MedSynthea + Eaglesoft for Hospice Billing
Connect MedSynthea to Eaglesoft via REST API to automate Hospice revenue cycle workflows end-to-end — from eligibility verification through G0299-G0300 coding and ERA payment posting, with 0% PHI in system logs.
Deploy Hospice Automation with Eaglesoft in 4 Steps
REST API integration — no EHR vendor changes required.
Authenticate Eaglesoft
Authorize MedSynthea via REST API. No vendor changes required — standard OAuth2/SMART credentials used.
Map Hospice Workflows
Configure G0299-G0300 (Nursing visits) + G0154 fee schedules, payer contracts, and six-month prognosis documentation prevention rules.
Activate AI Agents
9 agents begin processing Hospice encounters from Eaglesoft: eligibility, coding, scrubbing, and claim submission.
ERA Write-Back
Approved payment data posts back to Eaglesoft via REST API write-back, closing the billing loop automatically.
Hospice Revenue Cycle Challenges MedSynthea Solves in Eaglesoft
Hospice billing is governed by G0299-G0300 (Nursing visits) + G0154 coding complexity and strict payer LCD policies.
Six-month prognosis documentation
Eaglesoft practices in Hospice face repeated denials for six-month prognosis documentation. MedSynthea reads clinical notes from Eaglesoft via REST API and flags documentation gaps before claim submission.
G0299-G0300 (Nursing visits) + G0154
MedSynthea's CODE agent validates all G0299-G0300 (Nursing visits) + G0154 codes pulled from Eaglesoft clinical documentation against NCCI edit tables and payer-specific modifier rules.
Hospice agencies face $1.8 billion in improper Medicare payments annually, with six-month prognosis documentation failures and inadequate interdisciplinary care plan documentation cited as the primary causes (OIG Hospice Report 2024).
9 AI Agents Working Inside Eaglesoft for Hospice
Each agent reads from and writes back to Eaglesoft via REST API for a closed-loop Hospice billing workflow.
Scheduling Agent
Analyzes appointment patterns, flags high-risk no-show appointments, captures scheduling context (procedure type, referral source, insurance class) that affects downstream coding and billing decisions
In Eaglesoft: reads G0299-G0300 data via REST API
Eligibility Agent
Queries 900+ payer databases in real time, validates active coverage, extracts benefit-level details (co-pay, deductible, out-of-pocket), identifies coverage gaps and prior auth requirements before the encounter begins
In Eaglesoft: reads G0299-G0300 data via REST API
Documentation Agent
Converts encounter audio into structured clinical text using specialty-aware transcription models. Links every transcribed segment to the specific audio timestamp it came from, creating an immutable evidence chain. Formats output for the NOTE agent to structure into reviewable clinical documentation
In Eaglesoft: reads G0299-G0300 data via REST API
Coding Agent
Reads structured clinical documentation, applies specialty-specific ICD-10 hierarchies and CPT code families, validates against payer-specific LCD policies and NCCI edit tables, applies correct modifiers, and proposes a complete reviewable code set linked to the clinical evidence that supports each code
In Eaglesoft: reads G0299-G0300 data via REST API
Scrubber Agent
Scores every claim against 200+ denial variables before submission. Identifies modifier conflicts, missing prior authorizations, LCD coverage gaps, eligibility issues, and payer-specific policy violations. Routes high-risk claims for human review before they reach the payer, preventing denials at the source
In Eaglesoft: reads G0299-G0300 data via REST API
Prior Auth Agent
Identifies prior authorization requirements from eligibility data and payer rules, assembles supporting clinical documentation, submits PA requests via payer APIs or electronic portals, tracks approval status in real time, and routes approvals back to the clinical workflow and Billing agent
In Eaglesoft: reads G0299-G0300 data via REST API
Billing Agent
Submits validated claims to payer clearing houses or direct payer APIs, monitors submission acknowledgement in real time, tracks claim status through the payer adjudication process, flags abnormal hold times for follow-up, and passes accepted claims to the FLW agent for ongoing tracking
In Eaglesoft: reads G0299-G0300 data via REST API
Denial Agent
Receives denial notifications, categorizes each denial by type (clinical necessity, coding, eligibility, authorization), retrieves original claim and clinical documentation, identifies the specific correction needed, assembles an appeal package with targeted documentation, and submits the appeal via payer portal or mail within the payer's filing window
In Eaglesoft: reads G0299-G0300 data via REST API
Reconciliation Agent
Receives 835 EDI ERA files and EOB documents from payers, matches each payment line to the original claim, posts payments to the appropriate account, flags underpayments against contracted rates, identifies incorrect adjustment codes, calculates patient balance responsibilities, and generates reconciliation reports for financial review
In Eaglesoft: reads G0299-G0300 data via REST API
Other Specialties Supported in Eaglesoft
MedSynthea automates all major specialties within Eaglesoft via REST API.
Hospice Billing in Other EHR Systems
Eaglesoft + Hospice Integration — Frequently Asked Questions
How does MedSynthea integrate with Eaglesoft for Hospice billing?
MedSynthea connects to Eaglesoft via REST API, reading clinical encounter data and writing approved G0299-G0300 (Nursing visits) + G0154 codes and documentation back into the EHR automatically — without any custom software engineering.
Does MedSynthea support Eaglesoft for Hospice prior authorization?
Yes. MedSynthea's PA agent reads Hospice encounter data from Eaglesoft via REST API, assembles required clinical documentation, and submits prior authorization requests automatically for Hospice procedures.
What Hospice CPT codes does MedSynthea validate in Eaglesoft?
MedSynthea's CODE agent validates G0299-G0300 (Nursing visits) + G0154 against payer LCD policies and NCCI edit tables, then writes approved codes directly into Eaglesoft with full evidence traceability — every code linked to source clinical notes.
How long does Eaglesoft + MedSynthea setup take for a Hospice practice?
Most Hospice practices complete Eaglesoft integration in under 2 weeks. MedSynthea authenticates via REST API — no EHR vendor code changes required. Configuration covers fee schedules, payer contracts, and Hospice-specific denial rules.
Connect Eaglesoft to MedSynthea for Hospice Billing
Zero custom engineering. REST API authentication. Live Hospice automation in under 2 weeks.
Book a Demo