Hospice billing is built around certification periods, levels of care, and the hospice cap — not visit-by-visit CPT coding. Medflux manages election dates, physician narrative requirements, and level-of-care billing so agencies get paid without recertification gaps or cap surprises.
Specialty edits that generic billers miss — and denials that keep recycling.
01Certification periods (two 90-day, then unlimited 60-day) each require a timely physician narrative or the claim is vulnerable to denial.
02Level-of-care billing (routine home care, continuous home care, GIP, respite) must match documented clinical status day by day.
03The hospice aggregate cap and inpatient cap limits require monitoring across the whole patient census, not just individual claims.
04Live discharge, revocation, and change-of-ownership scenarios each carry their own billing and notice requirements.
How we help
Medflux approach for Hospice
Operational ownership — not a ticket queue that goes quiet after submission.
Certification period tracking with narrative and physician signature deadlines flagged before they lapse.
Level-of-care claim construction that matches the documented clinical picture for each billed day.
Cap exposure monitoring so agencies see risk before a cost report surprises them.
Discharge and revocation billing handled with correct occurrence codes and effective dates.
Engagement path
From specialty audit to steady paid claims
01
Specialty audit
Review recent claims, denials, and CPT patterns for your panel.
02
Edit set tuned
Scrubbing and denial playbooks aligned to your specialty reality.
03
Daily ownership
Submission, follow-up, and appeals with a named next step every time.
04
Clear reporting
Production, collections, and aging in plain language — monthly.
FAQ
Hospice billing questions
We track billed days against cap guidance and flag rising exposure early. Final cap calculations remain a cost-report function you confirm with your accountant.
Yes. Those levels require hour and documentation thresholds we check before submission, not just a rate change.
We use the correct discharge/revocation codes and effective dates so the final claim in a certification period does not create a compliance flag.
Related
Nearby specialties
Related panels with similar CPT and denial patterns.
