Revenue leaks from three sources: billing ineligible patients (coverage lapses), under-coded episodes (PDGM), and employing excluded staff (OIG). Most agencies do not know how much they are losing because they lack visibility across all three. ClientCare monitors every leak source in a single platform and shows you exactly what is at risk.
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$34K
Avg. annual loss from coverage lapses alone
3
Revenue leak sources monitored simultaneously
$249/mo
All features included — no add-on fees
Revenue leakage in home health is invisible by default. You do not get an alert when a patient loses coverage, when an episode is under-coded, or when a staff member appears on the OIG exclusion list. You only find out when revenue drops and you do not know why.
Most agencies cobble together separate tools for eligibility checking, OIG screening, and billing review. Each tool has its own login, its own schedule, its own reports. Nothing is connected, so cross-cutting risks fall through the cracks.
Without a unified view of revenue risk, agencies react to problems one at a time. A coverage lapse gets caught here, an excluded employee gets flagged there, but nobody sees the full picture of how much revenue is at risk across all three leak sources.
Export CSVs from any EMR or HR system. Upload both patient and staff rosters to ClientCare. AI maps columns automatically — no special formatting, no integrations to build.
Eligibility monitoring starts checking patient coverage on risk-based intervals. Billing code validation scans diagnosis and procedure codes. OIG/LEIE screening runs against the federal exclusion list. All three run in parallel from day one.
Every risk surfaces on a single dashboard: coverage lapses with dollar impact, under-coded episodes with optimization opportunity, and excluded staff with compliance urgency. One view. No gaps between tools.
Coverage monitoring, billing validation, and exclusion screening — all in one platform. No separate logins. No gaps between tools.
Automated 270/271 EDI checks on risk-based intervals. Medicaid patients weekly, Medicare monthly, new intakes daily. Catches coverage drops before you bill an ineligible patient.
Validates diagnosis codes and procedure codes against current CMS code sets. Flags outdated codes, specificity issues, and gender/age mismatches before claims submit.
Every staff member screened against the federal OIG/LEIE exclusion list and SAM.gov monthly. Fuzzy name matching catches variations. Billing services from an excluded employee means mandatory refunds and potential penalties.
All three revenue leak sources surface on a single dashboard. See total revenue at risk, break it down by source, and drill into individual patients or staff. One login, one view, no gaps.
Any post-acute care provider billing Medicaid or Medicare. Revenue leakage affects agencies of every size.
All three leak sources hit HHAs hardest: coverage churn, PDGM under-coding, and excluded staff risk.
Medicare hospice benefit eligibility and staff screening are critical revenue protection layers.
Long-stay Medicaid residents and large staff rosters amplify every category of revenue leakage.
High Medicaid coverage churn combined with complex billing codes makes leakage prevention essential.
Placing excluded staff at client agencies creates liability for both parties. Screening is non-negotiable.
Waiver-funded services require continuous Medicaid eligibility monitoring and staff compliance.
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