Explore how effective Authorization Management can optimize your Home Care Revenue Cycle Management for enhanced efficiency.

This blog will discuss some of the critical features of Home Care Software that help manage authorizations and improve Revenue Cycle Management.

Overview

The demand for Home and community-based care will grow as more elderly populations prefer to age at Home. Even with the growth, home healthcare providers will continue to face significant headwinds. Labor shortage and wage growth will pose considerable challenges for home care agencies. Reimbursement cuts and other regulatory requirements will also pressure agencies' bottom line.

Effective Revenue Cycle Management will improve cash flow and enable home care agencies to meet the ongoing challenges. Contrary to the perception that Revenue Cycle Management starts after billing, it begins at intake and continues through authorization, scheduling, billing, and collections.

Authorization Management plays an outsized role in Home Care Revenue Cycle Management

Authorization Management plays an outsized role in Revenue Cycle Management. Effective and efficient authorization management will help home care agencies improve the bottom line by reducing non-billable shifts and payroll for non-billable shifts. Eligibility verification is the first step in authorization management. Proactively managing expiring authorizations and getting new authorizations when coverage changes will keep authorization current. Integrating authorization with scheduling will help agencies reduce or eliminate providing services without authorization. Claims scrubbers can hold the claims back for the services provided during that authorization process.

Home Care Agencies must leverage technology and integrated intelligent automation to improve authorization management efficiency and enable their staff to do more with less. Reducing revenue leakage and improving cash flow will help agencies improve their bottom lines, provide quality care, and improve patient and employee satisfaction.

Key Features for Effective Authorization Management to Improve RCM

Home Care Agencies, especially those providing Home and Community-Based services, face unique challenges in managing challenging and frequently changing authorization requirements.

The following are some key features of Home Care Software that can help home care agencies improve their authorization management process.

Eligibility Verification

Eligibility Verification is critical in managing authorizations effectively. Integrating eligibility Verification with the Intake process will allow agencies to verify eligibility in real-time during the intake process. Batch eligibility verification will help agencies check eligibility on a recurring basis to detect lapses or changes in coverage. The eligibility verification process should proactively notify us of any changes in coverage. Home care agencies should use the changes to review current authorizations and initiate the process to get new authorization if the payer has changed.

Authorization Management

For home care agencies providing Home and community-based services, authorization management is crucial in reducing non-billable services, paying employees for non-billable services, and improving the bottom line. Home Care Software should provide options to manage authorizations in units or hours. Software should make it easier to quickly identify expiring authorizations and initiate the process for new authorizations. The ability to change authorized hours or units during the authorization period will also be helpful. Authorization should be integrated with scheduling and billing. Home Care Software should also provide one area to manage all authorizations.

Integration with Scheduling

Authorization integrated with scheduling will help home care agencies reduce or eliminate scheduling services beyond authorized limits. Home Care Software should have an option to schedule from authorization. Proactive validations during scheduling will notify schedulers that authorization limits have been reached. Home Care Software should also be able to schedule and provide services during the authorization process, even though final approval has yet to be received.

Billing and Claims

Authorization should also be integrated with billing and claims. Home Care Software should have built-in validations in the claims processing functions to ensure that the authorizations have been obtained and are current. Holding claims for services provided during the authorization process will help agencies reduce denials and improve reimbursement time. Providing services during the authorization process will also help home care agencies recognize revenue even though claims are being held for authorization.

Reports

Home Care Software should have reports and notifications to manage the authorization process proactively. Reports providing a list of expiring authorizations and authorizations with missing information will be beneficial. Reports providing lapses or changes in coverage will be useful for changing or getting new authorizations. Utilization reports will also help agencies effectively manage and use all authorized hours for the authorization period.

Conclusion

Home Care Agencies should look for a Home Care Software platform with functions and features to make the authorization process efficient and manageable. Effective Authorization Management will reduce revenue leakage and improve collections, cash flow, and the agency's bottom line. The CareVoyant Home Care Software platform offers the right technology and tools to help home care agencies improve authorization efficiency, cash flow, and the bottom line.

About CareVoyant

CareVoyant is a leading provider of cloud-based integrated enterprise-scale home health care software that can support all home-based services under ONE Software, ONE Patient, and ONE Employee, making it a Single System of Record. We support all home based services, including Home Care, Private Duty Nursing, Private Duty Non-Medical, Home and Community Based Services (HCBS), Home Health, Pediatric Home Care, and Outpatient Therapy at Home.

CareVoyant functions – Intake, Authorization Management, Scheduling, Clinical with Mobile options, eMAR/eTAR, Electronic Visit Verification (EVV), Billing/AR, Secure Messaging, Notification, Reporting, and Dashboards – streamline workflow, meet regulatory requirements, improve quality of care, optimize reimbursement, improve operational efficiency and agency bottom line.

For more information, please visit CareVoyant.com or call us at 1-888-463-6797.