Home Health Billing Cash Flow
Your nurses finish their visits and your team bills the period, but Medicare and Humana sit on the money while the Request for Anticipated Payment you once relied on is gone.
Where your cash goes under PDGM, and how Copay closes the gap.
Care runs across a 30-day period
Your clinicians deliver scheduled nursing and therapy visits throughout the PDGM period.
30-day payment period
9 visitsYou bill at the end of the period
Your team submits the claim through your existing software, exactly as you do today.
Claim G0162
Humana · $182.60
Medicare and Humana pay weeks later
With the Request for Anticipated Payment gone, the cash for each period lands long after the work.
Copay pays the next business day
Copay purchases the eligible claim and deposits the capital the next business day, by ACH.
Deposit from Copay
ACH · Next business day
The home health codes Copay purchases.
Copay prices each claim individually at the service line, using how that specific code performs with your payer, rather than a blended portfolio average.
Every eligible home health code is funded the next business day.
Physician certification of a home health plan of care
PurchasedPhysician supervision of home health care requiring complex and multidisciplinary care modalities
PurchasedSkilled services of a registered nurse for management and evaluation of the plan of care, each 15 minutes
PurchasedCapital that fits the way agencies actually run.
Weekly payroll
Pay field clinicians every week.
Visiting nurses, aides, and therapists are paid weekly while each PDGM period is still adjudicating. Copay covers the eligible claims behind that payroll.
A narrow lien
A lien on the claims, not your agency.
Copay files a UCC-1 on the purchased receivables only. Your equipment, real estate, and other receivables are never pledged.
Non-recourse
A denied claim is our risk, not yours.
Non-recourse means a denied eligible claim is Copay's loss. If a purchased home health claim is denied after the fact, your capital is not clawed back.
Home health billing, answered.
No. Copay is not a loan, not factoring, and not a merchant cash advance. Copay purchases your eligible home health claims outright and deposits funds the next business day, with no debt and no repayment schedule.
Under the Patient-Driven Groupings Model, home health is paid in 30-day periods, and the elimination of the Request for Anticipated Payment removed the upfront cash agencies once relied on. Copay purchases your eligible claims and funds them the next business day, so you are not waiting weeks on each period to close.
Home health revenue runs heavily through Medicare and Medicare Advantage plans such as Humana, alongside Medicaid managed care. Copay purchases eligible claims billed to those payers, so the next-business-day deposit covers the bulk of your agency's volume.
Copay files a UCC-1 on the purchased receivables only, not a blanket lien on your business assets. Because Copay buys specific claims outright, your equipment, real estate, and other receivables are never pledged, unlike recourse factoring arrangements.
Non-recourse means a denied eligible claim is Copay's loss, not yours. If an eligible purchased home health claim is denied or downcoded after the fact, Copay absorbs the loss with no clawbacks against your agency.
From submitted claim to funded account.
While insurance takes 30 to 90 days, Copay moves in one.
Step 01 · Submit
You submit your claims as normal
Nothing changes about how your billing team works.
Claim #18473
DOS 02/04/24
Skilled services of a registered nurse for management and evaluation of the plan of care, each 15 minutes
Step 02 · Verify & Price
We verify and price in real time
Copay checks payor history and prices the claim at the CPT level.
Underwriting in progress
Step 03 · Approved
Advance approved
Capital is approved and scheduled for next business day deposit.
Advance Approved
$5,200
Net advance
Step 04 · Funded
Capital in your account
While the payor takes 30 to 90 days, you already have your capital.
Your account
$0
Available balance
Copay reconciles automatically when the payor pays. You do nothing.
Get paid on your home health claims the next business day.
Copay purchases your eligible home health claims under PDGM. No loans, no personal guarantee, no workflow change.