Medicare Home Health Billing

Stop letting Medicare revenue slip through the cracks

Purpose-built for home health billers who are tired of spreadsheets, missed deadlines, and preventable denials. Track PDGM episodes, get alerts before NOA and LUPA deadlines pass, and manage denials through all 5 Medicare appeal levels — so you protect every dollar of revenue.

Live dashboard snapshot

Total Billed

$847,250

Collection Rate

92%

NOA Due

2 alerts

LUPA Risk

2 periods

See full product preview below →

Built for the real challenges of Medicare billing

Home health billing is complex. PDGM rules, strict deadlines, and a 5-level appeal process mean small mistakes can cost thousands in lost revenue.

Missed NOA Deadlines

Automatic 5-day countdown alerts for every new episode

A missed NOA can reduce your reimbursement to $0

LUPA Surprises

Real-time visit tracking against HIPPS thresholds

LUPA episodes pay up to 60% less than full PDGM payment

Timely Filing Violations

365-day deadline tracking on every draft claim

Never lose billing rights on a valid claim

Product Preview

See Medipaid in action

Real UI from the actual application. Every screen is designed for the daily workflow of Medicare home health billers.

Claims Pipeline

Track every claim from draft to paid

CLM-2025-0142PaidHIPPS: 3AFKS

Johnson, Mary (MRN-10042)

01/01/25 - 01/30/25

Billed

$3,842.50

Paid

$3,842.50

Owed

$0.00

CLM-2025-0138SubmittedHIPPS: 3BFKS

Smith, Robert (MRN-10038)

01/05/25 - 02/03/25

Billed

$4,128.00

Paid

$0.00

Owed

$4,128.00

CLM-2025-0135DeniedHIPPS: 3CFLS

Williams, Susan (MRN-10035)

12/15/24 - 01/13/25

Billed

$3,956.75

Paid

$0.00

Owed

$3,956.75

Episode & Period Management

PDGM billing periods with HIPPS codes and LUPA tracking

Miller, DavidMRN-10045ActiveReady to Bill

01/15/25 - 03/15/25 · Dx: I509 · HIPPS: 3BFKS

PeriodDatesHIPPSVisitsStatusNOA
Period 101/15/25 - 02/13/253BFKS8 / 6FullSent 01/16/25
Period 202/14/25 - 03/15/253BFKS4 / 6LUPA RiskN/A

Action Items Dashboard

Never miss a deadline with automated alerts

Ready to Bill

3
Johnson, MaryCreate claim
Smith, RobertCreate claim
Williams, SusanCreate claim

NOA Due

2
Brown, James2d left
Davis, Linda4d left

LUPA Risk

2
Miller, David+2 visits
Wilson, Sarah+1 visit

Denials to Work

3
Taylor, Michael14d
Anderson, Jennifer30d
Thomas, William45d

Why billing teams trust Medipaid

Built by Billing Specialists

Designed by people who understand PDGM, LUPA thresholds, NOA deadlines, and Medicare's 5-level appeal process.

CMS Rule Compliant

Updated for CY2026 PDGM rates. Every validation and deadline calculation follows current CMS guidelines.

HIPAA Compliant From Day One

AES-256 encryption, row-level security, and HIPAA audit logging built into every layer.

Everything a Medicare biller needs

From patient intake to payment posting in one platform

Patient & Insurance Management

Full demographics, Medicare insurance with encrypted MBI, and complete episode history for every patient.

PDGM Episode Tracking

60-day episodes with automatic billing period creation, HIPPS code validation, and face-to-face documentation tracking.

Visit Logging & LUPA Monitoring

Log visits by discipline (SN, PT, OT, ST, HHA, MSW) with NPI tracking. Real-time LUPA threshold alerts.

UB-04 Claim Generation

Generate claims from billing periods with revenue codes, claim lines, HIPPS codes, and full EDI transaction history.

5-Level Denial Management

Track denials through all Medicare appeal levels: Redetermination, QIC, ALJ, Appeals Council, and Federal Court.

Payment Posting & AR

Record payments, track adjustments, monitor collection rates, and manage outstanding balances with aging reports.

From intake to paid claim

A streamlined workflow built for Medicare home health billing

1

Add your patient

Enter demographics and insurance details. MBI is encrypted with AES-256-GCM on save and never stored in plaintext.

Mary
Johnson
03/15/1948
1EG4-TE5-MK72
2

Create an episode

Open a 60-day PDGM episode with HIPPS code, primary diagnosis, and referring physician. Billing periods are created automatically.

01/15/2025
I509
Community
3BFKS
3

Log visits

Record each clinician visit by date and discipline. Watch your visit count approach the LUPA threshold in real-time.

01/20/2025
SN
Smith, Jane RN
Visit 5 of 6LUPA threshold met
4

Submit claims

When the period closes, mark it ready to bill. Generate the claim, submit to Medicare, and track status through payment.

CLM-2025-0142Ready to Submit
TOB: 0322 | Freq: 1

Billed

$3,842.50

HIPPS

3BFKS

Service Dates

01/15 - 02/13/25

Revenue Code

0023

Automated compliance checks that catch errors before they become denials

Every HIPPS code is validated, every LUPA threshold is monitored, and every deadline is tracked — automatically. Errors are caught before they reach Medicare.

HIPPS Validation

Import HIPPS codes from your EMR and validate against internal PDGM grouper. Catch discrepancies before they affect payment.

Revenue assurance

LUPA Detection

Automatic visit counting against period thresholds. Get alerts when periods are at risk of LUPA payment reduction.

Prevent underpayment

Deadline Tracking

NOA deadlines, timely filing limits, and appeal deadlines are all calculated automatically from episode and claim dates.

Zero missed deadlines

Built for compliance

HIPAA Compliant

All PHI encrypted in transit and at rest

AES-256 Encryption

Medicare IDs encrypted with military-grade encryption

Row-Level Security

Agency data completely isolated

PDGM CY2026

Updated for current CMS payment rules

Medicare Part A

Purpose-built for home health billing

Common questions from billing managers

Is Medipaid HIPAA compliant?

Yes. All protected health information is encrypted with AES-256-GCM. Medicare Beneficiary Identifiers are encrypted at rest and never stored in plaintext. Row-level security ensures agencies can only access their own data.

Does it integrate with our EMR?

Medipaid works alongside your existing EMR. Import HIPPS codes and patient data, then manage the billing workflow in Medipaid. Direct integrations with WellSky, Homecare Homebase, and Axxess are on the roadmap.

How long does onboarding take?

Most agencies are up and running within a day. Add your staff, import your active patients, and start tracking episodes immediately. No complex migration required.

What happens when CMS updates PDGM rules?

Medipaid is updated to reflect CMS rule changes, including annual HIPPS rate updates and policy changes. You always bill against current guidelines.

Is our data secure?

Your data is encrypted in transit and at rest. We use row-level security policies so each agency's data is completely isolated. HIPAA audit logging tracks every access to protected health information.

Do we need to train our whole team?

Medipaid is designed for billers who already understand Medicare home health. If you know PDGM, the interface will feel familiar immediately. No specialized training required.

Stop losing revenue to missed deadlines and preventable denials

Medipaid is currently in early access for home health agencies. Request access and we will get you set up.

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