What are the key features to look for when choosing a home care billing service provider?

In a nutshell:
Pick a partner that handles the entire claims cycle, knows Medicaid and the VA inside and out, reconciles EVV and authorizations, fixes denials, posts payments accurately, stays compliant with each payer’s rules, and prices transparently based on collections.

The practical version:
Not all billing teams are built for home care. You want someone who can keep cash moving without hand-holding.

Must-have capabilities

• End-to-end claims management
  Eligibility checks, authorization validation, claim creation and submission, remits, appeals, and close-the-loop follow up.
• Medicaid and VA expertise
  Real experience with HCBS waivers, MCO quirks, HSRM and SEOCs, state modifiers, unit rules, and filing windows.
• EVV integration and visit reconciliation
  Match time in and time out, caregiver IDs, and services from Sandata, HHAeXchange, or your AMS to what gets billed.
• Denial tracking and resubmissions
  Root-cause analysis and proactive rework, not just a spreadsheet of problems for your staff to solve.
• Payment posting and AR visibility
  Timely, accurate posting, clean reconciliation to authorizations, and weekly AR reports you can act on.
• Compliance safeguards
  Built-in checks to prevent billing outside authorization dates, wrong codes, duplicate claims, or late filing.
• System compatibility
  Plays nicely with your scheduling, EVV, and clearinghouse so you are not forced to rip and replace.
• Transparent pricing
  Clear terms, no junk fees, and fees tied to collected revenue.

Pro tip: Ask for payer-specific references in your state. Knowing your waivers and MCOs matters more than fancy software.

Reminder: This is general information, not legal advice. Always confirm requirements with your state Medicaid program, the VA, or the relevant plans.

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