What a premium billing and RCM module must prove
Home health billing buyers expect NOA timing, PDGM, LUPA awareness, DDE/837/835 language, clearinghouse readiness, denial categories, payment posting, and AR follow-up.
Billing and RCM module
Coordinate NOA timing, 837I claim batch prep, 835 ERA reconciliation, DDE direct entry, PDGM HIPPS context, LUPA billing adjustment visibility, denial queue by CARC/RARC code, payment posting, and AR work queues — with no clean-claim or reimbursement guarantee.
The page uses safe demo labels and shows the operational states that move work forward.
Revenue-cycle workflow support only. No clean-claim rate, reimbursement guarantee, or payer outcome is claimed.
Queue status is shown once in the hero product frame, then this page explains what each workflow does and where the work moves next.
This module page names the operational details an agency evaluator should expect before a demo.
Home health billing buyers expect NOA timing, PDGM, LUPA awareness, DDE/837/835 language, clearinghouse readiness, denial categories, payment posting, and AR follow-up.
Outputs become payment posting, denial follow-up, AR aging, QAPI billing trends, and leadership reporting.
Workflow coverage shown with demo-only public data and agency role context.
Workflow coverage shown with demo-only public data and agency role context.
Workflow coverage shown with demo-only public data and agency role context.
Workflow coverage shown with demo-only public data and agency role context.
Track payer authorizations by period, discipline, visit units, service code, and expiration; surface renewal alerts and utilization warnings; prevent over-service with scheduling guardrails; and route billing holds before work gets stuck.
Capture the six 21st Century Cures Act data elements per visit, route to state aggregator programs, triage clock-in and location exceptions with supervisor review, and resolve holds before billing — with explicit separation from state EVV certification claims.
Home health billing teams need NOA timing visibility, PDGM and LUPA awareness, documentation holds, authorizations, EVV exceptions, claim status, denials, payment posting, and AR follow-up in one review lane.
See HELIX in action
Walk through intake, documentation, care plans, scheduling, EVV, authorizations, billing, QAPI, reporting, and mobile workflows without routing through a login wall.