Full-cycle hospice & SNF billing: what it covers

The full-cycle workflow

Front end

Eligibility verification plus hospice election or SNF Medicare Part A benefit-period confirmation.
Physician certification of terminal illness or skilled need collected before admission.
Admission data entry checked against the certification on file.

Middle

Per-diem billing by level of care for hospice, or PDPM case-mix grouping for SNF.
Claims submission on the correct billing cycle for the setting.
Payment posting and reconciliation against per-diem or case-mix rates.

Back end

Denial management for certification-related and level-of-care denials.
Appeals filed with physician certification and clinical documentation attached.
Patient and family billing for room-and-board or non-covered services.

Oversight

Recertification due-date tracking across the full benefit period.
A/R aging and denial-rate reporting by level of care or payer.

Where practices get stuck without it

Recertifications lapse mid-benefit-period because no one tracks the window against the calendar.
Level-of-care billing doesn't match the documented condition, triggering denials.
Per-diem claims go out on the wrong cycle for the setting.
Patient and family billing conversations happen without the sensitivity hospice care calls for.
Leadership can't see which level of care or payer is driving the most denials.

What a RCVRY full-cycle billing team handles

Certification & Eligibility Tracking

Keeps every stay's certification status current across the benefit period.

Confirms benefit-period and certification status before admission.
Tracks recertification due dates across the full stay.
Verifies level-of-care documentation matches billing.

Per-Diem & Case-Mix Billing

Bills on the correct cycle for hospice or SNF, not a generic visit schedule.

Bills the correct level of care or PDPM grouping on schedule.
Submits claims on the appropriate per-diem cycle.
Posts and reconciles payments against contracted rates.

Denials, Appeals & Reporting

Handles billing conversations with the discretion the setting calls for.

Appeals certification and level-of-care denials with clinical support.
Handles patient and family billing with appropriate discretion.
Reports A/R and denial rate by level of care.

Who this process is for

Hospice agencies and skilled nursing facilities managing recertification cycles across a full census, and multi-site operators that need one standardized certification and billing process across every location.

Full-cycle hospice and SNF billing: what it covers