Hospice agencies operate under a reimbursement model with requirements that differ from traditional medical practices. Medicare hospice billing involves per-diem reimbursement, four levels of care, patient election documentation, certification requirements, sequential monthly claims, and strict filing deadlines.

A missed Notice of Election (NOE), inaccurate level-of-care reporting, incomplete documentation, or unresolved claim rejection can affect reimbursement and create additional compliance work.

These challenges make choosing the right hospice medical billing company an important operational decision. An experienced hospice billing partner can help agencies manage claims, monitor eligibility, address denials, reconcile payments, and maintain consistent accounts receivable follow-up.

This guide compares six companies to consider in 2027. The list includes dedicated hospice billing providers and broader medical billing companies. It is an editorial shortlist based on publicly described services, not an independently verified ranking.

6 Best Hospice Medical Billing Companies in 2027

1. The Medicator’s

Best for: Medical billing, denial management, credentialing, and broader revenue cycle support, subject to confirming hospice-specific requirements.

The Medicator’s provides medical billing and revenue cycle management services for healthcare practices, specialty groups, and multi-location organizations. Its published services include medical billing, accounts receivable management, denial management, eligibility verification, provider credentialing, and billing audits.

Hospice agencies considering an external billing partner may want to evaluate these services when internal teams are experiencing claim backlogs, unresolved denials, payment posting delays, or administrative staffing limitations.

However, general medical billing capabilities do not automatically establish experience with Medicare hospice claims. Before selecting The Medicator’s for hospice billing, agencies should confirm its experience with NOE and NOTR processing, sequential institutional claims, the four levels of hospice care, Medicare hospice cap monitoring, and hospice-specific documentation requirements.

Services to discuss:

• Medical billing and claims management

• Revenue cycle management

• Denial management and appeals

• Accounts receivable follow-up

• Eligibility verification

• Provider credentialing and enrollment

• Medical billing audits

Website: The Medicator’s

2. MedCare MSO

Best for: Dedicated hospice billing and end-to-end hospice revenue cycle management.

MedCare MSO publishes a specialized hospice medical billing service designed around Medicare hospice reimbursement requirements. Its stated services cover eligibility verification, daily Notice of Election filing, sequential monthly claims, denial management, collections, and accounts receivable follow-up.

The company also describes workflows for UB-04 claims, Medicare Administrative Contractor coordination, hospice coding, documentation review, and aggregate cap monitoring.

Its hospice-specific service offering makes it a relevant option for agencies looking for a billing provider that focuses on the operational details of the Medicare hospice benefit.

Services include:

• Hospice eligibility verification

• Daily NOE and NOTR processing

• Hospice coding and claim submission

• Sequential monthly claim management

• Denial management and ADR support

• Payment posting and AR follow-up

• Medicare hospice cap monitoring

Website: MedCare MSO

3. Healthcare Provider Solutions (HPS)

Best for: U.S.-based hospice billing, compliance support, and revenue cycle oversight.

Healthcare Provider Solutions provides outsourced billing and collection services for home health and hospice organizations. Its published hospice services include daily NOE management, claim monitoring, denial follow-up, payer coordination, and billing compliance support.

HPS also describes its use of agency EMR systems, reporting tools, and processes for monitoring claim status and Medicare T-status issues.

For hospice agencies that want billing assistance alongside operational and compliance guidance, HPS is worth evaluating. Its broader home care and hospice consulting capabilities may also be relevant to organizations that need help reviewing billing processes and improving financial operations.

Services include:

• Hospice billing and collections

• Daily NOE and NOTR management

• Medicare claim monitoring

• Denial and ADR follow-up

• Billing compliance reviews

• Accounts receivable support

• Revenue cycle consulting

Website: Healthcare Provider Solutions

4. SimiTree

Best for: Hospice billing combined with post-acute healthcare consulting and revenue cycle support.

SimiTree provides specialized billing services for home health, hospice, and behavioral health organizations. Its published capabilities include outsourced billing, revenue cycle support, financial reporting, and consulting.

The company also offers its CLARITY reporting dashboard, which it describes as providing real-time visibility into financial performance. Its hospice and home health experience may be relevant to agencies that want support beyond routine claim submission.

Hospice providers should discuss the exact scope of billing services, including NOE processing, Medicare eligibility, claim sequencing, denial follow-up, and cap monitoring, before signing an agreement.

Services include:

• Hospice and home health billing

• Revenue cycle management

• Financial performance reporting

• Billing consulting and training

• AR and collections support

• Interim staffing and operational support

Website: SimiTree

5. BillingParadise

Best for: Outsourced billing support for hospice and home health organizations.

BillingParadise provides medical billing services across multiple healthcare specialties. Its published specialty information identifies home health and hospice billing among its service offerings.

The company describes support for hospice and home health billing, including hospice cap monitoring and CMS-related compliance workflows. Agencies considering this provider should evaluate its experience with institutional hospice claims and the specific requirements of their Medicare Administrative Contractor.

BillingParadise may be worth considering for organizations seeking outsourced billing capacity, particularly when internal teams need additional support with claim processing and administrative follow-up.

Services to evaluate:

• Hospice and home health billing

• Claim submission and processing

• Revenue cycle support

• Hospice cap monitoring

• Denial follow-up

• Accounts receivable management

Website: BillingParadise

6. Transcure

Best for: General medical billing and revenue cycle support requiring hospice-specific capability verification.

Transcure provides medical billing, coding, accounts receivable management, and credentialing services across healthcare specialties.

These broader capabilities may be relevant to hospice organizations looking for additional administrative and revenue cycle support. However, a general medical billing portfolio should not be treated as proof of dedicated hospice billing expertise.

Before considering Transcure for a hospice engagement, agencies should request evidence of experience with institutional UB-04 claims, Medicare hospice election notices, per-diem reimbursement, levels of care, sequential billing, and hospice cap reporting.

Services to evaluate:

• Medical billing and coding

• Claims management

• Accounts receivable follow-up

• Denial management

• Credentialing and enrollment

• Hospice-specific billing experience, if available

Website: Transcure

Hospice Medical Billing Companies Comparison

The comparison reflects publicly described services. It does not establish independently verified rankings, client outcomes, or identical service coverage. Confirm current hospice capabilities directly with each company.

What Makes Hospice Medical Billing Different?

Hospice billing requires specialized knowledge of Medicare reimbursement, patient election requirements, institutional claims, and documentation. A billing company that primarily handles physician office claims may not have the processes needed to manage hospice revenue accurately.

1. Notice of Election (NOE) Filing

The Notice of Election establishes a Medicare beneficiary's election of hospice coverage. CMS requires hospices to submit the NOE within five calendar days after the hospice admission date.

The NOE must also be accepted by the Medicare Administrative Contractor within the applicable period. When an NOE is filed late, Medicare generally does not cover the days between the election date and the date the NOE is accepted, subject to applicable exceptions.

A hospice billing company should have a reliable process for preparing, submitting, and tracking NOEs rather than treating them as ordinary claim submissions.

2. Four Levels of Hospice Care

Medicare reimburses hospice services through four levels of care, each with distinct requirements.

Incorrectly reporting a level of care can lead to payment problems, claim corrections, and additional review.

3. Sequential Monthly Claims

Hospice claims are processed through a sequence of billing periods. A claim that remains unresolved or in a returned status can interfere with the processing of subsequent claims.

Billing teams must monitor claim status, resolve errors, and maintain continuity between monthly submissions.

Hospice agencies should ask potential vendors how they monitor rejected or returned claims and how quickly they address issues that may affect later billing periods.

4. Hospice Eligibility and Election Documentation

Hospice billing requires accurate beneficiary eligibility and election information. Agencies must maintain the documentation supporting hospice coverage and ensure that claims reflect the correct election and benefit period information.

A billing partner should understand how to identify coverage conflicts, verify beneficiary information, and coordinate corrections when Medicare records do not match agency records.

5. Hospice Cap Monitoring

Medicare's hospice aggregate cap limits the total Medicare reimbursement a hospice may receive for a cap year under applicable rules.

Agencies should monitor their cap exposure throughout the year rather than waiting until the end of the reporting period. A billing partner may assist with financial tracking and reporting, but the hospice should understand how the vendor calculates, monitors, and communicates potential cap exposure.

6. FY 2027 Hospice Election Statement Addendum

CMS finalized a requirement for hospices to furnish the hospice election statement addendum to Medicare beneficiaries at the time of hospice election. The requirement applies to elections beginning October 1, 2026.

The addendum must be furnished within five calendar days of the effective election date, and updates must be furnished within three calendar days of a plan-of-care change under the finalized requirements.

Hospice agencies should ensure that their billing and administrative workflows coordinate with the clinical and intake teams so required election documentation is completed and retained.

How to Choose the Right Hospice Billing Company

Before outsourcing billing, hospice administrators should evaluate a provider's experience with Medicare requirements, claim processing, documentation, and financial reporting.

Ask vendors to provide a written scope of work. Clarify whether their responsibilities include eligibility checks, NOE filing, claim submission, payment posting, denial appeals, AR recovery, cap reporting, and compliance-related documentation support.

When Should a Hospice Agency Outsource Medical Billing?

Outsourcing may be appropriate when an agency's internal billing operation cannot keep up with its patient census, claim volume, or compliance requirements.

Common indicators include:

• Missed or delayed NOE submissions.

• Growing accounts receivable balances.

• Repeated claim rejections and returned claims.

• Delays in sequential monthly claim processing.

• Limited internal hospice billing expertise.

• Inconsistent payment posting and reconciliation.

• Increasing denial and ADR workloads.

• Difficulty monitoring Medicare cap exposure.

• Staffing shortages or frequent billing team turnover.

• Limited visibility into claim status and revenue performance.

A specialized billing partner may provide additional operational capacity, but hospice leadership should retain oversight of compliance, documentation, financial reporting, and vendor performance.

Improve Hospice Revenue Cycle Performance With the Right Billing Support

Choosing a hospice medical billing company requires more than comparing general claim processing services. Agencies need to understand whether a provider can manage Medicare hospice requirements, election notices, levels of care, sequential claims, denial follow-up, and financial reporting.

The Medicator’s provides medical billing, revenue cycle management, denial management, eligibility verification, credentialing, and accounts receivable support. Hospice agencies considering an outsourcing arrangement should discuss their specific Medicare hospice requirements and confirm whether the available services match their operational needs.

Explore medical billing services, revenue cycle management services, and accounts receivable management to learn more about available support.

Contact The Medicator’s to discuss your billing requirements and request a practice analysis.

Phone: (888) 277-1460
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Frequently Asked Questions

1. What are the best hospice medical billing companies in 2027?

Companies to evaluate include The Medicator’s, MedCare MSO, Healthcare Provider Solutions, SimiTree, BillingParadise, and Transcure. Their published service capabilities differ, so hospice agencies should verify direct experience with Medicare hospice claims and NOE management before choosing a provider.

2. What services should a hospice billing company provide?

A hospice billing company may provide eligibility verification, NOE and NOTR processing, institutional claim submission, payment posting, denial management, AR follow-up, and financial reporting. Agencies should also confirm experience with the four Medicare levels of care and hospice cap monitoring.

3. What is an NOE in hospice billing?

A Notice of Election is a document submitted to Medicare to establish a beneficiary's election of hospice coverage. CMS generally requires the NOE to be submitted and accepted within five calendar days after the hospice admission date.

4. What are the four levels of hospice care?

Medicare recognizes Routine Home Care, Continuous Home Care, Inpatient Respite Care, and General Inpatient Care. Each level has different eligibility, documentation, and reimbursement considerations.

5. What happens if a hospice files an NOE late?

When an NOE is not timely filed, Medicare generally does not cover the days between the hospice election date and the date the NOE is accepted. The hospice may be able to request an exception when circumstances meet applicable CMS requirements.

6. Can hospice agencies outsource their entire revenue cycle?

Hospice agencies can outsource multiple revenue cycle functions, including claim submission, payment posting, denial management, and AR follow-up. The scope depends on the billing provider's capabilities and the agency's agreement.

7. How can a hospice agency reduce billing denials?

Agencies can reduce preventable denials by verifying eligibility, filing election notices on time, maintaining complete documentation, selecting the correct level of care, reviewing claim information, and monitoring returned claims. Regular billing audits and timely denial follow-up can also help.

8. What should a hospice agency ask before hiring a billing company?

Ask about direct hospice experience, NOE and NOTR workflows, institutional claim processing, sequential billing, Medicare cap monitoring, denial management, EMR compatibility, reporting, pricing, and references from similar agencies. Request a written service agreement that defines responsibilities and performance expectations.