Home Health Billing Answers, 2025

Available February 2025

Give your billing and collections staff the information they need to bill correctly on the front end and correct denials before they reach auditors with Home Health Billing Answers, 2025.

Written by home health expert Melinda Gaboury, Home Health Billing Answers, 2025, walks you through every step of the billing process and provides crucial tips for avoiding common billing errors. Plus, it explains in plain-English, the confusing billing jargon and acronyms that can trip billers up.

Home Health Billing Answers, 2025, also covers:

• Updated! Get new FY2025 PDGM categories, codes and OASIS items, and learn how your revenue will be impacted
• Updated! An expanded chapter on how to bill for Medicare Advantage vs. traditional Medicare
• Deep dive into the Patient-Driven Groupings Model (PDGM) to ensure your current admission, coding, documentation and billing processes are in compliance
• Learn how to calculate your payment in the PDGM payment system
• Understand how to operate in a payment model based on 30-day episodes, elimination of therapy visits as a factor of payment, new LUPA thresholds
• Get a primer on how admission source, timing, clinical group, functional level, primary diagnoses and comorbidity adjustment will impact payments
• Learn to adopt audit processes to ensure that you are collecting the level of detail needed from physicians so that your clinicians and coders can choose the right codes.
• Get step-by-step instruction on how to complete accurate Medicare claims (with examples)
• Find out how to avoid the most common billing errors and how to read reject/reason codes
• Receive an overview of non-covered services, claim types, HCPCS codes, revenue codes and how they are used
• Billers get the basic guidance needed to minimize denials, PEPs, LUPAs and more
• Bonus: Tools and templates to ensure your agency gets the money it has earned — and fast!

For bulk/group order please contact us at 800-650-6787 ext. 2715 or books@decisionhealth.com

ISBN: 978-1-963512-17-5

About the Author

Melinda A. Gaboury, COS-C, is co-founder and Chief Executive Officer of Healthcare Provider Solutions, Inc. (HPS). Melinda Gaboury and Mark Cannon founded the company in April 2001 to provide financial, reimbursement, billing, operational and clinical consulting to the home care and hospice industries. With more than 29 years in home care, Melinda has over 20 years of executive speaking and educating experience, including extensive day-to-day interaction with home care and hospice professionals. She routinely conducts Home Care and Hospice Reimbursement Workshops and speaks at state association meetings throughout the country. Melinda has profound experience in Medicare PPS training, billing, collections, case-mix calculations, chart reviews and due diligence. UPIC, RA, ADR & TPE appeals with all Medicare MACs have become the forefront of Melinda’s current impact on the industry. She is currently serving on the NAHC/HHFMA Advisory Board as ex-officio and is Treasurer on the Home Care Association of Florida Board of Directors.