Meet Hospice Engine: The EMR and Billing Team Built Only for Hospice

If you run a hospice agency in 2026, you are juggling more than ever — the new HOPE assessment, an aggressive CMS enforcement climate, payment suspensions in California and beyond, and the everyday math of keeping your AR clean enough to make payroll. Hospice Engine exists to take a big piece of that load off your desk. Here is what we do, who we serve, and how we are different from generic healthcare software.

What Is Hospice Engine?

Hospice Engine is a hospice-only EMR and billing service that has supported hospice agencies across the United States since 2012. We are not a home-health platform with a hospice module bolted on. We are not a generic medical billing company that took on a few hospice clients. Every line of our software, and every member of our billing team, is dedicated to one thing: hospice.

That focus matters. Hospice has its own benefit periods, its own Notice of Election rules, its own Room and Board billing arrangements, its own IDG cadence, and now its own HOPE assessment. A generic EMR or a generic biller will get you 80% of the way. The remaining 20% is where revenue gets lost and surveys get failed.

What We Do (In Plain English)

Our services fall into three buckets. Most agencies use a combination — pick the mix that fits where you are.

1. Hospice EMR Software

Our EMR software is built around the way hospice nurses, social workers, chaplains, and aides actually work. It runs in the browser on any device. The clinical side covers:

• HOPE assessment — fully compliant with the October 2025 CMS requirements that replaced the Hospice Item Set (HIS).
• Customizable clinical forms for every discipline — nursing visits, social work, spiritual care, aide notes, bereavement.
• Secure digital signatures with a unique PIN per clinician.
• Electronic orders with QAPI approval workflow — orders are reviewed for quality before they hit the physician's inbox.
• Electronic IDG meetings that auto-group patients by what actually needs discussion: recerts, level-of-care changes, DNR updates, and more.
• Integrated eligibility verification so you stop chasing Medicare A/B status by hand.

2. Hospice Billing Services

Our billing team is the part of Hospice Engine that pays for itself fastest. We manage the entire revenue cycle:

• Notices of Election submitted and monitored daily.
• Monthly claims submitted on the 1st.
• Daily follow-up on rejections, denials, and underpayments.
• Retroactive eligibility and Medicare Secondary Payer (MSP) claims handled correctly the first time.
• Room and Board billing for skilled nursing facility partners.
• Appeals on improperly denied claims — we keep going until they are paid or formally denied with cause.
• End-of-month AR aging reports so you always know where the money is.

And here is the part most billers do not do: when you onboard, our team performs a historical claims review. We look backward at your old claims and payments to find money your previous biller missed, wrote off, or never appealed. One agency recovered over $85,000 in claims they had given up on. That review is part of onboarding — not an add-on.

3. PPEO Consulting

CMS's Provisional Period of Enhanced Oversight (PPEO) has resulted in roughly 22% of reviewed hospices losing their Medicare enrollment. If you are a new hospice, a reactivating hospice, or a change-of-ownership hospice in Arizona, California, Nevada, Texas, Georgia, or Ohio, you are in scope — and the cost of going in unprepared is your enrollment.

Our PPEO consulting covers documentation audits, ADR response strategy, appeal preparation, and staff training, billed at $300/hour. We have walked many hospices through PPEO successfully and we know what the reviewers are actually looking for.

How We Are Different

There are other hospice EMR systems — HospiceMD, Kinnser, Consolo, WellSky, MatrixCare, KanTime, Netsmart. We have nothing against any of them. In fact, our billing team works inside most of them every day. Here is what sets Hospice Engine apart:

• Hospice-only. Not a side feature of a home-health platform. Every release, every form update, every billing rule we encode is about hospice.
• An in-house billing team, not a referral partner. When you call us about a claim, you reach the same team that submitted it. There is no third-party finger-pointing.
• Historical AR recovery is standard, not extra. Most billing companies start the clock the day they take over. We look at what came before, too.
• You can keep your current EMR. See our pages for HospiceMD, Kinnser, Consolo, WellSky, MatrixCare, Netsmart, and KanTime for details on how billing-only engagements work.
• Thirteen-plus years, fifty states. We have seen the field through ICD-10, the HIS, the HIS retirement, HOPE, the 2025 California suspensions, and the May 2026 national enrollment moratorium. We are still here.

Who Hospice Engine Is For

Most of the agencies we work with fall into one of these patterns:

• The new hospice. You just got your CHAP, ACHC, or Joint Commission accreditation and you need EMR and billing from day one. See EMR during accreditation.
• The growing hospice with billing pain. Your clinical side is solid but your AR is aging, your NOEs are late, or your last biller went quiet on appeals. See billing-only services.
• The established hospice ready to switch EMRs. Your current system was not built for hospice and you are tired of workarounds. See EMR without billing.
• The hospice that wants both, integrated. One platform, one team, one bill. See EMR plus billing.
• The hospice in a PPEO state, or facing reactivation or change of ownership. You need eyes on your documentation before the reviewer's eyes are on it.

What Our Clients Tell Us

"When Hospice Engine took over our billing, they found over $85,000 in old claims we had written off. Their team recovered every penny. I couldn't believe the money we were leaving on the table."
— Maria S., Administrator, Central Valley Hospice

"We switched from another EMR and the onboarding was seamless. But the real surprise was when their billing team found $42,000 in historical claims our previous biller had missed."
— Linda K., CEO, Pacific Northwest Hospice

How to Get Started

Getting started is straightforward. Most agencies are fully transitioned in two to three weeks — we have written a full billing onboarding timeline if you want the day-by-day breakdown.

The short version:

1. Schedule a conversation. Fifteen minutes is usually enough to figure out whether we are a fit.
2. We scope your needs. EMR, billing, PPEO, or some combination — and what your historical AR looks like.
3. We onboard. EMR access in a day or two. Medicare Part A access in about seven business days. NOE submission begins shortly after. Full monthly claims submission starts on the 1st of the following month.
4. We start recovering. Historical AR work begins the moment we have access — not after the rest of onboarding finishes.