Platform Live
Medical Billing by Specialty · Florida

Your specialty has
its own rules.
We know them all.

Home health, nurse registry, mental health — each practice type in Florida operates under different payer rules, coding protocols, and compliance standards. A generalist billing company doesn't know the difference. We do.

>97%
Clean claim rate
<24h
Claim submission
4
Specialty tracks
2 wks
To go live
Home Health

Home Health Billing Services

PDGM and community care billing for home health agencies across Florida.

Home health billing in Florida runs across two distinct tracks: institutional PDGM billing for certified agencies, and professional community care billing for HHA and PCA providers. Both require deep payer knowledge, EVV compliance, and HHAeXchange integration. We handle both.

Key capabilities

PDGM episode management and clinical grouping
OASIS submission, validation, and error correction
Community care professional billing (HHA, PCA)
HHAeXchange and Netsmart/Tellus EVV integration
Medicaid MMC billing — Sunshine, Humana, Molina, Simply
Florida AHCA compliance and audit support
RAP submission and final claim processing
Home health denial management and appeals

Common questions

What is PDGM and why does it matter for billing?

PDGM (Patient-Driven Groupings Model) replaced PPS for home health in 2020. It divides episodes into 30-day periods classified by referral source, timing, clinical grouping, and functional level. Incorrect PDGM classification directly reduces reimbursement — often without a denial, just a lower payment.

Do you integrate with HHAeXchange?

Yes. We integrate directly with HHAeXchange for EVV data validation and billing. We also support Netsmart/Tellus for agencies in the Florida fee-for-service delivery system.

Mental Health

Mental Health Billing Services

Outpatient behavioral health billing for Florida providers.

Outpatient mental health billing requires mastery of prior authorization workflows, behavioral health CPT coding, and strict patient privacy protocols. We handle authorization management, complex behavioral health coding, and payer-specific compliance for outpatient practices and telehealth providers in Florida.

Key capabilities

Prior authorization management — full lifecycle
Behavioral health CPT coding (90837, 90834, 90847, H codes)
Telehealth and telepsychiatry billing compliance
HIPAA-first workflows with enhanced PHI protection
Florida Medicaid behavioral health billing
Denial management for behavioral health payers
Outpatient individual, group, and family therapy
Medication management billing (99213, 99214, 90833)

Common questions

What types of mental health providers do you work with?

We work with outpatient individual and group practices — therapists, psychologists, psychiatrists, LCSWs, and mental health counselors billing professional claims in Florida. We do not currently support inpatient psychiatric facilities.

How do you handle prior authorization for behavioral health?

We manage the full prior auth lifecycle — initial authorization requests, concurrent reviews, and appeals for denied authorizations. Sessions are never billed without confirmed coverage.

Nurse Registry

Nurse Registry Billing Services

High-volume PDN billing built for Florida nurse registry operations.

Nurse registries in Florida operate under a unique regulatory model — high claim volumes, complex Medicaid and MCO rules, and strict DOL compliance requirements around the independent contractor model. We process large batches accurately and fast, with real-time eligibility verification and shift reconciliation built into the workflow.

Key capabilities

High-volume batch claims processing
Real-time and batch eligibility verification
Private duty nursing (PDN) billing expertise
Medicaid and MCO billing compliance for registries
Shift reconciliation and visit log validation
Florida registry compliance — DOL model separation support
Authorization management for PDN hours
iBudget and HCBS waiver billing

Common questions

What makes nurse registry billing different from regular home health billing?

Nurse registries operate under the DOL independent contractor model — caregivers are not employees. This creates distinct billing rules, compliance requirements, and payer relationships. Our billing workflows maintain the appropriate separation between registry administrative functions and caregiver-client relationships.

Can you handle very high claim volumes?

Yes. Nurse registries generate significantly higher claim volumes than other provider types. Our platform is built for batch processing with automated validation, reducing manual entry and submission delays.

Outpatient Clinics

Clinic Professional Billing

Professional billing for Florida outpatient clinics and provider practices.

For outpatient clinics and provider practices billing professional claims, we handle the full revenue cycle — eligibility, coding, submission, and AR follow-up. Best suited for primary care, internal medicine, and outpatient practices in Florida with established payer contracts.

Key capabilities

CMS-1500 professional claim submission
Patient eligibility verification
Medical coding (ICD-10, CPT, HCPCS)
Payment posting and ERA reconciliation
AR follow-up and denial management
Monthly KPI reporting
Dedicated account manager
HIPAA-compliant workflows

Common questions

What types of outpatient clinics do you work with?

We work best with primary care, internal medicine, and outpatient practices in Florida that are already contracted with commercial payers and need consistent, reliable professional billing. Contact us to discuss your specific specialty.

Do you handle credentialing?

If your providers are already credentialed, we update billing information with payers and you are ready to go. If you need new payer enrollment, that runs on a separate timeline — typically 45 to 90 days depending on the payer.

Also available

Billing companies working these specialties use the platform.

The Leymax platform is available for billing companies and independent billers managing home health agencies, nurse registries, and mental health providers in Florida.