Hospice Medical Billing Services

Benefit-period management, level-of-care accuracy and per-diem claim discipline for hospice programs — so compassionate care is matched by clean, timely payment.

Hospice billing runs on a calendar that forgives nothing. Payment is a per-diem tied to benefit periods and levels of care, the notice of election starts the clock, and a filing error in the first days of an election can cost an entire period of care. Elite Bill Care's hospice medical billing services are built for hospice programs whose clinical teams should be focused on patients and families — while election filings, level-of-care changes and per-diem claims are handled with the precision the Medicare hospice benefit demands.

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Hospice billing specifics

Election and benefit-period management — elections, revocations, discharges and transfers are tracked against the patient's benefit periods — two initial periods followed by unlimited subsequent periods — with period sequencing verified so every claim is built on the correct period from day one.
Notice of election timeliness — the notice of election is filed within the required window after the effective date of election, because a late filing leaves the days before it non-covered: days the hospice has already staffed and served.
Four levels of care, billed distinctly — routine home care, continuous home care, inpatient respite care and general inpatient care each carry their own per-diem and claim requirements; level changes mid-period are captured with the correct dates and detail so payment matches the care actually delivered.
Per-diem claim construction — claims are assembled day by day and level by level within the benefit period, with the visit and service detail payers require, and charges reconciled against the clinical record before submission.
Attending and related-care boundaries — services connected to the terminal illness that are billed outside the hospice benefit are identified correctly, including the GV and GW modifier context, so attending-physician and unrelated services do not collide with the hospice's own claims.
Eligibility and overlapping-benefit checks — Medicare eligibility, election status with other hospices, and Medicare Advantage enrollment are verified at admission and whenever status changes, preventing duplicate-election and payer-responsibility denials.

Common hospice billing challenges

The most expensive hospice error is administrative, not clinical: a notice of election filed late converts covered days into uncompensated care, and the exception process for recovering those days is narrow. Benefit-period errors compound quietly — a claim built on the wrong period, or a required face-to-face encounter missed in a later period, stalls payment for the whole election. Level-of-care documentation is the audit frontier: continuous home care and general inpatient care are paid at higher per-diems and reviewed accordingly, so days billed at those levels without supporting documentation are recouped. Add transfers between hospices, live discharges and revocations that must be sequenced correctly, and Medicare Advantage patients whose hospice payment routes differently, and even well-run hospices lose revenue to the calendar and the claim form rather than to the care itself.

How we run it

Admission triggers a billing checklist, not just a clinical one: eligibility and election status verified, notice of election filed and confirmed, benefit period established. Census changes — level changes, transfers, revocations, discharges — are reconciled against claims before the period closes, so the per-diem days billed match the days and levels documented. Claims are submitted in sequence by benefit period, exception requests for late notices are prepared with documented cause when they occur, and denials are worked by cause: election, eligibility, period sequencing and documentation. Hospices see unbilled days and their reasons in regular reporting, because in hospice billing an unbilled day is usually a permanent loss, not a delay.

Benefits of specialized hospice billing

Hospice revenue depends on getting time-sensitive filings and per-diem details right every single day. Elite Bill Care brings more than 10 years of billing experience, a 98% first-pass clean claim rate and denial management that has reduced denials by up to 30% for the programs we serve. Because our hospice medical billing services manage elections, benefit periods and levels of care as one connected workflow, fewer days go unbilled or underpaid and fewer payments come back in audits. The result is steadier per-diem revenue your program can plan on, in all 50 U.S. states.

Software and systems we work with

Our team works inside the major EHR and practice management platforms used by hospice and home-based care programs — including athenahealth, eClinicalWorks, AdvancedMD, Tebra, DrChrono, Office Ally, CollaborateMD, NextGen, Practice Fusion and TherapyNotes — and takes census and visit feeds from your hospice EHR. All work runs on HIPAA-compliant processes with role-based access to your systems.

Frequently asked questions

How do you prevent late notice-of-election filings?

Filing is triggered by admission, not by month-end batching. Each election is logged when the patient is admitted, the notice of election is filed within the required window, and confirmation is tracked until it posts. If a filing is ever late, we prepare the exception request with the documented circumstances instead of writing the days off silently.

Do you bill all four levels of care?

Yes. Routine home care, continuous home care, inpatient respite care and general inpatient care are each billed on the claim with their correct dates, per-diem and supporting detail. Level changes during a benefit period are captured from the census record so the claim reflects the care the patient actually received each day.

Can you track benefit periods and face-to-face requirements?

Yes. We maintain the period sequence for every patient — elections, transfers, revocations and discharges — and flag the face-to-face encounter requirements that apply in later benefit periods before they can hold a claim. Period errors are caught in reconciliation rather than discovered in a denial.

What happens when a patient transfers, revokes or is discharged alive?

We sequence the event correctly: the final claim for the closing period is built with the right discharge or revocation status, and where the patient elects with another hospice, the transfer is documented so the two programs' claims do not overlap or conflict. Nothing is left billed under an election that has ended.

Talk to Elite Bill Care about hospice billing

If late election filings, period errors or unbilled days are costing your program money, we can show you where the leakage is. Contact Elite Bill Care for a free consultation on hospice medical billing services for your organization.