Periods and groupings
Each 30-day period is grouped by admission source, timing, principal diagnosis, comorbidities, and functional level from OASIS. A vague principal diagnosis can push a period into the wrong group or send the claim back.
Thirty-day periods leave little room for late paperwork
Medicare pays home health agencies for 30-day periods of care, grouped from OASIS assessments, diagnoses, and visit counts. A late notice of admission reduces payment, and the agency cannot bill the patient for the difference.
Book a demoWhat drives a home health claim
Under the Patient-Driven Groupings Model, payment depends on clinical information as much as on visits.
Notice of admission
Agencies submit a one-time notice of admission within 5 calendar days of the start of care. A late one reduces payment for the period, and that reduction is the agency's liability.
Certification and plan of care
A physician or allowed practitioner certifies eligibility, including homebound status, and establishes the plan of care, with recertification every 60 days. Missing signatures or encounter documentation hold up the final claim.
Draw lines between clinical, intake, and billing
Intake, clinicians, and the business office each touch the claim. Clear handoffs keep periods from aging.
What the agency keeps
Intake, OASIS assessments, visits, and collecting certifications and orders stay with your agency, along with quality reporting to CMS.
What Taiga takes on
Taiga's billing team handles eligibility checks, claim submission and scrubbing, every denial and appeal, and patient statements and follow-up.
Where a decision is needed
Notice of admission timing, managed care authorizations, and chasing unsigned orders need a named owner, because each one runs on a clock.
Questions for a home health fit call
Bring de-identified examples of a paid period, a late or rejected claim, and an authorization request. Do not put patient details in the booking form.
What is your payer mix?
Estimate traditional Medicare, Medicare Advantage, Medicaid, and commercial shares, since authorization and billing rules differ.
Who files the notice of admission?
Describe who submits it today, how soon after start of care, and how you track it.
Where do OASIS and orders live?
Name your agency EMR and how signed orders and certifications come back from physicians.
For agencies that want claims worked to the end
Relevant to an independent home health agency whose business office can't keep up with rejected periods, managed care follow-up, and small balances.
Institutional billing needs a direct answer
Taiga has not published support for home health agency claims. This page does not determine eligibility, grouping, or coverage, and it does not replace your agency's compliance program.
Questions about home health billing
Can Taiga bill for a home health agency?
Home health is not on Taiga's published specialty list, and agencies bill institutional claims. Bring your payer and service mix, and Taiga will tell you straight whether it fits.
What happens if our notice of admission is late?
Medicare reduces the period's payment by the days between the start of care and the accepted notice, divided by 30. CMS can waive this only in exceptional circumstances.
Are supplies billed separately?
Generally no. Routine and nonroutine medical supplies are included in the home health period payment, while DME sits outside that bundle.
Does OASIS apply to non-Medicare patients now?
For most patients, yes. CMS made OASIS collection mandatory across all payers for non-exempt patients starting care on or after July 1, 2025.
Bring your agency's billing map
Show Taiga your census, payers, and how paperwork flows today. You will get a straight answer on whether it fits.
System guides show possible billing handoffs, not proven specialty compatibility.