Home Health Billing Answers, 2021

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Home Health Billing Answers, 2021

Product Code: DHPABBILLG21

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Home Health Billing Answers, 2021

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, 2021.

Written by home health expert Melinda Gaboury, Home Health Billing Answers, 2021, 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, 2021, 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.

  • Updated! Walk through the Patient-Driven Groupings Model (PDGM) to ensure your current admission, coding, documentation and billing processes are in compliance
  • Updated! Learn how to calculate your payment in the PDGM payment system
  • Updated! Learn how to operate in a payment model based on 30-day episodes, elimination of therapy visits as a factor of payment, new LUPA thresholds
  • Updated! Understand how admission source, timing, clinical group, functional level, primary diagnoses and comorbidity adjustment will impact payments
  • Updated! 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.
  • Updated! Get an update on new case-mix categories, codes and OASIS items, and learn how your revenue will be impacted.


Home Health Billing Answers, 2021,
also covers:

  • Claims submission: Get step-by-step instruction on how to complete accurate Medicare claims (with examples).
  • Billing errors: Find out how to avoid the most common billing errors and how to read reject/reason codes. Also, use the included pre-billing checklist to reduce errors.
  • Medicare claims: Receive an overview of non-covered services, claim types, HCPCS codes, revenue codes and how they are used.
  • Financial outcomes: 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!


Published: February 2021

Pages: 208
ISBN: 978-1-64535-083-5

About the Author

Melinda A. Gaboury, COS-C, Chief Executive Officer

Melinda A. Gaboury, with more than 29 years in home care, 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 PDGM 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 and Work Group and is Treasurer on the Home Care Association of Florida Board of Directors.  Melinda is also the author of the Home Health OASIS Guide to OASIS-D1