DeltaRCM

Home health

Episode billing is unforgiving. Miss the documentation window, lose the episode.

Episode-based billing, OASIS documentation, PDGM, and the operational rigor underneath.

The texture of this setting

Home health billing is episode-based — PDGM, 30-day periods, OASIS documentation, LUPA thresholds. Miss the documentation window and the episode collapses. Miss the HHRG calculation and the reimbursement is wrong.

The operational rigor underneath is real. So is the margin, when it's run well.

Operational challenges

OASIS timing windows

OASIS-E timepoints are unforgiving. Late submissions or data errors propagate into billing errors.

PDGM complexity

30-day periods, clinical groupings, admission source, timing factors — the math is unforgiving.

LUPA and PEP adjustments

Low-utilization thresholds and partial-episode payments require real-time tracking to catch before month-end.

How we handle it
  • OASIS data integrity checks before submission.

  • PDGM calculation and episode-level reporting.

  • LUPA threshold tracking with proactive flags.

  • Clinical-documentation improvement coordinated with billing.

Common specialties in this setting
  • Primary care
  • Skilled nursing

Free audit

Curious where your practice is leaking money?

We'll audit your current workflow for free and show you exactly where to act — usually in under a week. No contract. You keep whatever we find.