What to Expect: Your Hospice Billing Onboarding Timeline

One of the most common questions we hear from hospice agencies considering third-party billing is: "How long does it take to get started?" The good news is that the process is straightforward, and we can typically have your billing fully transitioned in just a few weeks.

Whether you're switching from an in-house biller, moving from another billing company, or starting a new hospice and need billing from day one, here's exactly what the onboarding process looks like when you partner with Hospice Engine.

The Onboarding Timeline

Step 1: EMR System Access

The first thing we need is login access to your EMR system. We'll provide you with a worksheet that details exactly how to create the user accounts our billing team needs.

This step is in your hands, so the faster you set up access, the faster we can get moving. Most agencies complete this within a day or two.

• We provide a detailed worksheet with user creation instructions
• You create the accounts in your EMR system
• We verify access and confirm we can see what we need

We work with all major hospice EMR systems including HospiceMD, Kinnser, Consolo, WellSky, MatrixCare, Netsmart, KanTime, and more. You don't need to switch your EMR to use our billing services.

Step 2: Medicare Part A Access (Approximately 7 Business Days)

We'll need access to Medicare Part A billing systems to submit claims on your behalf. This process typically takes about 7 business days to complete.

During this time, we handle the administrative work to get authorized as your billing agent. This is a standard Medicare process and we manage it from start to finish.

Step 3: Patient Import and Historical Claims Review

While Medicare access is being established, we don't sit idle. Our team immediately begins:

• Importing patient information — We pull your current patient census and service-level history from your EMR system
• Reviewing historical claims and payments — We go through your past claims to identify any missing payments, underpayments, or unpaid balances

This historical review is where many agencies get a pleasant surprise. When we dig into your AR, we frequently find money that was left on the table—claims that were denied and never appealed, payments that were short, or claims that were never submitted at all.

If we find outstanding balances, we start working on them right away. We don't wait until the full onboarding is complete. Recovery starts the moment we identify it.

Step 4: NOE Submission (Approximately 7 Days After Medicare Approval)

Once Medicare grants us access, we begin submitting Notices of Election (NOE) on your behalf as soon as Medicare permits—typically about 7 days after approval.

Timely NOE submission is critical. Medicare requires that NOEs be filed within 5 calendar days of the patient's admission to hospice. Late NOEs result in reduced reimbursement for the days between admission and when the NOE is filed. Our team monitors this daily to ensure nothing slips through.

Step 5: Monthly Claims Submission

We begin submitting your monthly claims on the 1st of the month following Medicare's approval. From this point forward, our team handles your entire revenue cycle:

• Monthly claim submission on the 1st
• Daily monitoring of claim status and rejections
• Follow-up on any denied or rejected claims
• Appeals for improperly denied claims
• End-of-month AR aging reports
• Ongoing eligibility verification

The Full Picture

Here's a quick summary of the typical timeline:

• Day 1: You provide EMR access using our worksheet
• Days 1–7: Medicare Part A access is established; we begin importing patient data and reviewing historical claims
• Days 7–14: NOE submission begins; historical AR recovery work is underway
• 1st of the following month: Full monthly claims submission begins

In most cases, the entire transition takes 2–3 weeks from the day you provide EMR access to the day we're fully managing your billing.

What Makes Our Onboarding Different

A lot of billing companies will take your account and start submitting claims going forward. That's the easy part. What sets our onboarding apart is what happens in the background:

• We look backward, not just forward — Our historical claims review frequently recovers thousands of dollars that previous billers missed. One agency recovered over $85,000 in claims they had written off.
• Recovery starts immediately — We don't wait for the full onboarding to complete before chasing down outstanding balances.
• We work with your EMR — No need to switch systems. We integrate with the tools you already use.
• Dedicated team — You get real hospice billing experts, not a generic medical billing company learning hospice on your dime.

Ready to Get Started?

The onboarding process is designed to be as smooth as possible for your team. We handle the heavy lifting so you can stay focused on patient care.

If you've been thinking about outsourcing your hospice billing—or if you're not happy with your current billing company—we'd love to show you what a dedicated hospice billing team can do for your revenue.