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Plutus Health combines hospice revenue cycle management expertise, payer intelligence, and OlympusAI to manage Medicare billing, NOE compliance, sequential claims, denials, and A/R before revenue gets stuck downstream.
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Medicare generally requires the Notice of Election (NOE) within five calendar days of the hospice election. Late filing can leave the hospice financially liable for affected days.
Hospice claims must be processed in sequence. A rejected or unresolved claim can hold up subsequent billing, delaying reimbursement and increasing A/R.
RHC, CHC, IRC, and GIP each carry specific billing requirements. Revenue codes, Q-codes, dates, and documentation must align with the billed level of care.
Hospices must determine whether services, medications, and supplies are related to the terminal diagnosis. Incorrect relatedness decisions can lead to denials, compliance risk, and payment recoupments.
End-to-end Medicare hospice billing across benefit periods, levels of care, claim submission, payment posting, and follow-up.
Manage Notice of Election (NOE) and Notice of Termination/Revocation (NOTR) submissions and associated Medicare billing timelines.
Track claim sequencing and resolve billing interruptions before they hold up subsequent Medicare claims.
Validate levels of care, revenue codes, Q-codes, dates of service, and required claim information before submission.
Identify denial root causes, manage appeals and follow-up, and work aging accounts to accelerate outstanding revenue.
OlympusAI brings Agentic AI into hospice revenue cycle management, identifying billing risk, validating claims, and surfacing exceptions for experienced RCM specialists before downstream revenue problems.
Medicare requires the NOE within 5 calendar days of the hospice election. Late filing can put reimbursement for affected days at risk unless an exception applies.
Medicare hospice uses two 90-day benefit periods followed by unlimited 60-day periods, subject to continued eligibility and recertification requirements.
The Medicare hospice aggregate cap limits total payments to a hospice based on the number of Medicare beneficiaries served during the cap period.
The Hospice Outcomes and Patient Evaluation (HOPE) replaced HIS beginning October 1, 2025, introducing standardized assessments during hospice care.
Outsourcing provides specialized support for Medicare hospice billing, denials, compliance, and A/R recovery without adding pressure to an internal billing team.
We review claims, denials, A/R, payer performance, and billing workflows to identify revenue leakage and prioritize improvement opportunities.
We diagnose your current state, baseline the leakage, and show you the to-be model.
The RCM Assessment is free. The findings are yours to keep, regardless of whether we work together.
Board-ready findings memo, quantified leakage estimate, transformation roadmap.