Our Home Health billing services are designed to address the distinct needs of medical providers delivering in-home patient care. We specialize in managing the complexities of coding and billing for services such as skilled home nursing, mobility needs, medicine management, physical therapy, occupational therapy, palliative care, infusion therapy, and chronic disease management.
Home Health billing operates within one of the most documentation-dependent reimbursement structures in post-acute care — where revenue is governed by PDGM episode classification, accurate OASIS scoring, and the precise capture of clinical groupings, comorbidity adjustments, and Low Utilization Payment Adjustments that CMS monitors through targeted probe audits and RAC reviews.
MBC acts as your Revenue Integrity Partner by ensuring that every home health episode is reimbursed to its highest defensible PDGM accuracy, OASIS clinical and functional scoring correctly reflects patient complexity, and payer policies around 30-day payment periods, physician order management, and EVV compliance are executed with precision — so your agency retains every dollar it clinically justifies.
Our medical billers in Hawaii aim to provide you to the best Medical Billing services with maximum efficiency. For almost 10 years in the industry now many of them have been involved in all aspects of medical billing, coding, collections and compliance to HIPAA guidelines. Our billers are located in all the major cities like Honolulu, Hilo, Kailua, Kaneohe and Kapolei. Their skills across the following can help your practice to thrive:
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Patient demographics Entry
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Filing of Electronic claims
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Follow up on outstanding and denied claims
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Auditing Codes with ICD-9 and CPT
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Timely Payment posting
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Providing reports on a regular basis to show claims status
Home Health agencies lose significant revenue through inaccurate OASIS scoring that downgrades clinical groupings, missed comorbidity capture that eliminates case-mix adjustments, and LUPA threshold mismanagement that converts full episodes into partial payments without clinical justification.
MBC's Revenue Diagnostic evaluates your home health billing at the episode, payer, and OASIS assessment level — identifying where PDGM grouping accuracy is underperforming, which RAP and final claim submissions are failing adjudication and why, and how your AR aging and episode payment yield compare against post-acute benchmarks. The output is a clear, actionable breakdown of the revenue your agency is currently leaving uncollected.
At MBC, we ensure accurate reimbursements, minimize denials, and maintain compliance with industry regulations. We help you optimize revenue cycle management. Whether your practice focuses on post-surgical recovery, hospice care, telehealth visits, or rehabilitative services, our expertise ensures your administrative processes run smoothly, allowing you to dedicate more time to enhancing patient outcomes.
Home Health billing is a visit-driven, OASIS-dependent discipline where PDGM miscalculation, EVV documentation gaps, and LUPA mismanagement compound across every 30-day period — quietly eroding margins that agencies cannot recover once episodes are closed and cost reports are filed.
MBC helps home health agencies Yield your EBITDA by maximizing reimbursement accuracy across all PDGM clinical and functional groupings, reducing denials on RAP submissions and final claims, and ensuring that every billable visit delivered — from skilled nursing and physical therapy to chronic care management under physician orders — is captured, coded, and collected in full. The result is a billing operation that turns your patient census directly into sustainable financial performance.
