AI Automation for Home Health & Hospice Agencies

Home health referrals arrive from hospitals, physicians, and discharge planners via fax, phone, and portal — each with different formats and information completeness. Staff manually enter demographics, insurance, clinical information, and physician orders. A single referral takes 30-45 minutes to process, and missed referrals mean lost patients.

Scheduling home health visits requires matching clinician skills, patient needs, geographic proximity, and availability — across a service area that may span hundreds of square miles. Poor route optimization wastes clinician time on driving instead of patient care.

OASIS (Outcome and Assessment Information Set) assessments are required for every Medicare home health patient at admission, recertification, and discharge. Each assessment has 100+ items. Clinicians spend more time documenting than providing care — and incomplete OASIS assessments trigger payment adjustments.

Home health billing under PDGM (Patient-Driven Groupings Model) requires accurate OASIS scoring, proper diagnosis coding, and timely claims submission. Medicare conditions of participation add face-to-face encounter documentation, plan of care signatures, and recertification requirements. Errors at any step delay or prevent payment.

Care plans involve physicians, nurses, therapists, aides, and family caregivers — all working in different locations. Medication changes, new orders, and schedule adjustments must be communicated to every team member in real time. Manual coordination via phone and fax creates delays and errors.