The Post-Acute Care Billing Platform

The billing platform home health agencies actually want to use

Track PDGM episodes, catch NOA and LUPA deadlines before they pass, and manage claims through all 5 Medicare appeal levels — from a single platform built by people who understand home health operations.

Live dashboard snapshot

Total Billed

$847,250

Collection Rate

92%

NOA Due

2 alerts

LUPA Risk

2 periods

See full product preview below →

Every missed deadline costs your agency money

PDGM rules are unforgiving. A late NOA can zero out an episode. A LUPA shortfall can cut payment by 60%. A missed timely filing window means the claim is gone forever.

Missed NOA Deadlines

Automatic 5-day countdown alerts for every new episode

Miss the 5-day NOA window and Medicare pays $0 for that episode — regardless of care delivered

LUPA Surprises

Real-time visit tracking against HIPPS thresholds

LUPA reduces your payment by up to 60%. One missed visit can mean thousands lost per period

Timely Filing Violations

365-day deadline tracking on every draft claim

After 365 days, Medicare won't accept the claim at all — even if the care was medically necessary

Built for the people who run home health

Agency Owners

See your revenue pipeline, catch leaks before they happen, and know exactly where every dollar stands — across every episode, claim, and appeal.

Billing Teams

Stop chasing deadlines in spreadsheets. Every NOA, LUPA threshold, and filing deadline is tracked automatically — so you focus on billing, not calendar math.

Clinical Leaders

Focus on care delivery. Medipaid handles the billing complexity — visit tracking, HIPPS validation, and documentation requirements — so clinical decisions aren't driven by billing gaps.

Product Preview

See Medipaid in action

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

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 home health agencies choose Medipaid

Built by Home Health Operators

Designed by people who have run home health billing operations — not generic SaaS developers guessing at healthcare.

Always Current with CMS

Updated for CY2026 PDGM rates and payment rules. When CMS changes the rules, Medipaid updates — so you always bill correctly.

HIPAA-Ready Infrastructure

Every layer — encryption, access controls, audit logging — is built for HIPAA from day one. Not bolted on later.

One platform for the full Medicare home health billing lifecycle

From patient intake to final payment — every step tracked, every deadline guarded, every dollar accounted for

Patient & Insurance Management

Full demographics, encrypted Medicare IDs, and complete episode history — so every claim starts with clean, verified data.

PDGM Episode Tracking

Create a 60-day episode and billing periods generate automatically. HIPPS codes are validated on entry. Face-to-face documentation is tracked to close compliance gaps.

Visit Logging & LUPA Monitoring

Log every visit by discipline and clinician NPI. See your LUPA threshold status in real time — so you know exactly how many visits are needed before the period closes.

UB-04 Claim Generation

Generate UB-04 claims directly from billing periods — revenue codes, claim lines, and HIPPS codes pre-populated. Every EDI transaction is logged for audit readiness.

5-Level Denial Management

When Medicare denies a claim, Medipaid tracks your appeal through all 5 levels — with deadlines for each stage so you never miss an escalation window.

Payment Posting & AR

Post payments, track adjustments, and monitor your collection rate and AR aging — so you always know what has been paid, what is outstanding, and what needs follow-up.

Four steps from patient intake to paid claim

A streamlined workflow built for Medicare home health agencies

1

Add your patient

Enter demographics and Medicare insurance details. MBI is automatically encrypted on save — your team never sees or stores it in plaintext.

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

Create an episode

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

01/15/2025
I509
Community
3BFKS
3

Log visits

Log each clinician visit by date and discipline. Your LUPA threshold updates in real time — so you always know if a period needs more visits before it closes.

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

Submit claims

When the period ends, generate the claim with one click. Submit to Medicare and track status through payment — or through the appeal process if denied.

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 the PDGM grouper. Catch discrepancies before they affect payment.

Validates every HIPPS code before submission

LUPA Detection

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

Alerts when visits are below threshold with days remaining

Deadline Tracking

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

Tracks NOA, timely filing, and appeal deadlines to the day

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

Questions from agency owners and billing teams

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 today. You can enter HIPPS codes and patient data directly, or import via CSV. Direct integrations with WellSky, Homecare Homebase, and Axxess are in development for 2026.

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?

If your team already understands Medicare home health, the interface will feel familiar immediately. Most agencies are billing within the first day — no specialized training, no multi-week implementation.

Does Medipaid handle clinical documentation or just billing?

Medipaid focuses on the billing lifecycle — but it tracks face-to-face documentation requirements, visit counts by discipline, and OASIS-related HIPPS code validation. It is designed to work alongside your EMR, not replace it.

How is Medipaid different from the billing module in our EMR?

EMR billing modules handle basic claims but miss the nuances of PDGM — LUPA monitoring, NOA deadline tracking, 5-level appeal management, and HIPPS validation. Medipaid is purpose-built for the billing lifecycle that EMR modules underserve.

Your agency's revenue deserves a better billing platform

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