How it runs for home care and home health agencies
Private-pay checks, ACH pulls and portal payments are applied to the oldest open statement unless the family says otherwise. Unapplied cash is worked within two business days, so the aging you see reflects what has really been paid.
What is cash application?
Cash application means matching money received from customers to the invoices it pays and recording that in the accounting system. It covers bank receipts, checks, lockbox files, card payouts and remittance advices, including partial payments, deductions and payments with no reference. Done well, the aging is accurate and no customer is chased for an invoice they already paid.
What we handle for home care and home health agencies
- Import 835 remittances and apply each line to its claim with adjustment codes
- Post denials and short pays by reason code for the billing team to work
- Apply private-pay checks, ACH and portal payments to the right statement
- Record recoupments and take-backs against the original claim, not as new items
- Clear unapplied cash within two business days with a documented reason
The KPI that matters here
Remittances applied within two business days of deposit, with unapplied cash held under one percent of monthly receipts.
Home care compliance notes
EVV
The 21st Century Cures Act requires electronic visit verification for Medicaid personal-care and home-health visits, captured through state aggregators such as HHAeXchange or Sandata. We bill only from verified visits and keep an exception log for visits that need a manual correction before they can be claimed.
HIPAA
Client names, diagnoses and authorizations are protected health information. We sign a BAA, our staff are HIPAA-trained, access is limited to the roles that need it, and PHI never appears in ledger memos or emailed spreadsheets.
State Medicaid and MCO rules
Each state waiver and each managed-care organization sets its own authorization limits, unit rounding, timely-filing window and recoupment process. We track authorizations against billed units and record recoupments as reductions to the original claim, not as unexplained bank debits.
FLSA Home Care Rule
Most agency caregivers are entitled to minimum wage and overtime, and travel time between clients counts. Your payroll provider computes the pay; we make sure the ledger and the labor-cost reports reflect it correctly and that live-in and sleep-time arrangements are coded as your counsel directs.
Home care software we work in
- QuickBooks Online
- Gusto
- ADP
- Bill.com
- AxisCare
- WellSky
- Alora
- HHAeXchange
- All 50 platforms
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Frequently asked questions
What is an 835 and why does it matter to my books?
An 835 is the electronic remittance advice a payer sends with a payment, listing every claim paid, adjusted or denied and the reason. Applying it line by line closes the right claims, records write-offs correctly and surfaces denials to work. Without it, the deposit is just a number in the bank and the aging slowly stops meaning anything.
How do you apply a family payment that does not match any invoice?
We check the memo, the client's open statements and any retainer on file, then apply the payment to the oldest open balance unless the family's note says otherwise. If it still does not fit, it sits in unapplied cash with a task to call the family, and it is resolved within two business days. Overpayments are held as credits until you decide to refund or apply them.
Do you apply payments in our billing platform or in the accounting file?
Both, and they must agree. Payments are applied at the claim or statement level in AxisCare, WellSky, Alora or HHAeXchange so the aging there is right, and the totals are posted to the ledger so the balance sheet matches. A monthly tie-out between the platform's aging and the receivable account is part of every close.
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