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.

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