Revenue Recovery & HIPAA Compliance

Find the revenue your agency is missing. Get HIPAA compliant before OCR finds you.Consulting services for agencies and billing consultants.

No cost. No commitment. 48-hour turnaround. HIPAA compliant.

How It Works

1

Send Two Files

Your billing/aging report and payment summary from your EHR. CSV or Excel, whatever you have.

2

We Analyze

Within 48 hours, we reconcile your billings against your collections and identify every gap.

3

Get Your Report

A clear, one-page report showing the dollar amount you're leaving on the table and where it is.

Consulting Services

Revenue recovery, compliance, and policies & procedures for home health agencies. Start with a free gap analysis. Each service builds on the last.

Start Here

Revenue Gap Analysis

FreeNo cost, no commitment

Identifies $30K–$50K/yr in recoverable revenue

Send me your billing summary and payment report. I'll show you the gap between what you billed and what you collected, broken down by denied claims, PDGM undercoding, and eligibility lapses.

  • 48-hour turnaround
  • Two files: billing report + payment summary
  • BAA signed before any data exchange
  • One-page report with dollar amounts
  • Estimated recoverable revenue

Revenue Recovery Audit

$1,500 - $3,000Per audit engagement

Typical recovery: $15K–$50K per audit (5–15x return)

Detailed audit of your patient roster: eligibility gaps, PDGM comorbidity misses, billing code errors, and OIG/LEIE staff screening. Per-patient findings with recommended actions.

  • Patient roster CSV analysis
  • Eligibility verification against all payers
  • PDGM comorbidity capture review
  • Billing code validation (ICD-10, HCPCS)
  • OIG exclusion screening for all staff

P&P Gap Analysis

$3,000 - $5,000One-time assessment

Survey deficiencies cost $25K–$100K to fix after the fact

Review your current policies and procedures against CMS Conditions of Participation, state licensure requirements, and accreditation standards (ACHC, CHAP, Joint Commission).

  • Gap analysis against CMS CoPs
  • State-specific requirements review
  • Accreditation standards mapping
  • Prioritized remediation plan
  • Deficiency risk assessment

P&P Manual Development

$8,000 - $20,000Complete manual, 4-12 weeks

Decertification costs agencies $500K+/yr in lost Medicare revenue

Complete customized policy manual (80-150 policies) tailored to your agency's operations, service area, EHR system, payer mix, and staffing model. Not a template — built for you.

  • 80-150 customized policies
  • Procedure guides and forms
  • Job descriptions and competencies
  • QAPI program framework included
  • Compliance program (OIG 7 elements)

Survey Readiness

$5,000 - $15,000Mock survey + remediation

Plan of correction costs $25K–$75K — a mock survey finds it first

Simulated survey experience covering clinical records, staff interviews, policy review, and environmental assessment. Detailed findings report with plan of correction templates.

  • Mock survey (1-3 day engagement)
  • Clinical record review
  • Staff interview preparation
  • Remediation plan with priorities
  • Plan of correction templates

QAPI Program Setup

$5,000 - $12,000Program design + first PIP

CMS-required — non-compliance risks citations and decertification

Design your Quality Assessment and Performance Improvement program using real audit data. Includes QAPI plan, Performance Improvement Projects (PIPs), and data collection framework.

  • QAPI plan aligned with CMS requirements
  • Performance Improvement Projects (PIPs)
  • Data collection and analysis framework
  • Governing body reporting templates
  • Uses your audit data as the foundation

Ongoing Monitoring

$249 - $699/moContinuous automated monitoring

One caught lapse/mo saves ~$3,200 — pays for itself in week 1

Continuous eligibility verification, billing code validation, and PDGM optimization via the ClientCare platform. Automated alerts when coverage lapses or coding gaps are detected.

  • Weekly eligibility checks against all payers
  • Automated billing code validation
  • PDGM comorbidity capture monitoring
  • OIG/LEIE staff screening (included)
  • Dashboard with risk tickets and alerts

Manage billing for multiple agencies? All services available on a per-agency basis. Partner program →

HIPAA Compliance Services

No official HIPAA certification exists. What matters is documented policies, regular risk assessments, and a program that can withstand an OCR audit. We build that for you.

Most Popular

HIPAA Compliance Audit

$2,500 - $5,000One-time assessment, 2–3 weeks

Average HIPAA breach costs $400K+ — the audit costs 1% of that

Structured gap assessment based on the HHS/OCR Security Risk Assessment framework. Covers Privacy Rule, Security Rule, and Breach Notification Rule. You get a branded report with your compliance score, risk register, and remediation roadmap.

  • Administrative, Physical & Technical Safeguard review
  • Policy gap check against 10+ required HIPAA policies
  • Risk register with likelihood × impact scoring
  • Prioritized remediation roadmap with timeline
  • Branded PDF report ready for board or accreditor

HIPAA Compliance Program

$500 - $1,500/moOngoing compliance management

OCR penalties reach $2.1M/violation — ongoing compliance prevents them

Complete HIPAA compliance management: customized policy templates, annual Security Risk Assessment with year-over-year tracking, staff training with certificates, BAA management, and breach/incident response procedures.

  • 10+ customized HIPAA policy templates
  • Annual SRA with year-over-year tracking
  • Staff training modules with quiz & certificates
  • BAA tracking and renewal reminders
  • Breach risk assessment & notification tracking

Complete Compliance Bundle

$800 - $2,000/moClientCare + HIPAA, one invoice

One caught lapse + one avoided breach pays for a full year

Combines ClientCare’s Medicaid monitoring (eligibility, billing, PDGM) with the full HIPAA compliance program. One dashboard, one vendor, one invoice for complete regulatory coverage.

  • Everything in Ongoing Monitoring
  • Everything in HIPAA Compliance Program
  • Unified compliance dashboard
  • Combined reporting and analytics
  • Single point of contact for all compliance

About

I'm Matt Saucedo. I work with home health agencies on revenue recovery, HIPAA compliance, and policies & procedures. Most agencies I work with are leaving $30,000 to $50,000 a year on the table from billing gaps they don't know about — and most are running compliance programs that wouldn't survive an OCR audit. I help them fix both.

Frequently Asked Questions

What do I need to send you for the free gap analysis?

Two files: (1) your billing or aging report for the last quarter, and (2) your payment summary or deposit report for the same period. Both can be exported from your EHR (WellSky, Axxess, HCHB, etc.) as CSV or Excel. If you're not sure how to export them, I'll walk you through it.

Is this HIPAA compliant?

Yes. We sign a Business Associate Agreement (BAA) before you send any data containing patient information. All data is encrypted in transit and at rest. We follow HHS guidelines under 45 CFR 164.504(e).

What happens after the free gap analysis?

I walk you through the findings on a call. If the numbers make sense and you want to dig deeper, we can do a full Revenue Recovery Audit ($1,500-$3,000) that identifies specific patients, claims, and coding opportunities. But there's no obligation — the gap analysis stands on its own.

Do I need to install any software?

No. For the gap analysis and revenue recovery audit, you send me files and I send you a report. No software to install, no accounts to create, no training required. If you later want ongoing automated monitoring, we have a platform for that — but it's entirely optional.

How long does each service take?

The free gap analysis takes 48 hours. Revenue Recovery Audits take 48-72 hours. P&P work ranges from 1-12 weeks depending on scope. Survey readiness engagements are typically 2-4 weeks. We'll give you a clear timeline before starting any engagement.

What size agencies do you work with?

Primarily agencies with 50-500 patients billing Medicare and/or Medicaid. The revenue gap tends to be largest at agencies doing 100+ episodes per year, but we've found significant gaps at smaller agencies too.

What does a HIPAA compliance audit cover?

The audit follows the HHS/OCR Security Risk Assessment framework, covering all five HIPAA requirement areas: Administrative Safeguards (workforce security, training, contingency plans), Physical Safeguards (facility access, device controls), Technical Safeguards (access control, encryption, audit controls), Organizational Requirements (BAAs), and Privacy Rule requirements (patient rights, minimum necessary standard). You get a branded report with a compliance score, gap analysis, risk register, and remediation roadmap.

Do I need a certification to be HIPAA compliant?

No. There is no official government-issued HIPAA certification. The industry runs on third-party training certificates and demonstrated compliance. What matters is having documented policies, conducting regular risk assessments, training your staff, and maintaining a program that can withstand an OCR audit.

What are the penalties for HIPAA violations?

OCR collected over $15 million in HIPAA violation settlements in 2023. Individual penalties can reach $2.1 million per violation category per year. Beyond fines, a breach triggers mandatory notification requirements, potential lawsuits, and reputational damage. Most violations stem from not conducting regular Security Risk Assessments.

Ready to Get Started?

Free revenue gap analysis or HIPAA compliance audit. Pick the one that fits.

Or email me directly: matt@clientcare.pro