Four levels of care
Each day is billed as routine home care, continuous home care, inpatient respite care, or general inpatient care. Continuous care and inpatient days need documentation that justifies the higher level for that specific day.
Hospice pays by the day, if the paperwork holds
Medicare pays a hospice a daily rate for every day a patient is enrolled, at one of four levels of care. That payment only holds when the election, notice of election, certifications, and plan of care line up, and a late notice costs days you can't bill anyone for.
Book a demoHow the hospice benefit gets paid
The hospice benefit replaces standard Medicare coverage for the terminal illness, so its billing rules look nothing like an office visit.
Election and notice of election
The patient signs an election statement, and the hospice must file a notice of election within 5 calendar days. Revocations, transfers, and discharges each have their own notice, and gaps between them stall claims.
Benefit periods and certification
Care runs in two 90-day periods followed by unlimited 60-day periods. Each period needs a certification of terminal illness, and the third period onward also needs a documented face-to-face encounter.
Divide the clinical team, intake, and the business office
Intake owns the election, the interdisciplinary group owns the plan of care, and billing depends on both being complete and on time.
What the hospice keeps
Elections, certifications, face-to-face encounters, the plan of care, and level-of-care decisions stay with your clinical and intake teams, along with quality reporting.
What Taiga takes on
Taiga's billing team runs eligibility checks, claim submission and scrubbing, every denial and appeal including small ones, and patient statements and follow-up.
Where a decision is needed
Notices of election and termination, Medicare Advantage and Medicaid authorizations, and room and board arrangements with facilities each need a named owner before claims move.
Questions for a hospice fit call
Bring de-identified examples of a paid month, a claim held by a notice problem, and a level-of-care denial. Leave all patient details out of the booking form.
What is your level-of-care mix?
Estimate routine home care days against continuous care, respite, and general inpatient days, and where inpatient care happens.
Who files notices today?
Describe who submits notices of election, revocation, and transfer, and how you catch one that missed the 5-day window.
Who bills physician services?
Separate hospice-employed physician and nurse practitioner services from community attending physicians who bill on their own.
For hospices that want every claim followed to the end
Relevant to an independent hospice whose business office loses time to held claims, notice problems, and appeals that never get worked.
Hospice claims need a direct fit answer
Taiga has not published support for hospice claims. This page does not decide eligibility, level of care, or cap liability, and it does not replace your compliance program.
Questions about hospice billing
Does Taiga work with hospice programs?
Hospice is not one of the specialties Taiga names publicly, and hospices bill institutional claims. Bring your census and payer mix and Taiga will tell you straight whether it fits.
What happens if a notice of election is late?
Medicare does not cover the days from the election date until the notice is filed, and the hospice cannot bill the patient for them. CMS allows exceptions only in limited circumstances.
When is a face-to-face encounter required?
Starting with the recertification for the third benefit period, and for every recertification after it, a hospice physician or hospice nurse practitioner must document a face-to-face encounter supporting a prognosis of six months or less.
How do community physician visits get billed for hospice patients?
An attending physician who is not employed by the hospice bills Medicare Part B for professional services. When the attending is a hospice employee, the hospice bills those services instead.
Bring your hospice billing map
Share your census, levels of care, and how notices move today. Taiga will say plainly whether it can carry the work.
System guides show possible billing handoffs, not proven specialty compatibility.