Given the current economic and regulatory environment for home health agencies, many have been largely driven by Medicare payments, making agencies hesitant to turn to managed care and commercial insurance to drive additional revenue.
The process to seek and secure payment outside of traditional channels can be overwhelming. However, considering that some agencies increase revenue by 20% to 30% when introducing alternative payment sources, it’s worth considering as Medicare increases regulations and compliance measures.
As cash flow pressure continues to mount, considering contracting for managed care and commercial insurance companies is key because it will allow you to process claims for a greater cross-section of patients. The following tips can help you maximize payment diversification for your home health agency:
Identify insurance companies
Credentialing with specific insurance companies is the cornerstone to successfully expanding your agency’s revenue streams. Home health agencies should start by identifying the specific insurance companies they’d like to be in-network with. While large companies are often some obvious choices, there might be smaller, more local companies that could be ideal for contracting, as well.
Dominion Revenue Solutions can expedite the credentialing process for you and make sure that your home health agency is an in-network provider with key private insurance companies.
Know patient eligibility
In addition to commercial health insurance credentialing for home health agencies, Dominion Revenue Solutions’ medical billing team can also ensure that patient eligibility is accurate to avoid denied claims from managed care and commercial insurance companies. It is important to understand that unless eligibility checks are done correctly, they could lead to providing services that aren’t covered and won’t be reimbursed.
It is especially important for home healthcare agencies that the coverage commercial insurance companies offer for home health services is determined upfront when negotiating contracts. In addition, it is important to determine whether authorization is required by the insurance company for patient eligibility. Lastly, detailing patients’ deductibles and copayments is also critical.
Understand the billing process
Having a team of experts to expertly handle your billing process can mean the difference between approved and denied claims as well as the strength of your cash flow stream. Dominion Revenue Solutions helps home health agencies efficiently manage electronic billing to expedite claims and make sure that timely filing deadlines are met for commercial insurance providers, ensuring that maximum revenue is realized.
Manage denied claims
Another critical aspect of commercial insurance billing is the management of denied claims. Dominion Revenue Solutions can help your home health agency minimize denials and manage any that do occur to quickly correct them so that your agency can receive the revenue it deserves. Prioritizing follow up efforts is absolutely critical for commercial insurance claims. Let Dominion Revenue Solutions be your partner in these efforts to maximize your agency’s revenue.
Creating comprehensive revenue streams, including commercial insurance to supplement existing Medicare for your home health agency is paramount in the current market environment. These tips for creating additional revenue through commercial insurance credentialing, billing and claim management can help ensure this key goal is met and your home health agency remains financially healthy.
Dominion Revenue Solutions can help you secure commercial insurance credentialing and increase your revenue through being an in-network provider for the commercial insurance companies you wish to work with. Contact us today for a complimentary consultation.
