Comprehensive Hospice Billing
Streamlined outsourced billing built specifically for hospice providers.
Cliniqon delivers end-to-end hospice billing services that feature manual audits and claim-edit reconciliations to ensure timely, error-free submissions. By combining specialized documentation support with rigorous compliance standards, we provide a scalable, cost-effective partnership tailored to your needs—whether you run a boutique hospice or process over 500 claims a month for a rapidly growing organization.
End-to-End billing for Hospice Agencies
Our hospice billing services cover the entire process, from Front-end to Back-end billing. With Cliniqon’s hospice billing RCM services, you can focus on delivering compassionate care while we expertly manage your financial operations, streamlining the billing cycle and improving your revenue flow.
Insurance Verification
We ensure smooth billing right from the start by accurately collecting patient information and verifying insurance coverage. Additionally, we obtain the necessary preauthorization that insurers often require.
Claims Scrubbing and Submission
Our hospice billing experts review each claim with advanced tools before submission, guaranteeing accuracy and compliance, which results in faster reimbursements.
Denial Management and Appeals
We swiftly handle any denied claims and manage appeals to maximize approvals. Our team also confirms if payments are accurately posted to patient accounts, keeping your revenue cycle on track.
Patient Collections
Our specialists follow up with patients regarding outstanding balances, ensuring timely payments and maintaining a smooth financial process for your agency.
Insurance Verification
We ensure smooth billing right from the start by accurately collecting patient information and verifying insurance coverage. Additionally, we obtain the necessary preauthorization that insurers often require.
Claims Scrubbing and Submission
Our hospice billing experts review each claim with advanced tools before submission, guaranteeing accuracy and compliance, which results in faster reimbursements.
Denial Management and Appeals
We swiftly handle any denied claims and manage appeals to maximize approvals. Our team also confirms if payments are accurately posted to patient accounts, keeping your revenue cycle on track.
Patient Collections
Our specialists follow up with patients regarding outstanding balances, ensuring timely payments and maintaining a smooth financial process for your agency.
Our Client Testimonial
The backend team achieved remarkable success this month, exceeding the hospice collection goal by $600K through strong AR cleanup efforts. Sarah's leadership has brought accountability and organization, helping Riyas, Arun, and Amanda thrive. The team's progress reflects the positive direction needed for our continued growth and expansion.
Markie Rodgers
Director of Revenue Cycle Management
Gulfside Healthcare Services
Cliniqon’s Hospice Billing and RCM Workflow
From guaranteed 5-day NOE submissions to paid claims, Cliniqon’s end-to-end hospice billing cycle validates clinical documentation, captures all four levels of care, and resolves DDE roadblocks to secure every dollar of your earned revenue.
Why Choose Cliniqon’s Hospice Billing Services?
Enhanced Efficiency
Partnering with us lets your team focus on patient care while we handle your financial operations, improving overall efficiency.
Cost Savings
Skip the overhead costs of an in-house billing team. Our hospice billing RCM outsourcing solutions reduce staffing, training, and infrastructure expenses.
Greater Accuracy
Our hospice billing experts ensure error-free submissions by staying updated on all guidelines and using claim-scrubbing tools.
Data Security
We ensure top-tier data protection will fully HIPAA-compliant services, safeguarding your patient information according to industry standards.
Fast Claims Processing
Our advanced technology and skilled specialists speed up claims, shortening revenue cycles and enabling quicker reimbursements.
FAQs
Outsourcing helps reduce overhead, improve accuracy, and free up your team to focus on patient care.
It’s the process of identifying denied claims, correcting issues, and filing appeals to secure reimbursement.
Yes.
We apply the CMS hospice payment rates and wage index appropriate to the date of service, location, and level of care, including published rate-table corrections.
We reduce denials, accelerate reimbursements, and optimize billing workflows.
No, our pricing is transparent with no setup or hidden fees.
Yes, you receive full visibility through detailed reports and dashboards.
Yes, we tailor our services to fit your hospice agency’s workflow and size.
Yes. Although payers often sit on hospice reimbursements, Cliniqon goes after denials which payers issue and A/R with a process built around how hospice reimbursement actually works: Find the Root Cause, Then Appeal: Instead of mailing boilerplate appeals or writing off balances, we dig into denials by payer, reason code, and level of care.
Then we appeal the claim which those records back, using physician certifications of terminal illness (CTI) and clinical eligibility records.
Work Directly in Medicare DDE: Billers whom DDE training has prepared log into Medicare’s Direct Data Entry ("black screen") system. They read claim status codes, fix errors which billers spot at the source, and unblock pended claims. Recover Up to 2 Years of Backlog: When we onboard you, we audit aged A/R and actively chase historical claims which agencies have let age up to 2 years.
Proof in the Numbers: In Florida, Gulfside Healthcare Services blew past its monthly hospice collection target by $600,000 after Cliniqon cleaned up its A/R.
No. Cliniqon is not an automated billing software or a technology-only vendor. Instead of an AI-technology platform, we provide a customized expert-led operational partnership augmented by proprietary technology. While our Clinix AI Engine eliminates front-end data errors and pre-screens documentation, all hospice claim submissions, Medicare DDE troubleshooting, HOPE alignment, and denial appeals are directly managed by certified post-acute billing and clinical specialists.
Small hospices often worry about overhead, Cliniqon works with single-location and boutique agencies without forcing them to carry full-time in-house staff:
Pricing That Moves with Census: You pay based on your census. So instead of fixed payroll for admin staff, you get an operational partnership that lowers your net operating costs.
No Lock-Ins, No Setup Fees: You can onboard without setup charges, volume minimums, or rigid long-term contracts.
2 Year A/R Recovery: Small agencies may have pending payments. We can review and recover pending payments through precise denial management and claim submission process.
Full Clinical Team, Right Away: Small providers get certified hospice coders, HOPE-trained reviewers, and DDE billing specialists. These specialists also join mandatory Interdisciplinary Group (IDG) meetings.
Cliniqon scales across enterprise, multi-location, and multi-state hospice providers. We eliminate vendor fragmentation by bringing referral intake, HOPE quality reviews, billing for all four levels of care (RHC, CHC, GIP, Respite), and cash posting under one accountable standard. The Clinix AI Engine can automate low-level document scrubbing and pre-screens charts. As a result, clinical reviewers can process large volumes within a consistent less than 48 hour turnaround time.
Executive Financial Command View: The Clinix platform gives leadership real-time operational visibility across multiple locations, including Consolidated cash flow and A/R aging segmented by payer and level of care. Fiscal-year aggregate Hospice Cap utilization tracking with early threshold alerts to prevent clawback liabilities. Real-time monitoring of 5-day Notice of Election (NOE) submissions across all active election dates. Accredited Security: Operations meet enterprise-grade compliance standards. CHAP verifies us, we comply with HIPAA, and we hold dual ISO 9001 (Quality) and ISO 27001 (Data Security) certifications.
Most agencies see measurable cash flow improvement within 30–60 days. A complete revenue cycle optimization typically achieved within 90 days.
Although claims can stall in clearinghouses or payer systems, Cliniqon actively tracks them and resolves them.
Intervene in Clearinghouse & DDE: Specialists resolve rejections across all major clearinghouse channels (Waystar, Inovalon, Availity, Office Ally) and directly within Medicare DDE before claims age into uncollectible debt.
Escalate to Payers: Instead of waiting in general customer service phone queues, teams contact Medicare Administrative Contractors (such as NGS and CGS) directly to negotiate manual claim releases and secure contract recoupments.
Monitoring blocked claims that not yet Billed: The Clinix platform flags blocked claims on a live dashboard. It identifies the exact root cause—such as missing orders, documentation gaps, or eligibility discrepancies—and assigns team ownership for immediate resolution.
