Common Medicare Home Health Billing Errors and How to Avoid Them

Today’s home health care billing is more critical than ever. Shrinking reimbursement and increased regulations are forcing agencies to optimize their billing process. With many layers of complexity in the billing process, agencies have found that even a small number of billing errors have resulted in significant payment losses. Understanding common billing errors and how to avoid them can significantly increase your profitability. Here are some tips on common home health billing errors you can avoid:

1. Incorrect patient information- Inaccurate patient information will cause claim rejections or RTP claims. Incorrect patient address, zip codes, names and policy numbers are common and avoidable mistakes. Be sure your biller double checks patient demographics to avoid payment delays.

2. Incorrect source of admission- Determining whether a patient is being referred to your agency by a “physician referral” or “transferred” from another agency is one of the most misunderstood billing errors. Source of admission is determined by reviewing the patient’s eligibility documentation and must be accurately identified on the claim. Be sure your billers understand sources of admission to avoid payment delays.

3. Invalid diagnosis codes- Do not use codes that are marked “invalid”. Every October new diagnosis codes are published. Be sure your billers are keeping up to date with added, deleted and revised ICD-9-CM codes to avoid payment delays.

4. Incorrect or missing physician NPI- The physician’s full name and NPI must be entered on a claim correctly. Be sure your biller double checks this information to avoid payment delays.
The financial strength of your agency is directly related to timely billing and skilled billers. Use these tips and keep your eye on minimizing your rejected claims to maximize your productivity and provide your agency with a steady cash flow.

For more tips on Home Health Billing, contact Imark Consulting, Inc.

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One Response to Common Medicare Home Health Billing Errors and How to Avoid Them

  1. An excellent article which speaks about how to avoid the home health billing errors. Another site that I found helpful in this regard is

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