FOR HOME HEALTH AND HOSPICE AGENCIES
Unsigned orders hold your cash. Late notices cut it.
We rebuild and run the office work that holds claims and stalls intake, as your AI operating partner.
Who we mean
- Medicare-certified home health agencieson HCHB, WellSky, Axxess or MatrixCare
- Hospiceson Consolo, FireNote, WellSky or HCHB
- Multi-branch agencies on one EMR
- Agencies in Review Choice Demonstration states
Where the hours go
Slow intake loses referrals.
Packets keyed, face-to-face, HETS and MA authorizations checked by hand while the discharge planner waits.
Unbilled AR waits on signatures.
Medicare claims wait on the signed 485 or CTI, chased order by order by phone.
Each branch works its backlog by hand.
NOA and NOE rejections, RTPs and EVV exceptions surface late and get worked differently at each branch.
What we build, and what we leave alone
Claims wait on paperwork. We rebuild the paperwork, not the care.
Unbilled AR, late notice cuts and pre-claim review exposure trace to office work. Automation runs HETS, ages unsigned orders and holds incomplete claims; AI drafts intake and fixes for staff to confirm. Clinicians keep OASIS and eligibility; coders keep coding.
- Home health: NOA, 485, OASIS match
- Hospice: NOE, CTI, recertification face-to-face
- Practitioners sign orders and plans
- Pre-claim review tracked in RCD states
Staffing and managed IT
Adjacent: a related back office
RSC Solutions: first delivery inside 60 days
A staffing and managed-IT firm with an enterprise end client. The relationship is still running.
60 days
Entity formed, facility built and team hired before award. First delivery inside 60 days.
No home health or hospice engagement is published yet.
What transfers: Only the team setup transfers: how people we manage would join your office. It is not an automation result.
Questions from agency leaders
For Medicare home health, as of 2026: 30-day PDGM periods, grouped partly by admission source and timing; the NOA accepted within five calendar days after start of care; the plan of care signed before billing; and the OASIS match in iQIES, or the claim returns.
For Medicare hospice, as of 2026: the NOE filed within five calendar days after the election date; the CTI before any claim; a face-to-face within 30 days before each recertification from the third period on; room and board; and the October to September cap year.
Only as documents that move. OASIS answers, coding, eligibility and level of care stay with clinicians and coders; the physician or allowed practitioner signs orders. Field scheduling stays with your team. We track queues, signatures and iQIES acceptance, not content.
It adds a queue. As of November 2026, Medicare's home health demonstration runs in IL, OH, TX, NC, FL and OK. Under pre-claim review, billing without a request means prepayment review and a 25 percent cut if payable. We can rebuild that tracking.
Office labor per admission, days claims sit unbilled, and payment lost to late notices. The discovery measures each in one department, such as intake, orders or billing across branches on one EMR, and prices every rebuild before you commit.
One fixed fee for a six to eight week discovery of one office department, agreed before we start. The team keeps working; field clinicians stay outside it. You get a workflow map and a fixed-price proposal for the first build. No obligation to continue.
Sources for the rules and deadlines on this pagechecked November 1, 2026
- Medicare home health NOA accepted within five calendar days after start of care; a late NOA reduces the period payment for each day late. CGS Medicare, Home Health NOA guidance, checked November 1, 2026
- Late NOA: the 30-day period payment is reduced by the days from admission to the NOA filing. 42 CFR 484.205(j) (Cornell LII), checked November 1, 2026
- Medicare hospice NOE filed within five calendar days after the election; late NOE days are not paid. 42 CFR 418.24 (Cornell LII), checked November 1, 2026
- Hospice CTI before the claim; face-to-face within 30 days before the third and later recertifications. 42 CFR 418.22 (Cornell LII), checked November 1, 2026
- Home health plan of care signed by the physician or allowed practitioner before each claim. 42 CFR 409.43 (Cornell LII), checked November 1, 2026
- Home health face-to-face encounter documented by the certifying practitioner. 42 CFR 424.22 (Cornell LII), checked November 1, 2026
- HETS returns Medicare eligibility, prior periods and Medicare Advantage enrollment. CMS, HIPAA Eligibility Transaction System, checked November 1, 2026
- Home health final claims return without a matching OASIS; NOA and NOE rejections and RTPs worked in FISS DDE. CGS Medicare, Top Claim Submission Errors, checked November 1, 2026
- PDGM pays Medicare home health in 30-day periods, grouped partly by admission source and timing. CMS, Home Health Patient-Driven Groupings Model, checked November 1, 2026
- Review Choice Demonstration states for home health (IL, OH, TX, NC, FL, OK). CMS, Review Choice Demonstration for Home Health Services, checked November 1, 2026
- Pre-claim review: a claim billed without a request goes to prepayment review and, if payable, is paid 25 percent less. CMS, Review Choice Demonstration FAQs, questions 78 and 81, checked November 1, 2026
- Hospice cap year runs October 1 to September 30 (the cap period is the twelve months ending September 30). 42 CFR 418.3, cap period (Cornell LII), checked November 1, 2026
- Hospices pay nursing facilities room and board and seek Medicaid reimbursement. Hospice News, March 3, 2025, checked November 1, 2026
- Medicaid home health visits require electronic visit verification. Medicaid.gov, Electronic Visit Verification, checked November 1, 2026
- Discharge planners often send one referral to several agencies at once. Enzo Health, Hospital Discharge Planner (industry source), checked November 1, 2026
Rules change and vary by program, state and contract. Your compliance team confirms what applies to you.
Sources for the rules and deadlines on this pagechecked November 1, 2026
- Medicare home health NOA accepted within five calendar days after start of care; a late NOA reduces the period payment for each day late. CGS Medicare, Home Health NOA guidance, checked November 1, 2026
- Late NOA: the 30-day period payment is reduced by the days from admission to the NOA filing. 42 CFR 484.205(j) (Cornell LII), checked November 1, 2026
- Medicare hospice NOE filed within five calendar days after the election; late NOE days are not paid. 42 CFR 418.24 (Cornell LII), checked November 1, 2026
- Hospice CTI before the claim; face-to-face within 30 days before the third and later recertifications. 42 CFR 418.22 (Cornell LII), checked November 1, 2026
- Home health plan of care signed by the physician or allowed practitioner before each claim. 42 CFR 409.43 (Cornell LII), checked November 1, 2026
- Home health face-to-face encounter documented by the certifying practitioner. 42 CFR 424.22 (Cornell LII), checked November 1, 2026
- HETS returns Medicare eligibility, prior periods and Medicare Advantage enrollment. CMS, HIPAA Eligibility Transaction System, checked November 1, 2026
- Home health final claims return without a matching OASIS; NOA and NOE rejections and RTPs worked in FISS DDE. CGS Medicare, Top Claim Submission Errors, checked November 1, 2026
- PDGM pays Medicare home health in 30-day periods, grouped partly by admission source and timing. CMS, Home Health Patient-Driven Groupings Model, checked November 1, 2026
- Review Choice Demonstration states for home health (IL, OH, TX, NC, FL, OK). CMS, Review Choice Demonstration for Home Health Services, checked November 1, 2026
- Pre-claim review: a claim billed without a request goes to prepayment review and, if payable, is paid 25 percent less. CMS, Review Choice Demonstration FAQs, questions 78 and 81, checked November 1, 2026
- Hospice cap year runs October 1 to September 30 (the cap period is the twelve months ending September 30). 42 CFR 418.3, cap period (Cornell LII), checked November 1, 2026
- Hospices pay nursing facilities room and board and seek Medicaid reimbursement. Hospice News, March 3, 2025, checked November 1, 2026
- Medicaid home health visits require electronic visit verification. Medicaid.gov, Electronic Visit Verification, checked November 1, 2026
- Discharge planners often send one referral to several agencies at once. Enzo Health, Hospital Discharge Planner (industry source), checked November 1, 2026
Rules change and vary by program, state and contract. Your compliance team confirms what applies to you.
- BAA
- HIPAA
- Posture
- Notice
- BAA
- Where a department handles protected health information, we execute a business associate agreement before Trace is installed or any data is accessed.
- HIPAA
- We execute a Business Associate Agreement before any engagement that touches PHI, and PHI is accessed only inside client-controlled systems by named individuals. Our first healthcare engagement under BAA is in progress.
- Posture
- Ready and aligned describe design posture, not certification. Reliable Group does not currently hold SOC 2 or ISO 27001 certification; our teams operate inside client-certified environments under client controls.
- Notice
- We deploy Trace only after your organization has given team members any written notice your state requires; we provide the notice template.
Your client-specific workflows, data and documentation are yours. Trace is Reliable Group software, licensed under the engagement; third-party tools keep their own license terms.
Last reviewed October 2026
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