Medical Billing and RCM

Service Scope & Methodology

Four Pillars delivers end-to-end medical billing engineered specifically for the complexities of home health and hospice reimbursement. From submitting Notice of Admission (NOA) within CMS’s strict 5-day window to scrubbing and releasing final End of Episode (EOE) claims, our experienced billing specialists maximize cash flow. We aggressively work aged accounts receivable, resolve claim rejections within 24 hours, post ERAs accurately, and maintain Days Sales Outstanding (DSO) under 32 days.

Key Scope of Work & Clinical Deliverables

• 01

  NOA & RAP 5-Day CMS Mandate Submission

  Guaranteed timely submission of Notice of Admission (NOA) within 5 calendar days of Start of Care to prevent non-timely submission penalties.

• 02

  Final Claim (EOE) Scrubbing & Transmission

  Multi-tier claim scrubbing verifying billable visits, physician signatures, OASIS match, and secondary payor primary rules.

• 03

  Electronic Remittance Advice (ERA) Cash Posting

  Daily electronic 835 payment posting, contractual allowance reconciliation, and line-item adjustment tracking.

• 04

  Denial Management & Rapid Remediation

  Immediate investigation of claim rejections (RTP), clearinghouse edits, and payor denials with rapid rebilling within 24 hours.

• 05

  Aged A/R Recovery (>60, >90, >120 Days)

  Systematic audit and recovery of unresolved outstanding claims, clearing historic backlogs and unlocking trapped revenue.

• 06

  Executive Financial & KPI Reporting

  Monthly executive dashboards detailing DSO, clean claim rates, cash collection velocity, and payor reimbursement yields.

Supported Electronic Health Records (EHRs)

Our teams work natively inside your agency's existing EHR environment using secure, direct-access credentials with zero disruption to field clinicians.

KanTimeAxxessDevero (MyUnity)CompassusEpicHCHB (Homecare Homebase)MatrixCare (Brightree)MEDITECHNetsmartWellSky (Kinnser)HealthWyse