Billing
Process of submitting claims for payment.
Definition
Process of submitting claims for payment.
Why it matters
Billing is part of the Revenue Cycle vocabulary used across home health operations, documentation, and revenue cycle. Understanding it helps clinicians, QA leads, and administrators stay aligned on care quality and compliance.
What Should I Document? 100 OASIS Situations Home Health Nurses Face Every Day
100 real OASIS scenarios, worked end to end — clinical situation, common mistake, better approach, and key takeaway. Built around OASIS-E2 (effective April 1, 2026) to turn what you assess into accurate, defensible documentation.
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Conversations on revenue cycle
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Ep 15Ep 15 · Jun 8, 2026
The Biggest Mistake Healthcare Makes About Nurses
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Ep 13Ep 13 · May 18, 2026
Why OASIS Is Every Nurse's Biggest Nightmare
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Ep 23Ep 23 · Aug 17, 2026
The Hidden Spreadsheet Error That's Causing the Nursing Shortage | Robert Wingo
Robert Wingo, BSN, RN, NI-BCWatch
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LUPA (Low Utilization Payment Adjustment) kicks in when a 30-day home health period falls below its PDGM visit threshold, shifting payment from the case-mix-adjusted 30-day rate to per-visit. This guide explains how thresholds work, what causes avoidable LUPAs, and how to manage LUPA risk without chasing visits.
Why Home Health Agencies Lose Money on Incomplete Visit Notes
An incomplete visit note rarely creates just one problem, it moves downstream into QA rework, billing holds, denials, and audit risk. This guide breaks down the 7 most common documentation gaps, how they drain revenue, and the workflow (frameworks, real-time QA, prompts, and clinician-reviewed AI) that helps nurses finish accurate notes the first time.
Why Medicare Home Health Claims Get Denied
Medicare home health claim denials are revenue leaks, not just billing issues. This guide breaks down the ten most common reasons claims get denied, from OASIS gaps and late NOAs to coding and medical-necessity problems, and how to prevent them to get paid faster.
What Documentation Should Home Health Agencies Audit Before Billing?
Before billing, confirm that eligibility, medical necessity, orders, OASIS-E2, coding, and visit documentation tell a consistent story and support the services on the claim.
Billable vs. Non-Billable Discharge in Home Health: What's the Difference?
A discharge OASIS does not automatically make a home health visit billable. Learn how covered skilled services, payer rules, documentation, and the final clinician determine whether a discharge encounter may be payable.