How Long-Term Care Insurance Billing Systems Boost Care Outcomes

2021 is the year of the home.

Patients are becoming more comfortable using technology to receive care in the comfort of their own home while simultaneously becoming concerned about entering hospitals during the COVID-19 pandemic. And both hospitals and skilled nursing facilities (SNF) are beginning to battle home health agencies for ownership of the at-home space.

One key to people staying in their homes at all, though, is long-term care insurance. And a smooth long-term care insurance (LTCI) process requires smooth billing. For its needs, Alliance Homecare out of New York City turned to cloud-based, home health care software provider AlayaCare.


“We’ve been with AlayaCare for about a year and a half,” says Shena Melgar, Alliance Homecare’s director of accounts receivable and payroll. “A lot of agencies in New York City don’t do long-term care insurance. We’ve been utilizing AlayaCare’s platform for about a quarter now, and it’s been very helpful for us.”

Here are the top four benefits that the right long-term care insurance billing system can provide.

Straightforward technology


Alliance Homecare is a concierge home care agency, offering care in the home or in senior living, with a focus on 24/7 care. There is often a language barrier between Alliance Homecare’s administrative team and the direct care staff, Melgar says, so the ease of interfacing with AlayaCare’s LTCI billing system is critical.

The AlayaCare system and its accompanying apps are very straight-forward and intuitive, and that increases use and adherence to the technology.

“Our clock-in-and-out rates are dramatically higher than they used to be in our old system,” Melgar says. This improves notation, too. When caregivers check out of their shifts, they have to check off that they have supported each client’s activities of daily living (ADL). Showing the insurer that the caregiver has helped with each ADL is required for getting paid 100% for all work.

“That’s a big change from our old system to this system,” Melgar says.

Streamlined billing

Private pay is very straightforward, but insurance, obviously, is not. Before Alliance made the move to AlayaCare, it used three different systems for its LTCI billing needs. With multiple systems, Alliance’s head of claims submission and billing had to extract data from the invoice and break it down so that the client could see both the entire bill and what they owed after insurance, if anything.

With AlayaCare, everything is simplified. Each person’s file includes the policy number, claims number and policy details, such as a daily cap of $400, Melgar says. If the invoice says $500, AlayaCare will generate two invoices: one for the insurer, showing the $400, and one for the client, showing the $400-$100 split.

“We’re able to split the invoice the way it needs to be split based on the policy limitations,” she says.

Centralized Department of Health Documentation

Another benefit of being able to do away with its previous three systems is having all client details and caregiver details in a centralized location, Melgar says.

“I personally no longer need to go into a care management system to look at all the care managers’ notes,” she says. “It’s all in AlayaCare.”

As a result, Melgar and other members of the Alliance team can easily access any client information, especially information required by the U.S. Department of Health (DOH), no matter where they are.

“The DOH-required documentation is actually way better in AlayaCare,” Melgar says. “Before we had it housed in a regular file in our shared drive. Now it’s all been customized in AlayaCare. Whenever a nurse is out doing an assessment, they can easily pull up a client’s folder on the app and fill out a plan-of-care while they’re on the road instead of having to go back to the office to do a clinical writeup.”

Major time savings

All of this adds up to a major time savings. Melgar estimates that AlayaCare saves the head of billing up to four hours of work per day.

“Our agency does bill on a weekly basis,” she says. “That’s 16 hours of work per week that she’s been given back.”

This article is sponsored by AlayaCare. To learn more about how AlayaCare can help you with your long-term care insurance billing needs, visit

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