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Why Home Health Agencies Lose Money Before They Ever Bill · The Home Health & Hospice Profitability Podcast

0:02
SPEAKER_00: Every home health and hospice owner knows the feeling.
0:05
SPEAKER_00: Census is up, the team is working harder than it ever has, and the margin still isn't there.
0:10
SPEAKER_00: Your host has spent a career finding out why.
0:13
SPEAKER_00: Doug Walters is a CPA with a master's degree in taxation.
0:17
SPEAKER_00: And before that, a home health agency owner himself.
0:20
SPEAKER_00: So he's lived the problem before he built a career solving it.
0:24
SPEAKER_00: He founded Walters and Associates in 1999, and the firm has since served more than a thousand home health and hospice providers nationwide.
0:34
SPEAKER_00: Medicare and Medicaid cost reports, hospice cap, outsourced CFO work, and tax.
0:40
SPEAKER_00: It anchors the Walters Family Companies, alongside Walters Billing Solutions, running revenue cycle and denials management for agencies, and Walters Strategic Advisors Managing Well for the Owners Who Built Than.
0:54
SPEAKER_00: Three companies, one obsession.
0:56
SPEAKER_00: The profitability of home health and hospice.
0:59
SPEAKER_00: Here's Doug Walters.
1:00
SPEAKER_02: Welcome back to the Home Health and Hospice Profitability Podcast.
1:04
SPEAKER_02: I've got with me Amanda Sheldon, who leads our billing team.
1:07
SPEAKER_02: Amanda, welcome.
1:08
SPEAKER_01: Thank you for having me.
1:09
SPEAKER_01: I'm excited to be here.
1:11
SPEAKER_02: I am so excited to have you on today.
1:13
SPEAKER_02: You know, revenue cycle management is such a big topic.
1:15
SPEAKER_02: And I wanted to dig in on that a little bit because I think it's confusing for a lot of people.
1:20
SPEAKER_02: The terminology, especially given the environment we're in with such regulatory scrutiny, so many providers are going through a lot of what do I say pressure financially with all of the audits.
1:34
SPEAKER_02: We're seeing providers being shut down, even cap issues, uh ZPIG audits, everything that they're faced with, cash flow becomes so important.
1:42
SPEAKER_01: Yeah.
1:42
SPEAKER_02: So wanted to dig in on this and talk about how important the revenue cycle management is or area is because it is so vitally important to these providers.
1:50
SPEAKER_02: So when we talk about revenue cycle management, walk me through what that means.
1:55
SPEAKER_01: Yeah.
1:55
SPEAKER_01: So those agencies think it means billing, but it's really, it's really so much more than that.
2:01
SPEAKER_01: The whole revenue cycle is truly the entire financial process, right?
2:05
SPEAKER_01: So from the time the referral is accepted to admission to scheduling to billing until you know the claim is out of zero balance.
2:15
SPEAKER_01: And it's so important to make sure that every piece of it, every part of it understands at least the basics of it, right?
2:24
SPEAKER_01: They don't, you know, your marketer doesn't necessarily have to understand all the ins and outs of billing, but they should at least understand, you know, which referrals are the most lucrative.
2:32
SPEAKER_01: And, you know, it it often isn't discovered until a claim denial comes in.
2:37
SPEAKER_02: Got it.
2:38
SPEAKER_02: So if you had to pick a single moment when revenue cycle begins, when is that?
2:41
SPEAKER_01: The moment that the marketer walks into the hospital.
2:44
SPEAKER_02: Got it.
2:45
SPEAKER_02: Yeah.
2:45
SPEAKER_02: So you're talking about as soon as we get a referral, that's when revenue cycle management starts.
2:50
SPEAKER_02: Correct.
2:51
SPEAKER_02: Yeah, interesting.
2:52
SPEAKER_02: Let's talk about contracts and marketing.
2:54
SPEAKER_02: Since you're you brought up marketing, how often do you find marketers who don't know what the payers pay?
2:59
SPEAKER_01: It's really agency dependent.
3:01
SPEAKER_01: You know, one of the things that we talk about a lot with our clients is, you know, do the executives know and understand their contracts, right?
3:07
SPEAKER_01: It all starts at the top.
3:09
SPEAKER_01: And, you know, does the agency have a you know, quick reference material, a built-out chart that your marketer can quickly reference to see which payers to target, right?
3:19
SPEAKER_01: So they know when they go in the hospital, you know, obviously everybody wants those good Medicare referrals, but do you have, you know, maybe a commercial payer that's paying like Medicare or 90% of the Medicare rate?
3:30
SPEAKER_01: You know, maybe you want to go after those instead of your, you know, Medicaid managed care payers that maybe you're only going to pay you$80 for a visit.
3:37
SPEAKER_01: But marketing is such a relationship business.
3:39
SPEAKER_01: So of course you have to take those payers, you know, that might not be as profitable so you can get those more lucrative referrals.
3:46
SPEAKER_01: But overall, agencies should have a solid idea of what their cost per visit is so that they know which payers to go after and which payers will exceed that.
3:56
SPEAKER_02: What does that cost the agency if they don't know?
3:58
SPEAKER_01: It really depends.
3:59
SPEAKER_01: I mean, a lot of times providers or agencies, I guess, would take referrals and the census might look really great.
4:06
SPEAKER_01: But if you have a census and you've only got about 20 to 30% of it being Medicare, and the majority of it is fee for service, you know, they're going to pay you$80,$90,$110 a visit.
4:17
SPEAKER_01: You know, those obviously aren't going to be as lucrative as the Medicare referrals would be.
4:21
SPEAKER_01: Um, so really is agency dependent, hopefully.
4:24
SPEAKER_02: For sure.
4:25
SPEAKER_02: You work with a lot of patients on the billing side.
4:28
SPEAKER_02: Walk me through a referral that looked good for census and turned not to lose money.
4:32
SPEAKER_01: We actually see this a lot.
4:33
SPEAKER_01: So the agency accepts a referral before the documentation is complete, right?
4:37
SPEAKER_01: So it comes in, maybe the face-to-face isn't signed, right?
4:41
SPEAKER_01: And so physicians are difficult to get a hold of.
4:44
SPEAKER_01: So maybe they decide to accept it anyway, expecting that eventually, you know, they'll be able to get the face-to-face documentation will be received.
4:52
SPEAKER_01: And, you know, so the nurse goes out, completes the start of care, scheduling continues to schedule visits.
4:58
SPEAKER_01: You know, this then you have your orders tracking team, you know, chasing down that face-to-face, trying to make sure that it gets signed.
5:05
SPEAKER_01: And then next thing you know, the billing ends up on hold, right?
5:09
SPEAKER_01: Because you can't bill.
5:10
SPEAKER_01: You don't, you know, you can't bill without the face-to-face signed and dated and returned back.
5:13
SPEAKER_01: So now the agency has paid clinicians' time and mileage, the intake team, their billing team, their orders tracking team, all of these things.
5:22
SPEAKER_01: And it all occurred before billing ever even touched the claim.
5:25
SPEAKER_01: And, you know, it's delayed cash, and on top of the expenses to see the patient, the patient's now discharged.
5:31
SPEAKER_01: And if the documentation is never received, eventually, you know, the claim is never going to get paid.
5:35
SPEAKER_01: It's going to be a write-off.
5:37
SPEAKER_02: Yeah.
5:37
SPEAKER_02: Yeah.
5:38
SPEAKER_02: That's expensive.
5:39
SPEAKER_01: Yes, it's very expensive.
5:41
SPEAKER_01: It is definitely a slippery slope.
5:43
SPEAKER_02: So let's talk about eligibility verification.
5:46
SPEAKER_01: Yes, that's a big topic.
5:48
SPEAKER_02: What does an eligibility check look like?
5:49
SPEAKER_02: Now, where do agencies really cut corners on that?
5:53
SPEAKER_01: So it to me, it's just as important as billing your NOAs timely, right?
5:57
SPEAKER_01: Or your NOEs timely.
5:59
SPEAKER_01: You have to know what insurance the patient has so that way you can you can get it built correctly, right?
6:04
SPEAKER_01: So for our clients, we actually do bi-weekly verifications, but you know, most agencies are doing monthly.
6:11
SPEAKER_01: Some agencies just don't have the staff to do it monthly, truthfully, especially if they're not set up with like a clearinghouse or you know, they might have you know staff in on an interim basis and maybe it's not a full-time job for them, so they don't really understand what they're doing.
6:24
SPEAKER_01: But we've seen patients age into Medicare, you know, in the middle of an episode.
6:28
SPEAKER_01: And so now you have Medicare secondary payer.
6:31
SPEAKER_01: And if you don't get that NOA out within that five-day time period from a started care, you know, if the if the primary insurance comes back and says, hey, you need to be listed in secondary, which we see a lot, especially if the commercial carrier patient has like a deductible or some kind of out-of-pocket expense, you know, the agency ends up having to write those off.
6:50
SPEAKER_01: So it's it's super important, very, very important.
6:53
SPEAKER_01: And the HETS enrollment is really easy to do.
6:56
SPEAKER_01: That's something that providers can do through CMS.
6:58
SPEAKER_01: And then for us, like we we have a clearinghouse that we use, but you know, it you can do it through your Mac most of the time, like Palmetto e services and NGS Connects.
7:08
SPEAKER_01: They they most of them have you know different portals you can get on to run the eligibility verification.
7:13
SPEAKER_01: And then the commercial insurances, again, if you don't have like a good clearinghouse, they mostly all have portals.
7:19
SPEAKER_01: Or if it comes down to it and you have a weird one, pick up the phone and make a phone call.
7:23
SPEAKER_01: Super important.
7:24
SPEAKER_02: And how often are you running those?
7:26
SPEAKER_01: So for our clients, we do it bi-weekly.
7:28
SPEAKER_01: We always recommend even our clients that we don't do eligibility for, we recommend that they do a bi-weekly check.
7:33
SPEAKER_01: It's it's just really important, especially with commercial carriers that have those retroactive dates.
7:38
SPEAKER_01: Cause sometimes, like a patient will switch to from traditional Medicaid to a managed care Medicaid.
7:44
SPEAKER_01: And, you know, until the carrier gets it entered into their enrollment system, might be the 15th, 16th of the month, but the patient was really active on the first.
7:52
SPEAKER_01: Right.
7:52
SPEAKER_01: So then now it snowballs because if that plan requires an authorization for home health services, you're now 15 days in, right?
8:00
SPEAKER_01: So it's it's super, super important to make sure that you're doing that so it can be caught early instead of monthly, where you would essentially be a whole month in, right?
8:08
SPEAKER_02: Yeah, yeah.
8:09
SPEAKER_02: That then you could lose a lot if you do it every three days, as opposed to every two weeks.
8:12
SPEAKER_02: I mean, even weekly would be even better then, right?
8:14
SPEAKER_01: Yeah, yeah.
8:15
SPEAKER_01: I mean, yeah, you could you could do it weekly.
8:17
SPEAKER_01: I mean, I I think it's just a lot of work.
8:19
SPEAKER_01: Yeah, I think it's a lot of work.
8:20
SPEAKER_01: It's like I said, especially if you don't have a good clearinghouse setup that you could just like run a 270 back trial.
8:25
SPEAKER_01: If you have to go and check every single one of them and you have a large census, it could be it could be time consuming.
8:30
SPEAKER_01: But in my experience, it's been the most it's been the best way to prevent further issues down the line.
8:37
SPEAKER_02: Yeah, yeah, that makes sense.
8:39
SPEAKER_02: Okay.
8:40
SPEAKER_02: So we've done the eligibility check.
8:42
SPEAKER_02: What's the most common surprise you find after admission?
8:46
SPEAKER_01: Medicare, secondary coverage for Medicare secondary payer.
8:50
SPEAKER_02: So walk me through that.
8:52
SPEAKER_01: Patient might age into Medicare, middle of the episode, right?
8:55
SPEAKER_01: Maybe they're working, the commercial insurance is primary, but now they've aged into Medicare, they have Medicare, you know, maybe the first of October.
9:03
SPEAKER_01: Okay.
9:04
SPEAKER_01: They don't do the eligibility check until, you know, November 1st.
9:09
SPEAKER_01: Well, now Medicare was secondary, so they were supposed to have sent that NOA within that five-day time period.
9:17
SPEAKER_01: Now you don't have the NOA on file, which means you can't fill Medicare if that commercial carrier comes back and doesn't pay.
9:24
SPEAKER_02: Right.
9:24
SPEAKER_02: So eligibility is such an important part of the revenue cycle management.
9:29
SPEAKER_01: Yeah, such a huge part.
9:30
SPEAKER_01: Yep.
9:32
SPEAKER_02: So let's talk about referral intake and leakage.
9:35
SPEAKER_02: Okay.
9:35
SPEAKER_02: What's the minimum a referral packet must have before you accept the patient?
9:40
SPEAKER_01: The first thing is you want to make sure that they're appropriate for home health, right?
9:43
SPEAKER_01: So you got to understand their diagnosis and kind of an of you know an idea of how much how much clinical power it's going to take for you to service the patient.
9:51
SPEAKER_01: But I think the most important thing is the face-to-face and then the insurance information, right?
9:56
SPEAKER_01: So that's a huge thing we see with our agencies where they they don't have, they don't have the correct insurance information, maybe entered into the chart.
10:05
SPEAKER_01: Maybe the patient was entered in as the last minute, you know, referrally decided to accept something wasn't entered correctly.
10:12
SPEAKER_01: If you don't have the ID card, which a lot of times you don't, the clinician should be asking for it on the first visit when they do their initial assessment.
10:18
SPEAKER_01: Super important.
10:19
SPEAKER_01: So I would say ID card, face to face, most important.
10:22
SPEAKER_01: Face to face, most important, the ID card.
10:25
SPEAKER_02: Yeah, makes sense.
10:26
SPEAKER_02: So yeah, that I guess if you're missing one item, you just don't want to miss that face to face.
10:29
SPEAKER_02: That's the most important thing.
10:30
SPEAKER_01: Face to face, most like above everything else is the most important in payment for making sure that you can actually bill, that everything's compliant, face assigned and dated face to face.
10:41
SPEAKER_01: Absolutely.
10:42
SPEAKER_02: Got it.
10:42
SPEAKER_02: What does it cost an agency when a notice of admission or election goes in late?
10:48
SPEAKER_01: A lot.
10:49
SPEAKER_01: So so it's another area where we see agencies losing money unnecessarily because it has to be submitted to Medicare within that five calendar day window from the start of care.
11:00
SPEAKER_01: And, you know, if it's not, Medicare begins deducting money from your final claim payment.
11:07
SPEAKER_01: Right.
11:07
SPEAKER_01: So for example, if the agency sends it just one day late, right?
11:12
SPEAKER_01: So they admit the patient, they send the NOA or the NOE on the sixth day, thinking, okay, well, it's just one day late, right?
11:20
SPEAKER_01: Well, actually, Medicare starts deducting six days worth of payment because Medicare considers that to be six days late.
11:26
SPEAKER_01: Right.
11:27
SPEAKER_01: And so then every day that you're late, it's going to deduct, you know, 70, and then it just continues to build, right?
11:33
SPEAKER_01: And one thing that we we see with a lot of our agencies is not monitoring RTP claims.
11:40
SPEAKER_01: So RTP claims are claims that are returned to the provider.
11:44
SPEAKER_01: They need some kind of a correction made.
11:46
SPEAKER_01: And for those, if it's an NOA or an NOE, you only have two calendar days to correct it.
11:51
SPEAKER_01: If you don't correct it, then it's going to be considered late.
11:56
SPEAKER_02: So is that at the clearinghouse level?
11:58
SPEAKER_02: You can see a report, or is that in their billing system, their EMR, where they're pulling those reports to see the RTPs?
12:04
SPEAKER_02: Or what how walk me through how a provider identifies those RTP claims and monitors them?
12:11
SPEAKER_02: Like what's the process to set that up so that they don't miss them?
12:14
SPEAKER_01: Yeah, so that's a really good question.
12:15
SPEAKER_01: So it depends on your clearinghouse.
12:17
SPEAKER_01: A lot of clearinghouses have different platforms that you or different reports that you can pull, right?
12:22
SPEAKER_01: So like a Novalon has one, Waystar has a Medicare claim editor, you know, Access is another one where it'll actually show you those RTPs.
12:30
SPEAKER_01: But to be just a hundred percent transparent with you, DDE is the most, it's gonna be the most reliable source of information because that is directly, you know, that's Medicare's claim processing system.
12:41
SPEAKER_02: Yeah, that's direct data entry, uh, which is Medicare's antiquated system, right?
12:46
SPEAKER_02: Yeah, yes, the black screen, the old, it looks like a DOS program.
12:52
SPEAKER_01: It's the whole thing.
12:53
SPEAKER_02: So yeah, but it works, it's effective.
12:55
SPEAKER_01: It does, yeah.
12:56
SPEAKER_01: And it's it it seems crazy, but it just it really is.
12:59
SPEAKER_01: For me, I'm like, let's just go to the source.
13:01
SPEAKER_01: You know, obviously we have like you know, the fancy reports and stuff, but let's just go to the resort, the source, and you know, to do do what we have to do, and we do that every single day.
13:09
SPEAKER_02: So you know, for those of uh the listening audience that know me know that I had a home health company for about a decade.
13:15
SPEAKER_02: I actually had a few of them, Medicare certified agencies, as well as you know, did some private duty along the way.
13:22
SPEAKER_02: But one of the things I used to love to do was go into DDE, and I prided myself on understanding that system, and I would literally, you know, because I I had the CPA firm as well.
13:32
SPEAKER_02: So this was a uh a business I had with a partner of mine.
13:35
SPEAKER_02: And so I would I would be on site maybe once a week, and every week when I went there, I would literally go through DDE and review every single claim that we had, and I would always find money, you know, I would always find something that was you know denied for some reason, uh didn't go through, uh, but it was well worth the effort to go through DDE and look at the claims.
13:53
SPEAKER_02: Uh because I like I said, I always found money doing it.
13:55
SPEAKER_01: Absolutely 100%.
13:57
SPEAKER_01: Yep.
13:57
SPEAKER_01: Super, so, so, super important.
13:59
SPEAKER_01: Those R2P claims, they will definitely, they'll definitely they'll come back in Hawaii.
14:05
SPEAKER_02: Okay, so if an agency can add a pre-admission step between clinical and billing tomorrow, what would it be?
14:13
SPEAKER_01: So I'm gonna say run an eligibility check on every single patient and intake, and scan the documentation into the chart and make sure that the clinical team is aware there was a previous home health episode or inpatient's debt.
14:27
SPEAKER_01: And the reason that I say that is because recently we've seen, and I don't know if it's I mean, obviously this is something that we see regularly with all agencies, but more recently there's been a lot of downcoding, especially with our particular clients, where, you know, they're expecting maybe a two$2,000 payment and they're getting a$1,200 payment, right?
14:46
SPEAKER_01: Well, it's because they're not marking the correct spot on the oasis as late, right?
14:54
SPEAKER_01: So if the patient had a previous home health episode or a recent inpatient stay within the last 60 days, they need to be marking the episode as late, right?
15:03
SPEAKER_01: So if they mark it early, they have this inflated AR.
15:06
SPEAKER_01: Looks like they're gonna get more for that episode.
15:09
SPEAKER_01: Medicare receives a claim, Medicare downcodes it.
15:12
SPEAKER_01: Now you've only received$1,200 and you have an$800 contractual adjustment.
15:16
SPEAKER_02: Yeah, that's expensive.
15:18
SPEAKER_01: That's a that's a very expensive, yes.
15:20
SPEAKER_01: Yeah, especially because it's totally, I mean, no, I'm not gonna say it's not preventable.
15:24
SPEAKER_01: Yeah, I was gonna say I'm not gonna say it's always preventable because you know, Medicare is gonna have information about the patient that maybe you don't always have access to.
15:30
SPEAKER_01: But in the grand scheme of things, I would say the majority of the time, it is preventable.
15:35
SPEAKER_01: I mean, the clinicians in the home, like they can ask the patient have they had any recent unhealth episodes, have they had any recent invasion stays, you know, and and make sure that they're they're marking the OES correctly because it directly is reflective of their reimbursement.
15:49
SPEAKER_02: You know, when you pick up a client, what do you see is the biggest issue typically that's preventable?
15:55
SPEAKER_02: We're talking about these preventable issues, right?
15:56
SPEAKER_02: Like, do you see a lot of that?
15:57
SPEAKER_02: Do you see a lot of things that if you weren't if you were involved earlier, this could have been prevented, right?
16:02
SPEAKER_01: Yeah, a lot of it is like upstream issues.
16:06
SPEAKER_01: I mean, a lot of it is intake doesn't understand, right?
16:09
SPEAKER_01: So they they they do their part and then they hand it off, right?
16:12
SPEAKER_01: And then clinical goes out and they do their part and then they hand it off, right?
16:15
SPEAKER_01: So so nobody, you you have everybody that knows a little bit about something, but nobody knows a whole lot about anything, right?
16:22
SPEAKER_01: So I think for for like for our clients that we've had, it's been it's been difficult for some of them to really understand and accept, like, hey, your processes that you've thought all this time were working haven't been, and here's why, right?
16:37
SPEAKER_01: And so what really gets an agency's attention is when you start tying dollars to it, right?
16:41
SPEAKER_01: So like when the agency can see, okay, we have half a million dollars in claims on hold that we should have been paid for 60, 90 plus days ago, but they're still on hold because our orders tracking team isn't verifying, you know, that everything needed to build that claim is received and loaded in the chart, right?
17:02
SPEAKER_01: And so that those those things are so super important.
17:06
SPEAKER_01: It really is between like intake and that orders piece, making sure that the face-to-face is back and signed, all the orders are in back and signed, dated, not just signed, also dated, you know, because those are all pieces that we can't and can't bill without.
17:20
SPEAKER_01: And most EMR systems have like almost like a stop where it'll say, okay, you can't build this claim because you have unsigned orders.
17:28
SPEAKER_01: But if somebody's not checking that regularly, you know, that's unbuilt AR that you should have been paid for.
17:32
SPEAKER_01: That's just sitting out there waiting to get collected.
17:34
SPEAKER_01: And if you never get those things back, you might never get paid.
17:39
SPEAKER_02: Right.
17:40
SPEAKER_02: Well, you know, uh, as you know, Amanda, this is part one of a three-part series on revenue cycle management.
17:45
SPEAKER_02: It's such a huge topic.
17:46
SPEAKER_02: And so we're gonna dig in a little bit more on on the different departments on the next episode.
17:51
SPEAKER_02: So that's a great, that's a great lead-in to that.
17:54
SPEAKER_02: But before I let you go, tell me one thing one listener should check in their agency this week.
18:02
SPEAKER_01: Okay, so I would say check 10 to 20 accepted referrals and ask yourself if everything was received that was needed to deliver and ultimately be paid for the episode.
18:17
SPEAKER_02: That was expensive.
18:18
SPEAKER_02: So go back and audit the intake, look at make sure face-to-face is there, make sure the, you know, if it's a if it's uh if it's uh home health, make sure the face-to-face is there, if it's a hospice, make sure the noe has been filed.
18:30
SPEAKER_02: Yep.
18:31
SPEAKER_02: Timely, all of that.
18:32
SPEAKER_02: Just kind of go through the paperwork and then and then what?
18:35
SPEAKER_02: Anything else?
18:37
SPEAKER_01: Ask yourself, you know, did we have everything that we needed to deliver and ultimately be paid for that episode?
18:43
SPEAKER_01: Was it received timely?
18:44
SPEAKER_01: How long did it take, right?
18:45
SPEAKER_01: Were the orders back quick?
18:47
SPEAKER_01: Did your team follow up quickly?
18:48
SPEAKER_01: Was the correct insurance entered into the chart?
18:50
SPEAKER_01: You know, all of those things are all super, super important.
18:53
SPEAKER_01: I mean, I would say, I would say 10 to 20, definitely.
18:56
SPEAKER_01: Referrals that were sure that in the shore.
18:59
SPEAKER_02: Yeah, and that's probably that probably makes sense to do periodically.
19:01
SPEAKER_02: Yeah, right?
19:02
SPEAKER_02: Definitely.
19:02
SPEAKER_02: Yeah, definitely.
19:03
SPEAKER_02: Yeah, just just making sure you understand because sometimes things break down, right?
19:06
SPEAKER_02: We have we have personnel change, we have something that that's changed our process, and sometimes you don't know until it's too late.
19:13
SPEAKER_02: Exactly.
19:13
SPEAKER_02: Right.
19:14
SPEAKER_02: So I think having a routine process in there to just go back through and and double check even monthly or quarterly, at least to make sure that things are things are happening the way they should be happening.
19:24
SPEAKER_02: I used to go back and look at all of the admissions, and when I like I talked about with going through DDE, I used to look at okay, what are the admissions that we've had in the last week to 30 days, making sure that they were all billed, first of all, right?
19:36
SPEAKER_02: Because yeah, are they sitting somewhere?
19:38
SPEAKER_02: What's the problem?
19:39
SPEAKER_02: Like and nine times out of ten, I would always see, okay, well, there's all these patients that were never billed.
19:44
SPEAKER_02: What happened?
19:44
SPEAKER_02: Oh, we're waiting for a doctor's order, we're waiting for this, we're waiting for that.
19:47
SPEAKER_02: Well, where it's a breakdown, right?
19:48
SPEAKER_02: Let's let's go fix that problem.
19:50
SPEAKER_02: But you we don't have time to wait, right?
19:52
SPEAKER_02: We've got to get this money in the door.
19:54
SPEAKER_02: Uh, it's becoming more and more critical.
19:56
SPEAKER_02: So, really going through those claims, making sure that they're billed, making sure that they're paid.
20:00
SPEAKER_01: Yes.
20:00
SPEAKER_02: And that's sitting in RTP status somewhere.
20:02
SPEAKER_02: I mean, there's so many things you find out by looking at the claim level in your process and and where things can break down.
20:08
SPEAKER_02: So, so so vitally important.
20:10
SPEAKER_02: Finally, tell us tell the audience for those that don't know you, your services and some of the things that you do for clients.
20:15
SPEAKER_01: Yeah.
20:16
SPEAKER_01: So we pretty much own the whole revenue cycle as from a from billing on.
20:20
SPEAKER_01: You know, obviously we always work with our agencies to let them know when we see, you know, breakdowns in the revenue cycle, like, you know, hey, maybe, maybe you should make a chart and list out what your uh payers are paying per visit based on your contracts and that type of thing.
20:35
SPEAKER_01: But we also do eligibility and authorization.
20:38
SPEAKER_01: Um, so we have a department that handles that for them.
20:41
SPEAKER_01: And a lot of agencies, a lot of agencies usually don't come to us seeking that.
20:46
SPEAKER_01: They usually come to us at first because they're like, okay, well, we have all this money in aged claims.
20:50
SPEAKER_01: Like, where is it?
20:51
SPEAKER_01: Right.
20:51
SPEAKER_01: And as we go through and we kind of educate them and share with them, hey, this is what looks this where the breakdown appears to be occurring.
20:57
SPEAKER_01: That's when they're like, okay, can can you guys just do it?
20:59
SPEAKER_01: Right.
21:00
SPEAKER_01: And then we also offer consulting.
21:02
SPEAKER_01: So, you know, maybe like you said, Doug, maybe you don't have time to sit and sift through claims and make sure everything was built accurately, that things were paid timely or not held up, right?
21:12
SPEAKER_01: So we do offer that um and work with, you know, your internal billing team to make sure that things are moving smooth moving smoothly for them.
21:21
SPEAKER_01: Um, it really is just we really try.
21:24
SPEAKER_01: My goal for us is to be, you know, for our clients to feel like they just hired a billing team, right?
21:30
SPEAKER_01: A capable, experienced billing team and not like they've hired an outsourced company, right?
21:34
SPEAKER_01: It's it's just so important.
21:36
SPEAKER_01: You know, I don't ever want to get caught in that.
21:39
SPEAKER_01: Um so yeah.
21:41
SPEAKER_02: Yeah, no, that's great.
21:42
SPEAKER_02: And in, you know, being part of the Walters family companies, you know, with the CPA firm, the the billing company, and the wealth management company.
21:49
SPEAKER_02: I really enjoyed working with you.
21:50
SPEAKER_02: It's so refreshing to just see on the accounting side or the tax side when we look at a client, we see, wait a minute, revenue is off here, or something's wrong with their financial statements.
21:59
SPEAKER_02: Where's the the cash flow is is is hurting?
22:02
SPEAKER_02: What's happening?
22:03
SPEAKER_02: We start digging in on the billing side and to have a resource like you and in Walter's Building Solutions is just so powerful to go in there and get that fixed.
22:10
SPEAKER_02: And and we've seen that you know work seamlessly between the companies.
22:13
SPEAKER_02: So so thank you for all that hard work and and I appreciate your time today.
22:17
SPEAKER_02: And I'll see you on the next episode.
22:20
SPEAKER_01: All right, thank you.
22:21
SPEAKER_02: Thank you, Amanda.
22:22
SPEAKER_01: See ya.
22:23
SPEAKER_02: Bye.
22:29
SPEAKER_00: Thanks for listening to the Home Health and Hospice Profitability Podcast.
22:33
SPEAKER_00: If you enjoyed today's episode, make sure you subscribe so you don't miss coming next.
22:38
SPEAKER_00: You can also follow us on social media for more insights, updates, and practical ideas for running a stronger home health or hospice organization.
22:47
SPEAKER_00: If you'd like to learn more about how Walters can help your agency, visit WaltersAccounting.com, Walters Billing.com, and Walters Advisors.com.