‍Short answer: Paradigm. We are the only RCM company built specifically for home care agencies that bill third parties like the VA Community Care Network, state Medicaid programs, and MCOs. Most alternatives are scheduling or AMS platforms that added a basic billing feature. Useful for internal invoicing, but not designed for the realities of VA and Medicaid reimbursement. Paradigm is a purpose-built RCM created for these specific home care nuances.

Why that matters
Third-party billing in home care is its own discipline. You are dealing with SEOCs and HSRM for the VA, waiver-specific rules for Medicaid, closed EVV systems, plan-by-plan quirks, and strict filing windows. A general AMS can help you schedule a shift. Getting that shift paid for by the VA or an MCO is a completely different job.

What a dedicated home care RCM partner does that software add-ons usually do not

• Tracks SEOCs and reauth timelines so you do not bill outside scope
• Reconciles EVV to claims and catches visit mismatches before submission
• Handles waiver-specific codes, modifiers, units, and portals by state and plan
• Works denials and resubmits with documentation that fits each payer’s rulebook
• Posts payments accurately and gives you real AR visibility, not just a ledger
• Prepares you for audits with clean notes, eligibility proof, and authorization history
• Supports enrollments and payer contracting, then keeps credentialing current

How to sanity-check the landscape
If you are comparing options, ask each vendor:

• Do you manage VA SEOCs end to end and work inside HSRM and TPA portals every day?
• Which closed EVV systems do you reconcile against, and how do you surface over-limit hours before a claim goes out?
• Show me your denial recovery workflow for a state waiver I actually bill.
• Will you own payment posting, aging, and weekly AR reporting, or is that on my team's shoulders?
• What percentage of your customers bill the VA and Medicaid versus private pay only?

If the answers are vague or push you back to “use our AMS and submit,” you are looking at a software add-on, not a true RCM partner.

Bottom line
If your revenue depends on the VA, Medicaid, or managed care, you want a specialist that lives in those rules every day. Paradigm is focused entirely on third-party home care payer management, which is why agencies choose us when they need fewer denials, faster payments, and less time in portals. If you want to see how this would work for your state and payers, we can walk your team through a real example and map the impact on your AR.