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Hospice Compliance Mistakes to Avoid

Billing Errors & Overpayments

Hospice billing is a complicated process involving multiple parties. reimbursernent. claims. benefits, and more. Providers are paid on a per diem basis through Medicare for the costs of their patients. Submitting forms in a timely manner is crucial for those who are billing, as there are tight deadlines to adhere to. The business is responsible for providing all care and services to the patient as detailed in the plan of care without reimbursement from the Medicare Hospice Benefit from the effective date of election until the date NOE is filed.

At HospiceWorks, we understand the financial demands hospices face, billing is one of the biggest concerns among hospices since it involves tedious data entry. numerous forms, and the never ending correspondence and follow up to ensure your claims get paid. Our software was designed with this in mind and offers premium billing as a standard feature for users.

Avoiding HIPAA Violations

Protecting patients is of utmost importance in the healthcare industry. HIF’AA is based on the three rules of privacy. security, and break notifications. These security rules ensure that healthcare providers are keeping patient data safe while conducting business.

Patient inforrnation is at risk during the administration process, physical security, and on a technical level. One of the rnost common violations is when personal health information is disclosed without the authorization of that information.

Our software, HospiceWorks, operates with multiple levels of security to ensure that there are no breaches or risks. Organize your documents to ensure additional security and confidentiality. Stay on top of privacy notices, updates, regional laws, and complaint procedures.

The consequences of violating HIPAA can include fines, criminal penalties, restitution to victims, or termination. These can be detrimental to any business or individual that will also affect their credibility and integrity.

Providing Proper Documentation

It is irnportant for hospice businesses to have all the required documentation in order. Some regulatory errors will cause a hospice business to lose its license.

Hospices are also subject to government regulations on how rnuch they can charge per day under Medicare reimbursement rates. Additionally, they need to be clear on what types of clients may be accepted into their programs, such as people suffering from AIDS/HIV or cancer patients who want palliative care at home, but do not qualify for admission into a facility due to severity of illness.

Mandatory documents may include:

• Client care plan
• Case management assessment
• Medical orders
• Death certificate or cremation order of the deceased patient

Additional documentation different from the ones above, but really important to take care of are:

• Having medical records when admitting new patients
• Tracking length-of-stay accurately
• Providing adequate housekeeping


HospiceWorks is the first of its kind, cloud-based software with an integrated built-in rule engine to help hospice agencies follow best practices with developed step-by-step systems. The notifications and customizations will guide your business to compliance success so you never have to worry about inconsistencies or HIPAA violations again. With HospiceWorks, you can streamline the billing process, increase billing accuracy and eliminate double entries submitting clinical data required for processing claims into our software which means saving time as well. You can get a free 30-day preview of our software and understand how technology will make you save time and money, while you increase your delivery of care.

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