Is your home health or hospice agency losing revenue because of billing problems that actually started somewhere else?

When claims are denied, payments are delayed, or cash flow slows down, the billing department is often the first to get blamed. But the real problem may have started weeks or even months earlier.

In Episode 06, which is Part 2 of our three-part Revenue Cycle Management series on the Home Health and Hospice Profitability Podcast, host Doug Walters welcomes back Amanda Sheldon, Director of Revenue Cycle Management, to discuss the blame game between departments and how poor communication can lead to costly revenue leaks.

Amanda explains why revenue cycle management is a team effort involving marketing, intake, eligibility verification, clinical operations, documentation, orders tracking, and billing.

When one department misses something, the financial consequences can ripple throughout the agency.

In this episode, you'll learn:

• Why billing teams often get blamed for problems they didn't create
• How poor communication between departments leads to lost revenue
• Why understanding the entire revenue cycle matters
• How unpaid claims can accumulate even when an agency has cash in the bank
• Why hospice sequential billing requirements can create months of delayed payments
• How returned-to-provider (RTP) claims affect cash flow
• Why clinical documentation and orders tracking are critical to reimbursement
• How a Director of Nursing or clinical leader working in the field can create documentation backlogs
• How marketing and intake decisions can result in avoidable claim denials
• Why verifying insurance eligibility and network participation matters
• How to analyze accounts receivable aging reports
• Which revenue cycle KPIs agency owners should review weekly
• How to identify the root causes of denials and prevent recurring problems

Doug and Amanda also share real examples of agencies struggling with cash flow because of unresolved claims, incomplete documentation, and referrals accepted under insurance plans the agency wasn't contracted to serve.

One hospice agency had claims sitting in returned-to-provider status for months, creating a chain reaction that delayed subsequent billing.

Another home health agency struggled with cash flow because its clinical leadership was spending too much time seeing patients instead of completing the administrative work needed to move claims forward.

These examples highlight an important lesson: revenue cycle management isn't just about submitting claims. It's about building processes that help every department do its part correctly.

Amanda also explains why agencies should look beyond the amount billed versus the amount collected and focus on expected collectible revenue, outstanding accounts receivable, denial trends, and the time required to convert services into cash.

The takeaway: if you want to improve your agency's cash flow, start by identifying where the revenue cycle is breaking down rather than simply blaming the billing team.

Subscribe to the Home Health and Hospice Profitability Podcast for more conversations about revenue cycle management, Medicare reimbursement, agency profitability, financial operations, and the business of home health and hospice.

This is Part 2 of our three-part Revenue Cycle Management series.

What's the biggest revenue cycle challenge facing your agency: documentation delays, claim denials, eligibility issues, or communication between departments? Let us know in the comments.

#HomeHealth #Hospice #RevenueCycleManagement #HomeHealthBilling #HospiceBilling #HealthcareRCM #MedicalBilling #ClaimsDenials #AccountsReceivable #HealthcareFinance #HomeHealthProfitability #HospiceProfitability #DougWalters

VISIT OUR WEBSITES:

https://waltersaccounting.com
https://waltersadvisors.com
https://waltersbilling.com

Are your 1099 nurses and caregivers actually independent contractors, or could they legally be considered employees?

For home health and hospice agencies, getting worker classification wrong can create enormous financial and regulatory consequences.

In episode 05 of the Home Health and Hospice Profitability Podcast, host Doug Walters breaks down the 1099 contractor trap and explains why arrangements that appear to save agencies money today can lead to years of unpaid overtime, back taxes, penalties, and potential Medicare compliance problems.

Using a federal court case involving more than $9 million in damages, Doug explains how an independent contractor agreement, including provisions intended to protect the business, can actually become evidence against an agency.

He also explores why simply issuing a 1099 or having someone sign a contractor agreement doesn't necessarily make that worker an independent contractor.

In this episode:

• Why 1099 contractors can appear cheaper than W-2 employees
• How payroll taxes and overtime affect staffing costs
• The $9 million worker misclassification case
• Why independent contractor agreements may not protect your agency
• How worker classification is evaluated
• The importance of control, financial independence, and business relationships
• Why uniforms, scheduling, training, and non-compete agreements can create problems
• Special Medicare core services requirements for hospice agencies
• The risks of using contractors for nursing, social work, and counseling
• Why state independent contractor laws may not protect agencies from federal requirements
• How worker classification enforcement and litigation can differ
• IRS relief programs that may help eligible agencies correct past classification issues
• Why staff productivity matters when comparing W-2 and contract labor costs
• Practical steps for reviewing your current 1099 workforce

Doug also shares a simple exercise agency owners can complete this week: review everyone paid as an individual 1099 contractor, evaluate how those workers actually operate within the business, and identify arrangements that may need further review.

The takeaway is simple: just because a contractor arrangement has worked for years doesn't necessarily mean it's compliant.

Understanding your exposure today may help prevent a much more expensive problem tomorrow.

Subscribe to the Home Health and Hospice Profitability Podcast for more discussions about agency profitability, staffing, compliance, financial management, and the business challenges facing home health and hospice providers.

This episode is for general educational purposes only and does not constitute legal, tax, or employment advice. Worker classification requirements vary by jurisdiction and circumstances. Consult qualified legal and tax professionals before making classification decisions.

#HomeHealth #Hospice #1099vsW2 #IndependentContractor #WorkerMisclassification #HomeHealthAgency #HospiceAgency #HealthcareStaffing #HealthcareCompliance #AgencyProfitability #DougWalters

VISIT OUR WEBSITES:

https://waltersaccounting.com
https://waltersadvisors.com
https://waltersbilling.com

Revenue cycle management doesn't start when your billing team submits a claim. It starts the moment your agency begins evaluating a referral.

In Part 1 of this revenue cycle management series on Episode 04 of the Home Health and Hospice Profitability Podcast, host Doug Walters sits down with Amanda Sheldon to discuss the upstream mistakes that can delay payments, create unnecessary write-offs, and hurt agency cash flow.

They break down why intake, eligibility verification, payer contracts, face-to-face documentation, NOAs and NOEs, RTP claims, and communication between departments all play a role in whether an agency ultimately gets paid.

Amanda also explains why a growing census doesn't necessarily mean an agency is becoming more profitable. If your team doesn't understand what different payers reimburse, the true cost of providing care, or whether the required documentation is complete before accepting a patient, more volume can actually create more financial problems.

In this episode:

• Why revenue cycle management starts before billing
• How marketers and intake teams affect agency profitability
• Why agencies need to understand payer contracts
• How a referral can look good for census but still lose money
• Why face-to-face documentation is so important
• How often agencies should verify patient eligibility
• Medicare Secondary Payer issues agencies can miss
• Why late NOAs and NOEs can become expensive
• How RTP claims can delay or reduce reimbursement
• Why DDE remains an important tool for monitoring Medicare claims
• How incorrect information can contribute to Medicare downcoding
• Why communication between intake, clinical, orders, and billing matters
• How unbilled and aged claims can quietly damage cash flow
• A simple referral audit agencies can perform this week

Revenue cycle management isn't just the billing department's responsibility. Every step from referral through final payment can affect whether your agency gets paid accurately and on time.

This is Part 1 of a three-part series on revenue cycle management. Subscribe to the Home Health and Hospice Profitability Podcast so you don't miss the next episode.

#HomeHealth #Hospice #RevenueCycleManagement #HomeHealthBilling #HospiceBilling #HealthcareFinance #HomeHealthAgency #HospiceAgency #HealthcareManagement #Medicare #RCM

VISIT OUR WEBSITES:

https://waltersaccounting.com
https://waltersadvisors.com
https://waltersbilling.com