For Medicaid & HCBS home-care agencies with 100+ active clients
Care delivered.
Payroll paid.
Claim still stuck?
Your agency manages hundreds or thousands of visits every month. Small gaps between EVV, authorizations, claims, remittances, and payer follow-up can turn completed care into aging receivables.
Find out where your earned revenue is getting stuck.
For established agencies with 100+ active clients.
See what we review
If you run a 100+ client agency, you've probably seen this before.
- EVV verified — claim not paid
- Authorization expired
- Claim rejected
- 60+ day A/R
- Payer follow-up required
At 100+ clients, small billing problems stop being small.
One unresolved visit is an inconvenience. Multiply it across hundreds of clients, thousands of caregiver visits, multiple MCOs, authorization periods, EVV requirements, and weekly payroll—and the financial impact compounds quickly.
- 01
EVV exceptions
Completed visits can remain unbillable when required visit information does not reconcile correctly.
- 02
Authorization gaps
Expired dates, exhausted units, service mismatches, or authorization changes can interfere with reimbursement.
- 03
Rejected & denied claims
Claims requiring correction or follow-up can become increasingly difficult to recover as they age.
- 04
Aging A/R
The longer reimbursement remains unresolved, the more visibility and disciplined follow-up matter.
- 05
Remittance & payment issues
Submitted doesn't necessarily mean paid correctly. Payments and remittances still need to be reconciled.
- 06
Payer follow-up
Your staff can spend significant time researching claims, contacting payers, documenting responses, and resubmitting corrections.
Your problem usually isn't one giant billing mistake.
It's hundreds of small exceptions accumulating across a large operation.
The revenue cycle, end to end
Every completed visit has to make it through the entire revenue cycle.
A visit isn't revenue simply because care was delivered. It has to successfully move through every step between service delivery and collected payment.
- Step 01Caregiver visitVisit not verified
- Step 02EVV verifiedException unresolved
- Step 03Authorization matchedUnits or dates off
- Step 04Claim submittedRejection at clearinghouse
- Step 05Payer acceptedDenial or pend
- Step 06Payment postedUnderpaid or unposted
- Step 07Revenue collectedCollected
Revenue can stall at any handoff. At scale, the exceptions rarely announce themselves—they simply sit in a queue nobody owns.
The 90-Day Home Care Revenue Leakage Audit
Know what's stuck before you decide what to fix.
We review the last 90 days of your billing workflow to identify where reimbursement may be delayed, rejected, denied, aging, or otherwise requiring attention.
- 01
Unbilled visits
Identify completed visits that have not successfully progressed to billing.
- 02
EVV exceptions
Surface visit-verification issues affecting billing readiness.
- 03
Authorization exceptions
Identify potential authorization dates, units, and service mismatches.
- 04
Rejected & denied claims
Categorize claims requiring correction or follow-up.
- 05
Aging A/R
Surface outstanding balances and aging patterns requiring attention.
- 06
Remittance issues
Identify payment-posting, underpayment, or reconciliation issues where available.
- 07
30-day priority plan
Organize findings into a prioritized action plan.
Findings are organized around what is stuck, where it is stuck, and what deserves attention first.
Available for qualifying home-care agencies with 100+ active clients.
Ask your billing team these 3 questions tomorrow.
How much completed care is still unbilled?
How much A/R is rejected, denied, or more than 60 days old?
Which claims are approaching timely-filing or appeal deadlines?
If getting those answers takes days—or nobody knows—the problem isn't just claim submission. It's visibility.
Your caregivers don't wait for Medicaid to pay you.
- Payroll has a deadline.
- Rent has a deadline.
- Operating expenses have a deadline.
- Payer reimbursement doesn't always cooperate.
For an established home-care agency, revenue-cycle problems quickly become cash-flow problems.
Your team already did the hard part: delivering the care. The billing operation needs to make sure completed services move toward reimbursement as efficiently and accurately as possible.
Qualification
Built for established home-care operations.
Good fit
- 100+ active clients
- Medicaid / HCBS payer volume
- Significant weekly caregiver visit volume
- EVV-dependent billing
- Multiple authorizations to manage
- Existing billing/admin team
- Meaningful outstanding A/R
- Owner wants better visibility into reimbursement
Running a new or very small home-care agency?
Our service is designed around the operational complexity of established agencies and may not be the right fit yet.
From “we think we're owed money” to a clear action plan.
- Step 1
Qualify
Tell us about your agency, census, payer mix, current billing process, and A/R.
- Step 2
Review
We examine the agreed billing and revenue-cycle information across the review period.
- Step 3
Prioritize
You receive findings organized around what is stuck, where it is stuck, and what deserves attention first.
Proof
Built around home-care billing. Not generic medical billing.
This section is reserved for verified proof. No testimonials, logos, recovery amounts, or client counts are shown until they can be substantiated.
- Agency size
- To be provided
- Payer mix
- To be provided
- Problem identified
- To be provided
- Actions taken
- To be provided
- Verified result
- To be provided
More than claim submission.
| Function | Basic billing | Revenue-cycle approach |
|---|---|---|
| Submit claims | Included | Included |
| Monitor EVV exceptions | Not included | Included |
| Track authorization issues | Not included | Included |
| Work rejected claims | Limited | Included |
| Work denials | Limited | Included |
| Monitor aging A/R | Limited | Included |
| Reconcile payments | Limited | Included |
| Provide owner visibility | Limited | Included |
Exact services depend on engagement scope. This comparison describes general categories of work, not a commitment to specific tasks or outcomes.
FAQ
Questions established agencies ask.
Placeholders remain where capabilities have not yet been verified. Nothing on this page is claimed before it can be substantiated.
Request the audit
Request your 90-Day Revenue Leakage Audit.
A few operational details tell us whether an audit makes sense for your agency. This form is for business qualification only.
Do not include patient information, PHI, Medicaid IDs, or claim details. We never request protected information through this form.
For established Medicaid & HCBS home-care agencies
You already delivered the care.
Find out where the revenue got stuck.
If your agency manages 100+ active clients, request a 90-Day Home Care Revenue Leakage Audit.
100+ active clients required.