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Regional Home Health Agency Digital Transformation, Achieves 96% Clean Claims Rate and 62% Faster Documentation

About the Client

The client is a 45-branch regional home health agency serving over 12,000 patients monthly. The organization relied heavily on paper-based OASIS documentation, manual caregiver scheduling, and fragmented billing processes. These inefficiencies impacted care delivery, compliance, and revenue cycle performance. To modernize operations and scale efficiently, the agency partnered with Zymr.

Key Outcomes

62% Reduction in Documentation Time
96% Clean Claims Rate Achieved

Business Challenges

The agency depended on paper-based OASIS assessments, resulting in time-consuming documentation and increased risk of errors. Caregivers lacked real-time access to patient data, impacting care quality and compliance.

Manual scheduling processes made it difficult to efficiently assign caregivers, leading to missed visits and suboptimal resource utilization. The absence of automated systems also created challenges in tracking caregiver locations and visit validations.

Revenue cycle operations were impacted by disconnected billing systems, resulting in delayed claims processing and a high rate of denials. AR days remained high at 28, affecting cash flow and financial performance.

Additionally, the organization struggled to meet CMS quality benchmarks due to inconsistent documentation and lack of real-time reporting capabilities.

Business Impacts / Key Results Achieved

Zymr enabled a complete digital transformation by implementing a mobile-first home health platform, improving clinical workflows, compliance, and revenue cycle efficiency.

  • 62% Reduction in Documentation Time
  • Improved Clean Claims Rate to 96%
  • Reduced AR Days from 28 to 22
  • Achieved CMS 5-Star Quality Rating
  • Enabled Scalable Operations Across 45 Branches

Strategy and Solutions

Zymr implemented an integrated, mobile-first platform tailored to home health workflows, enabling seamless care delivery, compliance, and financial optimization.

  • Mobile-First Care Delivery Platform
    Enabled caregivers with real-time access to patient data, improving care coordination and documentation accuracy.
  • OASIS Documentation Automation
    Digitized and automated OASIS assessments to reduce manual effort and ensure compliance.
  • Geofencing EVV Integration
    Implemented electronic visit verification with geofencing to track caregiver visits and ensure regulatory compliance.
  • Caregiver Scheduling Optimization
    Streamlined scheduling workflows to improve resource utilization and reduce missed visits.
  • Payer Billing Integration
    Integrated billing systems to automate claims submission, reduce denials, and accelerate reimbursements.
  • Workflow Digitization
    Replaced manual, paper-based processes with digital workflows to enhance operational efficiency and scalability.
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