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.

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