Pricing, Contracts, and Billing
HomecareNet’s pricing, contracts and billing features are key to maximizing reimbursement revenue. Advanced payer setup gives users powerful tools to maximize revenue from services provided.
HomecareNet’s pricing, contracts and billing features are unparalleled. Robust and flexible, these key features allow you to create sophisticated payer-specific rules and to customize prices, contract details and claims. Plus, HomecareNet helps find “lost” revenue by identifying opportunities to bill that would be nearly impossible to identify with less sophisticated systems — maximizing revenue for the enterprise.
Sophisticated Contract Rules
HomecareNet was designed with today’s home care industry in mind. Contracts with different payers have varying terms and HomecareNet can capture these terms, maximizing the revenue from each contract.
HomecareNet allows you to construct contracts using payer-specific schedules or rules that are based on list price, AWP or cost. Prices for per diems are established by frequency, dose or other criteria. You can also define outliers to indicate which items should be included in a per diem, with or without a limit.
Home health organizations can establish a PPS contract that defines rates for LUPA patients. Hospices can define specific per-diem rates for different patient statuses.
HomecareNet offers easy-to-use automated updates of AWP’s (monthly), ASP’s, Medicare Allowables, and List Prices.
HomecareNet will automatically generate pharmacy, supply, HME, visit, and per diem charges. Payer-specific charges (e.g. Medicare kits or PPS episode charges) are easy and intuitive to establish within HomecareNet. Claim edits are enforced in the system and you can see warnings up-front, before billing.
HomecareNet’s advanced claims tools allow you to configure electronic and paper claims based on individual payer requirements so they are produced correctly the first time. HomecareNet supports all electronic claims that apply to home care – the 837 Professional, 837 Institutional, and NCPDP 5.1 – as well as the 1500, UB04, plain paper invoice and patient statements. These benefits save billing staff countless hours of time making manual adjustments to claims.
HomecareNet’s sophisticated rules let you bill en masse, not one patient at a time. HomecareNet allows you to split billing between carriers for different services. Products and services covered by certain payers (e.g. Medicare Part D) can be billed in real time, while the remainder of products and services in a given order can be billed through traditional methods. Once split-billing rules are set up, HomecareNet automatically applies them, without any intervention from you.
An Enterprise Solution
HomecareNet’s sophisticated features provide managers the ability to establish rules, ensuring that all transactions will adhere to these rules. Billing can be centralized or decentralized, with all unbilled and billed figures readily accessible in a single database for reporting.
For More Information
Call us at (800) 738-8850 to find out about HomecareNet’s fully integrated solutions for home infusion, HME and home healthcare, specialty pharmacy and hospice providers.