From weekly claim rejections to clean submissions and faster payments—here’s how one team overhauled their billing process.

Introduction

An Adult Day Care provider in Texas was struggling with something many operations face: claims being rejected or ignored, long delays in reimbursement, and a billing workflow full of manual tasks and hidden risks.


Six months after switching to ElderSuite, their billing error rate dropped by over 90%, and their reimbursement cycle became one of the smoothest parts of their operation.


This is how they made the shift—from frustration to confidence.

The Challenge

Before ElderSuite, the provider relied on:

  • Paper-based attendance tracking

  • Manually calculated units

  • Claims submitted through a clearinghouse portal

  • Re-entry of data across multiple systems

This approach led to:

  • Frequent rejections due to missing or mismatched data

  • Claims submitted with outdated procedure codes or incomplete ZIP codes

  • Time lost tracking down why a claim wasn’t paid

  • A billing specialist constantly “putting out fires” instead of working proactively

“We were correcting more claims than we were submitting cleanly. It felt like we were always behind.”

The ElderSuite Transformation


Step 1: Catching Errors Early with Claim Scrubbing

Once they implemented ElderSuite, the provider began using the Scrub Claims feature before submitting anything. The software flagged:

  • Missing required data

  • Invalid or blank procedure codes

  • Claims with no units due to incomplete time entries

This changed everything—errors were fixed before submission, not after denial.


Step 2: Accurate Unit Calculation from Attendance Records

Instead of manually totaling hours, staff entered attendance times into ElderSuite. From there:

  • Units were calculated automatically based on predefined thresholds

  • Claims were generated instantly without additional data entry

  • Entries with missing times were flagged and couldn’t be saved until corrected

“Once we started entering times directly, we stopped second-guessing every unit. The system just worked.”


Step 3: Streamlined Reconciliation

After claims were submitted, the provider used the Reconciliation tools to match payments, resolve discrepancies, and confirm claim statuses without leaving ElderSuite.

That meant:

  • No more switching between portals and spreadsheets

  • Clear records for audits and reporting

  • Full control over the billing process, end to end

The Results

After six months with ElderSuite:

  • Billing errors dropped by 93%

  • Reimbursement turnaround improved by 35%

  • Rejected claims became rare

  • Billing workload was cut in half

The provider now has a repeatable, reliable billing process—and fewer surprises at the end of the month.

“For the first time, we’re not worried about billing. It runs in the background, and we can finally focus on care.”

Conclusion

ElderSuite isn’t just about creating claims. It’s about getting them right the first time—with tools that catch errors early, automate calculations, and centralize your workflow. If your team is still correcting claims after submission, it might be time to upgrade the process.

Try ElderSuite Free for 30 Days

No contract. No setup fees. No pressure. Just complete access to the tools that help you get paid faster—with fewer headaches.


Visit www.eldersuite.com to get started today.