Authorizations & Eligibility

No More Unbillable Shifts.

It’s not just about delivering hours; it’s about getting paid for them. We make sure every home care visit is backed by the right approvals by the VA and Medicaid so nothing falls through the cracks.

Book A Demo

What We Handle

We'll guide you through the same processes as hundreds of our other home care clients.

VA Authorizations

Submission of renewal forms for you

Hour, rate, and service code review

Documentation compliance and renewal timing

Medicaid Eligibility

Weekly eligibility checks and redetermination tracking

Prior authorization (PA) requests and renewals

Authorization matching to EVV and shift data

What Makes Our Process Different?

It’s not our first rodeo, or even our 1,000th rodeo. We manage VA and Medicaid billing by proactively running checks on the information most likely to cause denials, escalate appeals rapidly when needed, and maintain relationships with the payers.

Front-end alignment

We don’t wait for denials to spot a problem. We verify authorizations, match service plans, codes, and payer rules before care begins.

Weekly eligibility audits

Our team runs batch eligibility checks every week for active clients, catching Medicaid terminations or changes before they block payment.

VA SEOC compliance

We ensure compliance with your SEOC—hours, rate, service code, and time period—so you’re not working outside the lines.

Real-time flagging

Our system catches misalignments between authorizations, shifts, and EVV. You’ll know if something’s off before it becomes a denial.

Proactive renewals

We track every end date and lead the renewal process—whether it’s a VA SEOC, a Medicaid waiver authorization, or an MCO-specific PA.

Documentation that holds up

We review care plans and RN assessments for VA compliance and Medicaid audit readiness, reducing risk and protecting revenue.

Get in Touch

home care billing Support

Frequently Asked Questions

What happens if a VA authorization lapses without my team realizing it?

Any care delivered during this time will be unbillable. We help you avoid this issue by proactively checking authorizations.

What if I need more hours?

We help you request an updated VA referral, with documentation support to justify the increase based on veteran needs.

Do VA authorizations expire?

Yes, typically every 6 to 12 months. We track that timeline and initiate renewals so your agency's care doesn't get interrupted.

What if I don’t have an RN?

Depending on your state, you may be mandated to use one.

What gets home care agencies denied?

Usually it's wrong codes, hours not justified, expired referrals, or documentation gaps. We’re here to prevent all of that.

How often do you check eligibility?

Every week. We flag any terminations, changes in waiver status, or pending redeterminations before they affect billing.

Do you handle prior authorizations too?

Yes. For services that require them, we submit PAs and manage renewals across all contracted MCOs.

What if a client loses eligibility?

We notify you immediately and help determine if they can be reinstated or transferred to a different payer.

How do you match authorizations to shifts?

We cross-check each shift against the authorized hours, codes, and timeframe—so billing is accurate and defensible.

Can you handle different MCO rules?

Absolutely. Each MCO has its own format, timelines, and codes. We manage the complexity so you don’t have to.

Let’s make sure every hour is billable

Authorizations and eligibility for the VA and Medicaid aren’t just paperwork—they’re the foundation of cash flow. We’ll make sure you're on solid ground.