specialists ($51,140), with benefits at 30% of total compensation. Software and training costs vary by agency and are not counted. We do not replace your front office; we take the claims work off it. Your TruCare rate depends on monthly collections and the services you use.

Want this run on your census instead of an example?

Talk to a home health billing expert

What changes by the second month

“We were never lazy about billing. We just could not see it. Nobody could tell me which periods were unbilled or why, so I assumed everything had gone out. TruCare started at the front end, with admissions and assessments, and the claims followed. NOAs go out on day 2, the returned-claim file is nearly empty, and I know what every payer owes us by branch without asking anyone.”

Sarah Mitchell

Administrator, Morgan Home Health Services

Billing that keeps upwith your agency