Eligibility Verification & Prior Authorization
Confirm patient insurance coverage and benefits before services to avoid denials.
Valiant Lifecare delivers end-to-end home-health billing — from eligibility and charge entry to OASIS review, RAP/EOE claims, and proactive denial management for your full revenue lifecycle.
Confirm patient insurance coverage and benefits before services to avoid denials.
Accurate capture of patient, insurance, and encounter details for clean claims.
Thorough coding and documentation review to comply with home-health regulatory standards and ensure reimbursement.
Submit RAPs (Request for Anticipated Payment) and end-of-episode claims via paper or electronic submission.
Post and reconcile electronic and manual payments, patient payments, and handle remittance advice.
Follow up on unpaid claims, research denials, resubmit corrected claims, and manage appeals.
Identify overpayments or credit issues, correct discrepancies, and prepare refunds or adjustments.
Tailored reports and dashboards to track revenue, claims status, denial rates, and financial performance.
Capture demographics, insurance details, and check coverage and benefits before care begins.
Gather physician orders, care plans, OASIS assessments, and face-to-face encounter confirmations.
Assign appropriate codes and enter charges for all services rendered, ensuring compliance with home health billing rules.
Submit claims — including RAP or final end-of-episode claims — via electronic or paper submission per payer guidelines.
Post payments received, reconcile electronic remittance advices, patient payments and adjustments.
Monitor outstanding claims, follow up with payers, identify denials or underpayments, and resubmit corrected claims or appeal.
Provide regular financial reports, denial patterns, claim turnaround, and revenue cycle performance dashboards.