Illinois Home Care Provider Resources
This page provides an overview of Illinois programs, waivers, payers, and EVV requirements relevant to home care (non-medical) providers operating in the state of Illinois.
Electronic Visit Verification
Illinois requires EVV for most Medicaid-funded personal care and home health aide services. Clean, timely visit data is critical—any issues in EVV can result in denied or delayed payments.
HHAeXchange
Open Model
EVV is required for Illinois Department on Aging (IDoA) and Division of Rehabilitation Services (DRS) providers beginning March 2, 2026.
Waivers & Programs
Illinois Division of Developmental Disabilities (DDD)
- Children and Young Adults with Developmental Disabilities Support Waiver
- Adults with Developmental Disabilities Waiver
Division of Specialized Care for Children (DSCC)
Medically Fragile and Technology Dependent Programs:
Supports children and individuals with complex medical needs requiring in-home services.
Illinois Division of Rehabilitation Services (DRS)
Home Services Program (HSP)
- Persons with Disabilities Waiver
- Persons with Brain Injury (BI) Waiver
- Persons with HIV or AIDS Waiver
Illinois Department on Aging (IDoA)
Persons Who Are Elderly Waiver:
Commonly referred to as the Community Care Program (CCP), supporting older adults who wish to remain safely at home.
Payers
State Agencies
- Division of Rehabilitation Services (DRS)
- Illinois Department on Aging (IDoA)
Fully Integrated Dual Eligible (FIDE SNP) Plans
- Aetna Medicare FIDE
- Humana Dual – Fully Integrated
- Molina Medicare Complete Care Plus
- Wellcare Meridian Dual Align
HealthChoice Illinois Managed Care Organizations (MCOs)
- Aetna Better Health
- Blue Cross Blue Shield Community Health Plans
- CountyCare Health Plan
- Meridian Health Plan
- Molina Healthcare
Waivers & Programs
Payers
Frequently Asked Questions
Often, yes. While agencies must first enroll with Illinois Medicaid, many Medicaid members receive services through Managed Care Organizations. Agencies may need separate contracts and credentialing approvals with participating MCOs before billing for services rendered to managed care members.
Illinois Medicaid commonly reimburses non-medical home care services through programs such as the Home Services Program (HSP), Community Care Program (CCP), and various Home and Community-Based Services (HCBS) waivers. Covered services may include personal care, homemaker assistance, and in-home support services.
Most states operate Medicaid waiver or community-based care programs that allow reimbursement for non-skilled services such as personal care, homemaker services, respite care, and attendant care. These programs are often administered through Home and Community-Based Services (HCBS) waivers, aging programs, disability waivers, or managed long-term services and supports (MLTSS) programs. Eligibility criteria, covered services, and billing requirements vary by state.
In many states, yes. Enrolling with the state Medicaid program is typically the first step, but agencies may also need to complete separate contracts, credentialing applications, or network enrollment with individual Medicaid MCOs before claims can be submitted for reimbursement. Requirements vary by state and payer, largely depending on whether the state operates an MLTSS (Managed Long Term Services and Supports Program).
Credentialing timelines vary by state and payer, but most home care agencies can expect the Medicaid enrollment and credentialing process to take anywhere from 60 to 180 days. Delays are often caused by incomplete applications, missing ownership documentation, background check issues, or required site visits. Agencies seeking participation with Managed Care Organizations (MCOs) should also account for additional contracting and payer credentialing timelines.
How Paradigm can Help
Paradigm offers a combination of tech and highly skilled people to bridge the gaps in:
We don’t stop at submission. We scrub claims, verify all documentation, manage denials, and post payments so your team can stay focused on care.
& Eligibility
We don’t stop at submission. We scrub claims, verify all documentation, manage denials, and post payments so your team can stay focused on care.
Credentialling
We don’t stop at submission. We scrub claims, verify all documentation, manage denials, and post payments so your team can stay focused on care.
We don’t stop at submission. We scrub claims, verify all documentation, manage denials, and post payments so your team can stay focused on care.
We don’t stop at submission. We scrub claims, verify all documentation, manage denials, and post payments so your team can stay focused on care.
Paradigm's provider coaching gave us the structure, accountability, and operational discipline to scale from startup mode into a high-growth agency adding hundreds of care hours in just a matter of months.”
Serving veterans across Cape Cod is a major part of our mission, and Paradigm has helped make that possible. Their support with VA billing and operations has given us confidence as we continue expanding services to veterans in our community.
“As the founder of a home care agency billing the VA. . . I can truly say using Paradigm is one of the best business decisions I’ve made.”
"Paradigm has been a tremendous help for managing and growing my business. They are the payer gurus in home care billing.”
The coaching helped us stop reacting to the business and start running it strategically with measurable goals, consistent accountability, and clearer operational focus.
“Prior to partnering with Paradigm, our VA billing was an ongoing stressor in the office. Working with Paradigm was the best choice our home care agency could have made.”
Provider Coaching gave our team clarity, consistency, and a roadmap for growth that immediately improved accountability across the organization.
“We’re growing quickly. . . using Paradigm has taken a lot of work out of our home care billing and the customer service response time is fantastic.”
The coaching process helped us identify operational blind spots, strengthen leadership alignment, and create repeatable processes that improved performance across the agency.
"Paradigm makes the home care billing process incredibly simple and efficient, especially when we have any type of billing issue. I don't know if I could handle our VA caseload if it wasn't for them!"
“I’ve been using Paradigm for our home care billing for two years now. They are very helpful with my VA billing and have EXCELLENT customer service. I highly recommend them.”
"In the past, some VA payments would show up 2-3 months after home care services were provided; with Paradigm in place, all VA payments arrive just a week after billing is concluded."
“Paradigm makes my life so much easier with automated home care billing. That gives me time to focus on other critical areas.”
"Paradigm handles all of our home care billing; our claims are submitted timely and correct. Most importantly, we're being paid quickly and accurately for our work!"
