Home care billing
Home care billing services cover two different jobs. Non-medical agencies bill Medicaid waiver hours against authorizations and EVV records, VA Community Care against referrals, long-term care insurers against care notes, and private clients against invoices.
Skilled home health and hospice agencies bill Medicare periods under PDGM with a Notice of Admission and an OASIS behind every claim. Remitwright gives both a dedicated biller who knows the difference, working inside your agency software.
Last reviewed by the Remitwright billing team. Editorial policy
Your data, your systems
Patient data stays in your systems. Your biller works inside your own software, clearinghouse and payer portals and never exports, downloads or stores claim files, remittances or patient lists on Remitwright devices or systems.
Two lanes
Non-medical home care
Personal care, companion care and attendant services funded by Medicaid waiver and HCBS programs, VA Community Care, long-term care insurance and private pay. The claim is a visit matched to an authorization and an EVV record.
Skilled home health and hospice
Medicare and Medicare Advantage home health under PDGM, with the Notice of Admission, the OASIS assessment and the final claim in sequence; hospice claims by level of care with the election and certification behind them.
Where the money goes
Six places between the visit and the remittance where care that was delivered stops turning into money.
A visit with a missing clock-in, a GPS point outside the tolerance or an unmatched caregiver cannot be billed until the exception is cleared in the aggregator. Agencies that clear exceptions weekly bill weeks late; agencies that never clear them never bill the visit.
Waiver hours are authorized in units for a period. Visits past the end date or over the units are delivered in good faith and denied. Tracking units against the authorization is the fix, not the appeal.
Each managed care plan has its own portal, its own claim edits, its own documentation requests and its own timely filing. One agency can be billing five sets of rules and treating them as one.
Community Care claims are paid against a referral with a date range, a service and a number of visits. Care delivered outside any of the three is denied, and the fix is a new referral, not a corrected claim.
Shifts worked, documented and never billed, because the schedule and the claims were never reconciled. The gap is invisible until someone counts.
A Notice of Admission late or missing, a period billed before the OASIS supports it, a final claim without the required visits: each one holds Medicare payment for the whole period.
What we do
Software
Your biller works inside your agency management system and the EVV aggregator as a user you create. Nothing is exported into systems of our own.
Scope
Start with the part that is costing you the most. Every scope runs inside your agency software, and scheduling, caregiver staffing and the care itself stay with you in all three.
Claims lane
Claims built from verified visits and completed periods, sent to each state program, plan, VA administrator or carrier in its own format, then remittances posted and denials worked to a cause. Scheduling, EVV and the care itself stay with your agency.
Review my home care billingClaims and exceptions
Billing only, plus the claim-side paperwork on EVV exceptions: each held visit tied to its claim, the exception and the reason code your state accepts, with the evidence your coordinator needs to clear it. Visit edits, scheduling and caregiver staffing stay with you.
Check my EVV exceptionsFunded programs
Waiver and HCBS claims to the state or each managed care plan, VA Community Care claims to the administrator for the referral's region, and every authorization and referral counted down by units and dates so renewals go in before care runs past them.
Review my waiver claimsStates
Waiver programs, EVV vendors and models, managed care plans and filing limits differ by state. Each state page sets them out with an official source beside every fact. Remitwright serves agencies in every state remotely.
No state matches that. Clear the search box, or choose All.
Questions
Electronic visit verification records who delivered a visit, to whom, when and where. Under section 12006 of the 21st Century Cures Act, Medicaid-funded personal care and home health visits must be verified electronically, and most states match claims against the EVV record. A visit with an EVV exception that has not been cleared is denied or held. Clearing exceptions before the claim goes out is one of the main drivers of clean home care claims.
Under a service authorization that sets the service code, the units and the period, submitted to the state program or the managed care plan that administers the waiver, with the EVV record matching the visit. The codes, the units and the authorization rules are set by each state and sometimes by each plan, which is why the state pages matter.
If nobody covers the shift, the visit leaves no EVV record, so there is no claim to send and the units authorized for it simply stay unused. If a replacement caregiver covers it, the visit is billable once its EVV record verifies, for the time the replacement actually worked; a late clock-in or a hand-entered visit needs an exception reason your state accepts. Either way the biller notes the missed visit and why, so the schedule and the claims still reconcile at month end. The EVV and billing trail of a missed visit follows one call-out from the schedule to the claim.
Scheduling can sit with your own coordinators or with a scheduling service, but not with Remitwright: we bill, and we do not schedule caregivers, fill open shifts or take call-outs. Your coordinators keep the schedule in your agency software. Once a visit is done, the biller reads that schedule as a record: each visit is matched to its EVV record and its authorization, verified visits become claims, visits that did not verify get a written reason they cannot be billed, and the causes that keep recurring go back to your scheduler.
The NOA is the notice a home health agency sends Medicare to open a home health admission. Medicare counts it as timely when it is accepted within five calendar days after the admission date; a late NOA cuts the period's payment by one-thirtieth for each day from the admission date until the NOA is accepted, and the agency cannot bill the patient for the cut. It replaced the request for anticipated payment and is the first thing checked when a home health period is unpaid.
Yes, all three. VA Community Care claims go to the third-party administrator for the Veteran's region with the referral's authorization number on the claim, and referrals are tracked the way authorizations are, so renewals go in before care runs past them. Long-term care insurance claims go to each carrier with the invoices and care notes its policy asks for, chased to payment. Private pay clients get invoices on the cycle you choose, with the service detail they expect.
A signed BAA, a user for your biller in your agency management software and the EVV aggregator and payer portals you use, your authorizations and referrals, and your payer mix. Bring your active client count and your funding mix to the review; that is enough to start.
Use one when visits are delivered and never billed, when EVV exceptions sit uncleared for weeks, or when the one person who knew the MCO portals leaves. Keep it in-house when the scheduler already reconciles visits to claims daily and the aging stays short. In-house vs outsourced billing sets out both cases.
Next step
A billing specialist reviews what you send and replies in writing with where the hours are going unbilled.
You answer three questions
A billing specialist reads them
A written reply by email
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While you wait: see the sample weekly report or read the home care billing guide. You can also download the sample weekly report (PDF).
