Eligibility Services

With more payer options emerging in hospice care—including new Medicare Advantage plans and pilot programs—patients are switching payers more frequently than ever before. While this shift creates more opportunities for patient choice, it also introduces serious challenges for hospice providers, particularly when it comes to billing and reimbursement timelines.

Unlike other care settings, hospice bills in arrears—you provide care for 30 days, meet all documentation requirements and then submit the claim. But what happens if the patient changed insurance plans mid-cycle, and no one caught it?

You may not realize the coverage has changed until the claim is denied—leaving you 45 days behind and without payment for care already delivered.

To help hospice agencies stay ahead of these changes, Advanced Revenue Cycle Management now offers eligibility and authorization services as part of our expanded support solutions. Our team helps monitor payer changes in real-time, so you’re alerted to any updates before it’s too late. This proactive approach allows you to confirm:

• If the patient is still covered under their existing plan
• If authorization is needed under a new payer
• If any readmission or documentation updates are required

By catching changes early, your agency avoids missed NOAs, claim rejections and unnecessary financial loss.

We know how difficult it is to juggle day-to-day patient care with backend billing demands—especially in hospice, where timing is everything. That’s why we’re here to help you take control of eligibility and authorizations with reliable, efficient support.

Want to learn more about how we can help protect your revenue? Contact us today to explore our eligibility services and other support solutions.