New Hospice on MatrixCare? How Billing Works During Accreditation (and Why It Costs Just $50/Month)

If you're standing up a brand-new hospice on MatrixCare, you're in the accreditation phase right now — test patients, surveys, and a Medicare number that hasn't come through yet. There's no real billing happening, so most billing companies aren't interested in talking to you until you're live. We do it the other way around. We get involved during accreditation, bill directly from your MatrixCare application once you're ready, and charge just $50 a month while you're getting set up.

Hospice Engine has specialized in hospice billing since 2012, and our team's hospice experience goes back further than that — including years running billing for an operator with multiple hospices across several West Coast states. Hospice is what we do. We also bill home health, so if you operate an associated home health agency, that's covered under the same roof.

Here's exactly how we work with new MatrixCare hospices, from accreditation through your first real billing cycle — and what it costs at each stage.

We Start Before You Can Bill

You give us a login to MatrixCare during your accreditation phase. There's no billing yet — but that's exactly when a lot of avoidable mistakes get made, and it's when having someone who has done this hundreds of times matters most.

During accreditation we help you with the things that trip up new operators:

• The test-patient trap. During accreditation you'll admit test patients. Once you're accredited, those patients have to be readmitted to bill correctly. New owners often don't know that, and getting it wrong costs revenue. We make sure it's handled.
• Medicare timing and regulations. When you can start billing, when to readmit, how the rules and timeframes actually work — we answer the questions as they come up, by email or phone.
• Setting you up to collect everything you're owed. If you or your owner are new to hospice, there are nuances in the patient lifecycle that decide whether you capture all your revenue or leave some behind. That's our job to flag.

Eligibility Checks — Even Before You're Accredited

Here's something a brand-new hospice usually can't do on its own yet: pull insurance eligibility. You don't have payer access during accreditation. We already do, through the agencies we bill for.

So when a referral comes in — including your test patients — send us the patient's demographic details and we'll tell you:

• Whether they're eligible and who their payer will be
• How long they've already been on hospice with prior providers
• Any patients who need authorizations, plus any special cases to watch

That prior-hospice history matters more than new operators expect — where a patient sits in their hospice lifecycle affects benefit periods and billing down the line. Knowing it up front keeps you out of trouble later.

Once You're Billing: The Monthly Rhythm

Daily NOE Monitoring

We monitor your admissions every day and submit the Notice of Election (NOE) that Medicare requires within 5 days of admission. If a new patient is getting close to that deadline or anything's missing, we alert you by email or phone before it becomes a problem.

Billing on the 1st — After a Quick Check-In

We bill on the 1st of the month unless you tell us otherwise. A few days before, we email you for any special details: discharges that haven't been entered yet, or special levels of care (like continuous care or GIP) that pay at a higher rate and need to be captured. If everything's clear, we're good to go. After we bill, you get an email with your billing stats so you know your revenue right away.

Cash-Flow Forecasting

One thing that sets us apart: we tell you when your Medicare payments are coming. For a new agency trying to make payroll and pay vendors on a schedule, knowing when the dollars hit your bank account is invaluable. You're not guessing.

Medicare Cap Tracking — All Year, Not Just at Report Time

This is a big one for new owners. Hospices have an annual Medicare cap, and if you're not watching it, a cap overpayment can blindside you when the report comes due — meaning you owe Medicare money back. Every month we send you a snapshot of where you stand against your cap, so you can manage admissions across the year and avoid a year-end surprise. Caught early, it's manageable. Caught at report time, it can be devastating to a young agency.

Simple, Honest Pricing

Our pricing is built so a new hospice isn't paying for billing it can't do yet:

During Accreditation: Flat $50/Month

While you're getting set up with Medicare and going through accreditation — before any billing is possible — it's a flat $50 per month. That gets you eligibility requests and direct access to us for questions about the accreditation process, Medicare regulations, and the timeframes for when you'll be approved to start billing. You're partnered with an experienced billing team from day one for the cost of a couple lunches.

Once We're Billing: $3 Per Patient, Per Day

When real billing begins, our rate is a flat $3 per patient per day, with a minimum.

• One patient hits our minimum tier of $250/month. (For perspective, a single hospice patient is typically about $6,000–$7,000/month in Medicare revenue — so the billing fee is a small fraction of it.)
• Above that, it's simply $3 per patient per day. Most hospices hover somewhere around 15 to 50 patients, and at that range you're just paying the per-day rate — which lands well below what our competitors charge.
• Large census? The pricing caps out, so it won't keep climbing indefinitely. We're happy to walk you through the exact numbers for your expected census.

Setup Takes About 7 Days

Getting started is quick. We email you a one-page agency setup worksheet that asks for the basics — your approved agency contacts, business name and address, tax ID, and the like. Fill it in, give us a MatrixCare login, and we can hit the ground running. From there, setup typically takes about 7 days.

You can read more about how we work inside MatrixCare on our MatrixCare billing services page, or see the full onboarding timeline for what the first few weeks look like.