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The Home Health & Hospice Profitability Podcast

The Home Health & Hospice Profitability Podcast

By: Doug Walters
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The Home Health and Hospice Profitability Podcast helps agency owners and leaders better understand the financial, operational, and regulatory issues that can directly impact the health of their business.

Hosted by Doug Walters, each episode breaks down complex topics affecting home health and hospice providers, from Medicare reimbursement and hospice cap exposure to compliance, financial reporting, acquisitions, and long-term profitability.

Doug is joined by experienced professionals who work directly with agencies every day, bringing practical insight into the challenges owners face and the decisions that can have significant financial consequences.

Whether you are launching an agency, managing a growing organization, or preparing for your next stage of growth, The Home Health and Hospice Profitability Podcast gives you actionable information to help protect your business, improve performance, and make more informed decisions.

© 2026 The Home Health & Hospice Profitability Podcast Economics
Episodes
  • How One Small Denial Exposed a $210,000 Problem

    How One Small Denial Exposed a $210,000 Problem
    29 Oct 2026
    What if your home health agency was getting paid for its claims, but receiving less money than it should?That's exactly what happened to one agency that unknowingly missed approximately $210,000 in potential Medicaid reimbursement.And it all started with what appeared to be a small billing problem.In Episode 07, which is Part 3 of our revenue cycle management series on the Home Health and Hospice Profitability Podcast, Doug Walters sits down with Amanda Sheldon, Director of Revenue Cycle Management at Walters Billing Solutions, to discuss the hidden billing errors that can affect agency cash flow, profitability, and growth.Working a denial and fixing a denial are not the same thing.Getting a denied claim reprocessed may bring in payment, but unless you identify and correct the underlying problem, the same denial can continue happening month after month.Amanda explains why agencies need to look beyond individual claims and identify patterns, payer trends, and system setup errors that can lead to repeated reimbursement problems.In this episode, we discuss:- The difference between working a denial and fixing its root cause- Why recurring denials can create unnecessary billing expenses- How a small Medicaid denial uncovered approximately $210,000 in missed revenue- Why incorrect rates in an electronic medical record (EMR) can lead to underpayments- How billing units and rounding requirements affect reimbursement- Why timely filing limits can prevent agencies from recovering older claims- How an incorrect claim form can cause an agency to receive substantially less than its contracted reimbursement- What agencies should review when setting up payers and contracts- Why expected payments should be reconciled against actual payments- How monthly financial reviews and adjustment reports can reveal operational problems- Why agency owners should understand how to run and interpret their accounts receivable aging reports- How a hospice accumulated nearly $500,000 in unpaid room-and-board claimsThe $210,000 Medicaid billing problemAmanda shares how her team investigated a handful of Medicaid denials and discovered that an agency's billing system had not been updated to reflect a reimbursement rate increase.The agency had been submitting claims using outdated rates for nearly a year.Because those claims were being paid, the missing revenue wasn't appearing as an outstanding balance on the agency's aging report.Further investigation revealed issues with billing units and rounding requirements.The team identified approximately $210,000 in missed revenue across the affected period and recovered nearly $98,000. Much of the remaining amount was outside the payer's 180-day timely filing window.The nearly $500,000 hospice room-and-board problemIn another example, Amanda describes a hospice agency that had accumulated nearly half a million dollars in unpaid room-and-board claims.Incorrect claim setup, billing requirements, and insurance eligibility issues had prevented the agency from receiving payment.The agency's leadership hadn't fully understood the extent of the problem because they weren't reviewing the appropriate financial reports.Amanda explains how identifying the correct payer requirements and improving the billing process helped the agency begin receiving payments, with recovery efforts continuing on older claims.The biggest takeaway?A claim being marked as paid doesn't necessarily mean it was paid correctly.Home health and hospice agencies need reliable processes for reviewing payer contracts, reconciling expected reimbursement against actual payments, monitoring denials, and understanding their financial reports.Because when billing problems go unnoticed, they can affect far more than the billing department. They can influence staffing, cash flow, financial planning, and ultimately an agency's ability to serve patients.Subscribe to the Home Health and Hospice Profitability Podcast for more conversations about revenue cycle management, Medicare and Medicaid reimbursement, agency operations, billing, compliance, and profitability.Have questions about revenue cycle management?Contact Walters Billing Solutions at 727-322-5111 and ask for Amanda Sheldon at extension 226.Question: Does your agency regularly compare what it expects to receive from payers with what actually gets paid?Share your experience in the comments.#HomeHealth #Hospice #RevenueCycleManagement #HomeHealthBilling #HospiceBilling #MedicaidBilling #MedicareBilling #HealthcareFinance #AgencyProfitability #MedicalVISIT OUR WEBSITES:https://waltersaccounting.comhttps://waltersadvisors.comhttps://waltersbilling.com
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    24 min
  • Your Home Health Agency Is Losing Money Before Billing Even Starts

    Your Home Health Agency Is Losing Money Before Billing Even Starts
    22 Oct 2026

    Is your home health or hospice agency losing revenue because of billing problems that actually started somewhere else?

    When claims are denied, payments are delayed, or cash flow slows down, the billing department is often the first to get blamed. But the real problem may have started weeks or even months earlier.

    In Episode 06, which is Part 2 of our three-part Revenue Cycle Management series on the Home Health and Hospice Profitability Podcast, host Doug Walters welcomes back Amanda Sheldon, Director of Revenue Cycle Management, to discuss the blame game between departments and how poor communication can lead to costly revenue leaks.

    Amanda explains why revenue cycle management is a team effort involving marketing, intake, eligibility verification, clinical operations, documentation, orders tracking, and billing.

    When one department misses something, the financial consequences can ripple throughout the agency.

    In this episode, you'll learn:

    • Why billing teams often get blamed for problems they didn't create
    • How poor communication between departments leads to lost revenue
    • Why understanding the entire revenue cycle matters
    • How unpaid claims can accumulate even when an agency has cash in the bank
    • Why hospice sequential billing requirements can create months of delayed payments
    • How returned-to-provider (RTP) claims affect cash flow
    • Why clinical documentation and orders tracking are critical to reimbursement
    • How a Director of Nursing or clinical leader working in the field can create documentation backlogs
    • How marketing and intake decisions can result in avoidable claim denials
    • Why verifying insurance eligibility and network participation matters
    • How to analyze accounts receivable aging reports
    • Which revenue cycle KPIs agency owners should review weekly
    • How to identify the root causes of denials and prevent recurring problems

    Doug and Amanda also share real examples of agencies struggling with cash flow because of unresolved claims, incomplete documentation, and referrals accepted under insurance plans the agency wasn't contracted to serve.

    One hospice agency had claims sitting in returned-to-provider status for months, creating a chain reaction that delayed subsequent billing.

    Another home health agency struggled with cash flow because its clinical leadership was spending too much time seeing patients instead of completing the administrative work needed to move claims forward.

    These examples highlight an important lesson: revenue cycle management isn't just about submitting claims. It's about building processes that help every department do its part correctly.

    Amanda also explains why agencies should look beyond the amount billed versus the amount collected and focus on expected collectible revenue, outstanding accounts receivable, denial trends, and the time required to convert services into cash.

    The takeaway: if you want to improve your agency's cash flow, start by identifying where the revenue cycle is breaking down rather than simply blaming the billing team.

    Subscribe to the Home Health and Hospice Profitability Podcast for more conversations about revenue cycle management, Medicare reimbursement, agency profitability, financial operations, and the business of home health and hospice.

    This is Part 2 of our three-part Revenue Cycle Management series.

    What's the biggest revenue cycle challenge facing your agency: documentation delays, claim denials, eligibility issues, or communication between departments? Let us know in the comments.

    #HomeHealth #Hospice #RevenueCycleManagement #HomeHealthBilling #HospiceBilling #HealthcareRCM #MedicalBilling #ClaimsDenials #AccountsReceivable #HealthcareFinance #HomeHealthProfitability #HospiceProfitability #DougWalters

    VISIT OUR WEBSITES:

    https://waltersaccounting.com
    https://waltersadvisors.com
    https://waltersbilling.com
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    21 min
  • The 1099 Trap That Could Bankrupt Your Home Health Agency

    The 1099 Trap That Could Bankrupt Your Home Health Agency
    15 Oct 2026

    Are your 1099 nurses and caregivers actually independent contractors, or could they legally be considered employees?

    For home health and hospice agencies, getting worker classification wrong can create enormous financial and regulatory consequences.

    In episode 05 of the Home Health and Hospice Profitability Podcast, host Doug Walters breaks down the 1099 contractor trap and explains why arrangements that appear to save agencies money today can lead to years of unpaid overtime, back taxes, penalties, and potential Medicare compliance problems.

    Using a federal court case involving more than $9 million in damages, Doug explains how an independent contractor agreement, including provisions intended to protect the business, can actually become evidence against an agency.

    He also explores why simply issuing a 1099 or having someone sign a contractor agreement doesn't necessarily make that worker an independent contractor.

    In this episode:

    • Why 1099 contractors can appear cheaper than W-2 employees
    • How payroll taxes and overtime affect staffing costs
    • The $9 million worker misclassification case
    • Why independent contractor agreements may not protect your agency
    • How worker classification is evaluated
    • The importance of control, financial independence, and business relationships
    • Why uniforms, scheduling, training, and non-compete agreements can create problems
    • Special Medicare core services requirements for hospice agencies
    • The risks of using contractors for nursing, social work, and counseling
    • Why state independent contractor laws may not protect agencies from federal requirements
    • How worker classification enforcement and litigation can differ
    • IRS relief programs that may help eligible agencies correct past classification issues
    • Why staff productivity matters when comparing W-2 and contract labor costs
    • Practical steps for reviewing your current 1099 workforce

    Doug also shares a simple exercise agency owners can complete this week: review everyone paid as an individual 1099 contractor, evaluate how those workers actually operate within the business, and identify arrangements that may need further review.

    The takeaway is simple: just because a contractor arrangement has worked for years doesn't necessarily mean it's compliant.

    Understanding your exposure today may help prevent a much more expensive problem tomorrow.

    Subscribe to the Home Health and Hospice Profitability Podcast for more discussions about agency profitability, staffing, compliance, financial management, and the business challenges facing home health and hospice providers.

    This episode is for general educational purposes only and does not constitute legal, tax, or employment advice. Worker classification requirements vary by jurisdiction and circumstances. Consult qualified legal and tax professionals before making classification decisions.

    #HomeHealth #Hospice #1099vsW2 #IndependentContractor #WorkerMisclassification #HomeHealthAgency #HospiceAgency #HealthcareStaffing #HealthcareCompliance #AgencyProfitability #DougWalters

    VISIT OUR WEBSITES:

    https://waltersaccounting.com
    https://waltersadvisors.com
    https://waltersbilling.com
    Show more Show less
    22 min
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