Turn post-acute claims into predictable cash flow.
HIPAA-compliant revenue cycle management for home health, hospice, and skilled nursing facilities. PDGM, PDPM, and hospice specialists — with automated scrubbing and denial prevention built in.
- Claim submission target
- 48-hr
- Inquiry response
- 1 day
- BAA in place
- Day 1
Revenue cycle command center
Claims pipeline healthy
- Clean claim rate
- 98.5%
- +3.2 pts
- Avg. turnaround
- 48 hr
- −26 hr
- Denial rate
- 1.8%
- −4.1 pts
Claims accepted per week
Last 8 weeks
- NOE acceptedHospice · Day 1 of 5On time
- PDGM final claim paidHome health · HIPPS verifiedPaid
- IPA review flaggedSNF · Triple check queuedReview
Trusted by teams working across the tools you already use
- Axxess
- WellSky
- Homecare Homebase
- MatrixCare
- PointClickCare
- Kinnser
Built around the rules that govern post-acute reimbursement
- CMS PDGM
- CMS PDPM
- Hospice CoPs
- HIPAA Privacy & Security Rules
- OIG Compliance Program Guidance
- X12 5010 EDI
- Medicare Claims Processing Manual
- HITECH Breach Notification
See what a 4% denial rate would recover.
Post-acute agencies typically run 10–18% denial rates. Our clients settle in around 4%. Move the sliders — the recovery figure updates live.
- Claims denied / month now
- 144
- With 99Billing
- 48
Estimate based on $1,850 average claim value and a 4% post-engagement denial target. Your actual numbers will vary — the free audit gives you the specifics.
Core verticals
Specialists for every post-acute payment model
Home health, hospice, and skilled nursing each run on different rules, deadlines, and assessment data. Our teams are organized by vertical, so the people billing your claims know those rules by heart.
Home Health
Home Health Billing
Every 30-day period managed under PDGM — OASIS review workflows, NOA timeliness, LUPA monitoring, and final claims that match the documentation.
- PDGM 30-day periods
- OASIS review
- NOA tracking
- LUPA monitoring
What clients see in the first 90 days
- 5-day OASIS lock-in workflow with reviewer sign-off
- NOA submitted within 48 hours of SOC — every episode
- LUPA risk flagged pre-billing, not post-denial
- Weekly aging reviews with 30/60/90 root-cause reporting
- Direct FISS/DDE access for same-day corrections
- Clean claim
- 98%+
- DSO drop
- −26d
- Denials
- −4pt
Hospice
Hospice Billing
Tiered per-diem accuracy, NOE/NOTR timeliness, CTI and face-to-face tracking, and cap monitoring — handled by specialists who bill hospice every day.
- Tiered RHC per diem
- NOE/NOTR timeliness
- Face-to-face compliance
- Cap monitoring
SNF
Skilled Nursing Facility Billing
PDPM optimization grounded in documentation, MDS assessment coordination, structured triple checks, and consolidated billing reconciliation.
- PDPM optimization
- MDS coordination
- Consolidated billing
- Triple check
Closed-loop denial management
Every denial root-caused and worked within 48 hours, with prevention fed back upstream.
Clearinghouse & EDI control
837I, 277CA, FISS/DDE, and 835 ERA workflows monitored daily so no claim goes missing.
HIPAA-first security
BAA before access, encryption everywhere, least-privilege accounts, and full audit logging.
Our commitments
Service standards you can hold us to
Clear, measurable commitments for every client, starting on day one.
Claim submission target
48-hr
From complete documentation to a submitted claim
Claims scrubbed before release
100%
Every claim checked against payer-specific edits before submission
Inquiry response
1 day
A post-acute billing specialist replies within one business day
Cost of your RCM audit
$0
A written findings report with the revenue impact of each issue
The medical billing company built for home health, hospice, and skilled nursing.
99 Billing Solutions is a U.S.-based revenue cycle management (RCM) company serving post-acute providers in all 50 states. We handle PDGM home health billing, hospice per-diem billing, PDPM skilled nursing facility billing, Medicare Advantage claims, state Medicaid, and commercial payer submissions — under a signed HIPAA Business Associate Agreement, from day one.
PDGM home health billing across every U.S. jurisdiction
Under the Patient-Driven Groupings Model (PDGM), every 30-day period is a separate billing event with its own case-mix HIPPS code, functional impairment level, comorbidity adjustment, LUPA threshold, and timeliness penalty risk. Our home health billers manage OASIS-E lock-in workflows, Notice of Admission (NOA) submission within 48 hours of Start of Care, LUPA risk monitoring, RAP replacement compliance, and final claim reconciliation against the plan of care. We work Palmetto GBA (J-M), Novitas (J-H, J-L), Noridian (J-E, J-F), National Government Services (J-6, J-K), CGS (J-15), WPS (J-5, J-8), and First Coast (J-N) — the seven Home Health & Hospice MACs that cover the entire United States.
Hospice billing: NOE, NOTR, CTI, face-to-face, and cap
Hospice billing is a compliance-first discipline. Missed NOE and NOTR windows convert billable days into provider liability overnight. Our hospice team files the Notice of Election within 5 calendar days of admission, tracks physician Certifications of Terminal Illness (CTI) and recertifications by benefit period, monitors the mandatory face-to-face encounter for the 3rd benefit period and beyond, applies tiered Routine Home Care (RHC) per-diem rates correctly through day 60 and beyond, bills General Inpatient (GIP), Continuous Home Care (CHC), and Inpatient Respite Care (IRC) at the correct revenue codes, and reconciles aggregate cap and inpatient cap positions quarterly so year-end true-ups don't become surprises.
SNF billing under PDPM with triple-check discipline
Skilled Nursing Facility billing under the Patient-Driven Payment Model (PDPM) rewards accurate MDS 3.0 coding across PT, OT, SLP, Nursing, and NTA case-mix categories. Our SNF billing team runs a documented triple-check on every claim before it drops: coding matched against MDS, therapy minutes reconciled against the plan of care, and consolidated billing edits confirmed for Part A stays. We handle Medicare Part A daily per-diems, Part B therapy caps and MPPR, HIPPS code assignment, interrupted stay policy, benefit-period exhaustion, and Medicare Advantage authorization workflows.
Clearinghouse, EDI, and denial prevention — end to end
Every 837I institutional claim we submit is scrubbed against payer-specific edits before it leaves. We monitor 277CA acknowledgments daily so nothing goes missing between the clearinghouse and FISS. When corrections are needed, we work directly in FISS/DDE or the payer portal — no waiting cycles. 835 ERAs are auto-posted and variances flagged. Every denial is root-caused, appealed through all five levels of the Medicare appeals process where warranted, and the root cause fed back into intake, coding, and QA so the same denial doesn't repeat.
HIPAA compliance and PHI security by default
A Business Associate Agreement is signed before we access a single record. All PHI travels over TLS 1.2+, is stored encrypted at rest, and is accessed only through least-privilege named accounts with MFA. HIPAA-compliant audit logs capture every read and write. Client exchange happens through a secure portal, SFTP, or HIPAA-compliant e-fax — never unencrypted email. Annual HIPAA and cybersecurity training is mandatory for every biller, coder, and manager on our team.
Post-acute billing services in every U.S. state
99 Billing Solutions provides home health, hospice, and skilled nursing facility (SNF) billing across all 50 U.S. states and the District of Columbia. Our billers are organized by Medicare Administrative Contractor (MAC) jurisdiction — so the person filing your 837I, working your NOA, or appealing your denial already knows the local rules, LCDs, and NCDs for your region.
Northeast
9 states
South
17 states
Midwest
12 states
Looking for billing services in a specific city? We serve every major metro — including Houston, Los Angeles, Chicago, Phoenix, Philadelphia, San Antonio, Dallas, Austin, Jacksonville, Charlotte, Indianapolis, Columbus, Fort Worth, San Francisco, Seattle, Denver, Boston, Nashville, Baltimore, Louisville, and Portland — plus every rural CBSA that participates in Medicare home health and hospice benefits.
Answers about home health, hospice, and SNF billing.
Written for owners, directors of finance, and RCM managers who are evaluating outsourcing post-acute revenue cycle. If your question isn't listed, request the free audit and we'll answer it in writing within one business day.
What states does 99 Billing Solutions serve for home health, hospice, and SNF billing?
99 Billing Solutions provides post-acute revenue cycle management to home health agencies, hospices, and skilled nursing facilities in all 50 U.S. states and the District of Columbia. Our billing teams are organized by MAC jurisdiction — Palmetto GBA (J-M), Novitas Solutions (J-H, J-L), Noridian (J-E, J-F), National Government Services (J-6, J-K), CGS (J-15), WPS (J-5, J-8), and First Coast Service Options (J-N) — so every claim is handled by billers who work that jurisdiction daily.
How much does 99 Billing Solutions' PDGM billing service cost?
Our home health billing service is priced on a percentage of collections model. There are no per-claim fees, no setup fees, and no long-term lock-in contracts. Pricing scales with your monthly episode volume; a free RCM audit produces a written quote within one business day. Most agencies see full ROI within the first two 30-day PDGM periods once denials drop and DSO shrinks.
How fast will you submit our Home Health claims and NOAs?
We commit to a 48-hour claim submission target from the moment documentation is complete. Notice of Admission (NOA) is filed within 48 hours of the Start of Care, well inside CMS's 5-day timely filing window. Our LUPA monitoring flags at-risk episodes before billing so you never lose a case-mix payment to preventable low-utilization thresholds.
Are you HIPAA compliant and will you sign a BAA?
Yes. A signed Business Associate Agreement (BAA) is executed on day one, before any Protected Health Information (PHI) is exchanged. Our environment is TLS-encrypted end-to-end, least-privilege access is enforced with MFA, and every action is captured in a HIPAA-compliant audit log. We support secure client portal, SFTP, and HIPAA-compliant e-fax for document exchange.
Do you handle Medicare, Medicaid, and Managed Medicare Advantage plans?
Yes. We bill Traditional Medicare (Part A and Part B), all state Medicaid programs including HCBS waivers and hospice room-and-board, Medicare Advantage plans from Humana, UnitedHealthcare, Aetna, Anthem/BCBS, WellCare, and every regional plan, plus commercial payers. We manage 837I institutional claims through the clearinghouse, 277CA acknowledgments, FISS/DDE direct data entry for corrections, and 835 ERA posting.
What EHR and clearinghouse platforms do you work with?
We work inside your existing environment. Supported home health and hospice EHRs include Axxess, WellSky (Kinnser), Homecare Homebase, MatrixCare, PointClickCare, Devero, Alora, Netsmart myUnity, and Brightree. Supported clearinghouses include Availity, Waystar, Change Healthcare (now Optum), and Trizetto. No platform migration required — we log in to yours.
How do you handle denial management and appeals?
Every denial is root-caused and worked within 48 hours. We categorize by CARC/RARC, refile corrected claims, submit redetermination and reconsideration appeals through the five levels of the Medicare appeals process, and feed prevention rules back upstream to coding and intake. Clients receive a weekly denial trend report with dollars-recovered and dollars-at-risk broken down by payer, denial reason, and referring source.
How long does it take to onboard a new agency?
Standard onboarding runs 5 to 10 business days from signed BAA to first submitted claim. Week one covers system access, workflow mapping, and a 30/60/90-day aging review to catch anything at risk. Most clients are running steady-state within the first 30-day PDGM period or first hospice benefit period.
BAA signed before we review a single claim
See exactly where your revenue is leaking.
Our free RCM audit benchmarks your clean claim rate, denial trends, timeliness, and aged A/R against post-acute best practice — with a dollar value attached to every finding.