Medicare Claims: 5 Common Issues That Drive Denials and Delays

In home health and hospice, Medicare claim accuracy is crucial for an agency to be protected from preventable delays, denials and audit exposure.

Learn about the five most common Medicare claim issues we see across post-acute providers. Some are simple data errors that trigger quick rejections and slow down cash flow. While these may feel minor, they delay revenue and increase administrative rework.

The bigger risk lies in clinical and billing accuracy. Incorrect level-of-care billing — whether overstating or understating services provided — can create audit vulnerability and repayment risk. Medicare expects the level of care billed to match the care delivered, and discrepancies in either direction are still considered errors. Proper use of the PM (post-mortem) modifier is another critical detail. Care provided after a patient’s passing must be clearly designated to prevent overpayments and future recoupments.

Each of these issues directly impacts your denial rate, compliance profile and revenue cycle performance.

With specialized Medicare expertise, intelligent workflow tools and coding precision, Advanced RevCycle helps agencies submit clean claims the first time — reducing delays, strengthening compliance and accelerating cash flow. Watch the full video to learn where agencies most often get tripped up, and how to prevent it.