Cash Flow

Bridging the gap between billing and reimbursement

The short version

You deliver care today but get paid weeks later — after authorizations, claim submission, edits, and payer processing. The fix isn’t working harder; it’s shortening each step, forecasting the gap, and keeping a cash buffer so a slow payer never becomes a missed payroll.

Why the gap exists

Home care revenue moves through a long pipeline: authorization, service delivery, documentation, claim submission, payer adjudication, and finally payment. Each handoff adds days. Medicaid, managed-care organizations (MCOs), and waiver programs each pay on their own clock, and a single missing field can send a claim back to the start.

The result is structural: your largest recurring cost — payroll — is due weekly or biweekly, while the revenue that funds it lands 2–6 weeks after the visit. That timing mismatch, not profitability, is what sinks most growing agencies.

Shorten the pipeline before you finance it

  • Bill daily, not monthly — the clock to payment starts when the claim is accepted, so submit clean claims as soon as visits are documented.
  • Scrub claims up front. Verify eligibility and authorization before the visit; the cheapest denial is the one that never happens.
  • Work your aging report weekly. Anything past the payer’s normal turnaround gets a follow-up call that week, not next month.
  • Track your denial reasons. Three or four issues usually cause most rejections — fix the source and your paid-first-time rate climbs.

Forecast the gap and hold a buffer

Build a rolling 13-week cash forecast: expected collections by payer against payroll and fixed costs, week by week. It turns “are we okay?” into a number you can see coming.

Then size a cash reserve to the gap — many agencies target enough operating cash to cover the average days between visit and payment (often 4–8 weeks of payroll). A line of credit can bridge a spike, but a buffer you own beats interest you pay.

Let NavSuccess handle itWe bill daily, work the aging report, and give you a rolling cash forecast so payroll is never a surprise.

NavSuccess does this for home care & healthcare agencies — see Cash-flow & forecasting.

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Common questions

How much cash reserve should a home care agency keep?

Enough to cover the typical lag between delivering care and getting paid — often 4–8 weeks of payroll plus fixed costs. The right number comes from your own days-to-payment by payer.

Is a line of credit a good idea for cash-flow gaps?

It’s a useful shock absorber for a temporary spike, but it shouldn’t fund a permanent, predictable gap. If you draw on it every month, the real fix is faster billing and a bigger buffer.

What’s the single biggest lever on cash flow?

Getting claims paid the first time. Every denial resets the payment clock and adds weeks — clean, timely claims do more for cash than any financing.

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