Invoicing & billing for home care & home health agencies

Invoicing for home care & home health agencies is really three jobs: Medicaid and MCO claims through the EVV aggregator, long-term-care insurance invoices with the visit notes each carrier demands, and private-pay statements families can understand. We run all three from the same verified-visit data so nothing is billed twice or missed. Claims go out on your agency's schedule, usually weekly, with units checked against the authorization before submission.

  • Since 2020
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How it runs for home care and home health agencies

LTC invoices are built to the policy's format, and private-pay statements show dates, hours, caregiver initials and the rate, with a payment link to your portal. Every invoice is posted to the ledger the day it is issued.

What are outsourced invoicing services?

Outsourced invoicing services mean a remote billing team prepares, checks and sends your customer invoices instead of your office staff doing it between other tasks. The team works inside your accounting or billing software, follows your rate cards and contract terms, and issues credit notes and corrections. You keep control of pricing, approvals and the customer relationship.

What we handle for home care and home health agencies

  • Submit Medicaid and MCO claims weekly from EVV-verified units within authorization
  • Build long-term-care insurance invoices with the visit detail each carrier requires
  • Issue private-pay statements showing dates, hours, caregiver and rate
  • Bill split-payer clients once and allocate to each payer's format
  • Post every claim and statement to the ledger on the day issued

The KPI that matters here

Every verified visit invoiced or claimed within 48 hours, with zero units billed above the active authorization.

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

More for home care and home health agencies

Frequently asked questions

How do you bill visits that were partly outside the authorization?

We bill the units inside the authorization and hold the remainder on an exception list with the client, date and units affected. Your scheduler or care manager decides whether to request an authorization increase, bill the family, or write the time off. Nothing is claimed above the authorized units, which protects you in an MCO audit.

Can you invoice long-term-care insurance carriers for our clients?

Yes. Each carrier has its own format, typically an itemized invoice plus signed care notes or timesheets, and some require the client to submit rather than the agency. We prepare the package in the carrier's format, log the submission date, and track the elimination period and daily benefit cap so the family knows what the policy will and will not cover.

What do private-pay statements look like?

A one-page statement on your letterhead listing each visit date, hours, service type, the rate and any retainer applied, with a link to your payment portal. Families of older adults often share statements with siblings or a power of attorney, so the layout is plain and the balance is easy to find. Statements go out weekly or biweekly on the schedule you choose.

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Next step

Books closed. Invoices paid. Every month.

Tell us what is going on with your books or billing. You will hear from a named person within 1 business day, with a custom quote and a plan for the first close.

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