Paradigm for MEDICAID
Paradigm takes all the headaches out of Medicaid billing for home care agencies.
Our one-of-a-kind solution automates Medicaid billing and payment reconciliation. Our built-in client eligibility checks ensure you never experience gaps in payment, and our EVV support allows you to maintain compliance while ensuring successful billing.
As the landscapes of home care and Medicaid continuously change, you can rely on Paradigm for stability and streamlined operations to propel your success
Authorization Automation
Paradigm manages your authorization and will let you know when your authorizations are expiring so that you never have to worry about a lapse in coverage. Moreover, Paradigm constantly checks validity of your authorizations against state databases and lets you know of any changes in real time.
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Billing and Claim Handling
MCOs and state direct programs will not pay until everything is submitted to them perfectly. This means that your billing submissions need to perfectly match your EVV data as received by the state or MCO. Paradigm's system works smoothly with whatever AMS/EHR system that you use. Furthermore, our system is integrated into the Medicaid and VA payers systems, so that payments and remittance are automatically posted on your side.
Rate and Policy Compliance
Medicaid rate and policy changes happen often. Don’t let that be to your detriment. Paradigm constantly ensures that you are compliant with local regulations and are billing at the correct rates. We also work together with state direct programs and MCOs to negotiate better Medicaid rates and more manageable policies for providers.
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EVV and Clearinghouse Management
Simply having all the correct systems live is inadequate. Making sure your EVV software is set up correctly is vital towards receiving payment for care. Upon onboarding, Paradigm’s growth management team offers free consultations to ensure that you are using your designated EVV, AMS and Clearinghouse softwares optimally.
Testimonials
We've been working with Paradigm for just over a year now for our VA billing. They make the process incredibly simple and efficient for me, 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 Paradigm!
Our company, Nu Care, joined forces with Paradigm around 1 year ago and we are so glad we did! We cannot even imagine what our billing outcome would have been like during the transition over to TriWest, which was scary in itself and unknown as to how exactly this process would impact our company. Paradigm handled the entire transition and our fears of the unknown were put at ease. Ever since the teaming up with Paradigm our company has been able to focus on other areas of growth, within our company, knowing our billing was being entirely handled. Paradigm is quick to respond, easy to come up with a solution that meets our needs, & has held our hand the entire way. It was the best decision our CEO could have ever made for our company Nu Care.
"Now that we use Paradigm, our interface to the VA is 100% automated and we are receiving accurate payments from VA in a timely fashion. While in the past, some payments would show up 2-3 months after services were provided, with Paradigm solution in place, all VA payments arrive just a week after billing is concluded."
"Being a small office and active owner I am involved in all aspects of my business. When you can outsource a piece of your operations in a way the streamlines effort and improves efficiency it is a win/win. Paradigm Senior Services has done that for me for my VA billing services. It started with taking the lead on the credentialing process which I was unable to complete myself. Additionally, I am getting my payments within 10 calendar days which is phenomenal. I consider Paradigm a trusted and valued partner."
"Prior to becoming partners with Paradigm Senior Services, our VA billing was an ongoing stressor in our office. I had to have a dedicated employee to focus on filing the claims and paying very close attention to not making any errors on the claims or they would be denied for payment. This became increasingly harder due to the constant changes to the programs we were needing to be in full compliance with as required by the VA.. Partnering with Paradigm had been the best choice we could have possibly made! They handle all of our current billing and our claims are submitted timely and correct. Most importantly, we are quickly being paid for the work and services we are providing to our clients!"
"Paradigm's services have been paramount in our VA success, since partnering with Paradigm we have doubled our overall business.When VA referrals come in we have the ability to never say NO, financially Paradigm provides us the resources necessary for us to always accept a new VA client without having to think of the reimbursement turnaround time… If you are looking to grow your business with the VA and don't want anything stunting/halting your growth then Paradigm is the partner for you."
"We have been working with Paradigm for a couple of years now. We are still a somewhat small company that is growing quickly so using Paradigm's system has been great because it has taken a great deal of work out of our hands. The system has saved us a lot of time and headaches in dealing with payers. The customer service response time is fantastic. I have almost always received a reply to my inquiries about Paradigm's system or the claim submission processes within a day but more typically those responses came from Paradigm team members within minutes or a few hours, who are diligent about finding me solutions to problems in a more than timely fashion."