Medicaid and mixed-payer agencies
You have a compliance system. You may not have an operations system.
If you bill Medicaid, your state or your plans have almost certainly given you an EVV portal at no cost. Keep it. It is where your verified visits and your claims belong. The question is what happens to everything it was never scoped to cover.
Before anything else: work out who sets your rules
Medicaid is not one thing, and this is the mistake that costs agencies the most time.
Fee-for-service means you bill the state directly, and your state Medicaid agency sets the EVV arrangement. One authority, one set of answers.
Managed care means you bill a plan, and each plan you contract with sets its own expectations. Three plans can mean three arrangements, and a state announcement about fee-for-service may not describe your situation at all.
In Florida, for instance, most non-medical personal care for adults runs through long-term care managed care plans, while the widely reported free state portal arrangement applies to fee-for-service. Agencies read the second and assume it describes the first. Our Florida guide separates the two.
Run the readiness check if you want a summary of what applies to you and what to ask.
Keep the free portal. Seriously.
We do not replace it and we would not want to. Your state portal submits claims, scrubs them before they go, receives authorizations and care plans from the payer, and satisfies the EVV requirement on its own. We do none of those things and we are not a designated system anywhere.
Anyone telling you that you need to buy software on top of a sponsored portal to be compliant is not telling you the truth. We set out the full comparison, including the rows where the free portal beats us, on the HHAeXchange comparison page.
The mixed-payer problem
A portal sponsored by a payer covers that payer's clients. That is the arrangement working as designed. It also means an agency with more than one payer is running more than one system, and usually a spreadsheet underneath to hold it together.
Here is the shape of it in an ordinary week:
- Your Medicaid visits are verified in a portal
- Your second plan's visits may be in a different one
- Your private pay visits are in neither
- Nobody can see next Tuesday in one place
- Payroll means adding hours from several sources by hand, which is where the errors come from
None of that is a compliance failure. It is an operations problem, and it is the specific problem CareVerify exists to solve.
What running both looks like
One schedule for every client
Medicaid, second plan, private pay, all on the same week grid, with conflicts caught as you create them.
One set of hours for payroll
Verified hours across all payers, with unresolved visits surfaced before you export rather than dropped. We still do not calculate pay.
An app that does not lose a visit
Check-ins are never blocked, including with no signal or failed GPS. A visit recorded and flagged is worth more than a visit lost.
Claims still go through your portal
Nothing about your Medicaid billing changes. In an open vendor state the two systems run side by side.
Do not buy this if
- Every visit you run bills to one payer whose portal you already have, and payroll is not painful
- You are hoping to stop using your state system. That is not what this is
- Your state mandates one system and you have not confirmed with them that running something alongside it is acceptable
- You need Medicaid claims submitted, clinical documentation, or OASIS
See it running alongside your portal
14 day trial. No card required. The clock starts at your first caregiver check-in.