Hospice Recertification Support Services
On-time recertifications across every benefit period. Hospice support specialists track the 90/90/60-day benefit period structure, schedule the face-to-face encounter for the third period and beyond under 42 CFR 418.22(a)(4), document clinical decline, and close the loop with the hospice physician before each recertification window closes. 800+ providers trust us. Pilot in 2 weeks.
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0:48Missed F2F encounters and late recert signatures are the quietest revenue leaks in hospice .
Recertification carries every certification rule plus the face-to-face requirement, the documented decline standard, and an unforgiving benefit period clock. Three failure modes drive almost every recert audit finding.
Recert signed after the benefit period starts
If the hospice physician signs the recertification after the next benefit period has already started, days before the signature are not payable. The recert window closes fast and the chart has to be ready.
F2F encounter missed for third+ period
42 CFR 418.22(a)(4) requires a face-to-face encounter within 30 days before recertification for the third and later benefit periods. A missed F2F means the entire recertification is invalid.
Decline documentation that does not support recert
Recertification requires documented clinical decline. Vague phrases like "patient stable" trigger ADRs. Specific decline indicators (weight loss, PPS drop, increased symptom burden) need to be in the chart.
Tell us about your agency.
Send us your situation and our team will scope the right setup, usually within one business day. No obligation.
What is a hospice recertification support service?
A hospice recertification support service is a remote BPO team that tracks every patient's benefit period clock, schedules the 42 CFR 418.22(a)(4) face-to-face encounter for the third and later periods, pulls clinical decline documentation from the IDG and RN case manager notes, and closes the loop with the hospice physician before the recertification window closes.
What your hospice recertification specialist handles, day to day
Pick the recertification queues that hurt most. Your hospice recert support staff absorbs them. Your RN case managers, IDG coordinators, and medical director focus on patients and families.
Benefit period tracking (90/90/60)
Tracks the first 90-day period, second 90-day period, then unlimited 60-day periods. Builds a recertification reminder schedule. Flags any benefit period at risk.
F2F scheduling for third+ period
Schedules the 42 CFR 418.22(a)(4) face-to-face encounter within 30 calendar days before the recertification date. Books with the hospice physician or nurse practitioner.
F2F attestation capture
Captures the face-to-face attestation from the hospice physician or NP. Confirms the attestation language meets CMS expectations. Files it in the chart with the recert packet.
Decline documentation prep
Pulls decline indicators from the RN case manager, social worker, and IDG notes. Weight loss, PPS drop, ADL decline, symptom burden. Builds the recert support narrative.
Recert packet assembly
Builds the recertification packet with the F2F attestation, decline documentation, and updated plan of care. Sends to the hospice physician for signature.
Signature follow-up
Sends reminders before the benefit period ends. Tracks each pending signature. Escalates to the medical director if the recert window is closing.
Late-recert mitigation
If a recert is at risk of slipping, our team escalates same-day. Captures the late-filed recertification properly. Documents the gap for compliance and ADR response.
ADR and audit prep
Keeps recert documentation organized and audit-ready. Pulls packets for ADR response. Maintains a clean paper trail of decline and F2F for each benefit period.
Hospice-trained support staff, not generic VAs
Most outsourcing companies offer call-center agents and call them "hospice support." We do not. Our hospice recertification specialists are trained on 42 CFR 418.22(a)(4), the 90/90/60 benefit period structure, F2F attestation requirements, and the documented decline standard before they ever touch a live patient chart.
Hospice trained, not generic
Every hospice support specialist passes an assessment on 42 CFR Part 418 Conditions of Participation, eligibility criteria, IDG composition, face-to-face encounter rules, and at least one major platform from HCHB, MatrixCare Hospice, WellSky Hospice, or KanTime Hospice before placement.
Stacked compliance posture
HIPAA + SOC 2 Type II + ISO 27001 + HITRUST. Plus alignment with 42 CFR Part 418, HQRP submission deadlines, and CAHPS Hospice survey requirements. Ask your current vendor for proof of all four. We will wait.
2-Week Risk-Free Pilot
Industry offers no trial. We give you 14 days of live hospice support work at the same rate. Cancel before day 14, owe nothing. No annual contracts after.
Staffingly vs DIY in-house vs generic VA vs onshore BPO
The real cost math for a single full-time hospice recertification FTE at a mid-size hospice agency.
From "let's talk" to live in 1 to 2 weeks
Six steps. Each one is documented. Nothing is mysterious.
Discovery call (15 min)
Tell us which recert queue is loudest. F2F scheduling? Late-recert risk? Decline documentation? ADR response? We map it on a shared call. No prep needed from you.
BAA + platform access
Business associate agreement signed. Role-based access provisioned in HCHB, MatrixCare Hospice, Suncoast, WellSky Hospice, KanTime Hospice, or Netsmart.
Workflow shadow (2 to 3 days)
Your hospice recert team shadows your IDG coordinator and medical director workflow. Recert routes captured. Tone matched. Escalation rules locked.
Parallel pilot starts
Week 2 to 3. Your recert specialist runs alongside your team. Daily 15-minute sync. You see every benefit period clock, every F2F scheduled, every recert filed.
Decision point (end of week 2)
Pilot results reviewed. Go or no-go. No penalty if you cancel. Most hospice agencies keep going.
Full handoff, cadence locked
Recertification-on-time and F2F-on-time KPIs in your inbox. Weekly review with your account lead. Monthly QA audit. Expansion paths discussed.
How your hospice support specialist's day actually looks
A real shift, hour by hour. Times shown in your local time. We rotate coverage so your recertification queue is never dark during business hours.
How Staffingly works, in practice
Inside the workA trained Staffingly specialist works inside your existing platform, with clear escalation back to your team.
One Flat Weekly Rate. No Surprises.
Dedicated senior care schedulers at a fixed weekly cost. Per scheduler FTE, per week. No contracts, no minimums, no hidden fees.
Want to compare against an in-house hire? Use the savings calculator.
Frequently asked questions
What is the hospice benefit period structure?
Hospice benefit periods run as two 90-day periods followed by an unlimited number of 60-day periods. Each period requires a written certification of terminal illness with a 6-month prognosis. From the third benefit period onward, a face-to-face encounter is also required within 30 days before recertification.
How early should we begin the recertification process?
Most hospice agencies begin recert prep 14 to 21 days before the benefit period ends. The face-to-face encounter for the third and later periods must occur within 30 calendar days before recertification, so it can be scheduled earlier than that 14-day window. Our team works backward from the period end date and builds reminders accordingly.
What decline indicators belong in a recertification?
Weight loss, Palliative Performance Scale (PPS) decline, increased ADL dependence, increased symptom burden, repeated infections, and frequency of ER or inpatient utilization are all common decline indicators. Recerts that read "patient stable" trigger ADRs. Specific decline indicators with dates support the recert.
When is a face-to-face encounter required?
42 CFR 418.22(a)(4) requires a face-to-face encounter with a hospice physician or hospice nurse practitioner before the start of the third benefit period and before each subsequent benefit period. The encounter must occur within 30 calendar days before recertification. The F2F provider must attest in writing.
What happens if a recertification is filed late?
A late recertification shifts the financial start of the next benefit period to the signature date. Days between the period start and the signature are not payable. Our team flags any recert at risk of slipping and escalates same-day. We also document the gap properly for compliance and any future ADR response.
How do you handle ADR risk on recertifications?
Additional Documentation Requests on recerts usually focus on whether decline is documented and whether the F2F encounter occurred and was attested correctly. Our team keeps recert documentation organized and audit-ready, pulls clinical decline indicators from IDG and case manager notes, and confirms each F2F attestation meets CMS language requirements.
How much does hospice recertification support cost?
Standard is $399 per FTE per week for a single-site hospice agency. Volume is $349 per FTE per week for 3+ FTEs at a mid-size or multi-site operator. Enterprise is $299 per FTE per week for 10+ FTEs in a multi-state network. No setup fees. Flat weekly billing.
How does the 2-Week Risk-Free Pilot work?
Two weeks of live hospice recertification work at the same per-FTE rate. We onboard in 5 to 10 business days, run your recert queue in parallel with your team, and you see every benefit period clock, every F2F scheduled, and every recert filed. Cancel before day 14, owe nothing. No annual contracts after.
President and CEO, Staffingly, Inc. 25+ years in IT consulting and healthcare BPO operations. One of the earliest US operators to set up an RPO/BPO delivery network in India. Leads AI-driven home care workflows that help agencies, home health providers, and multi-branch operators cut admin cost without compromising care.
