Authorizations & Eligibility

No More Unbillable Shifts.

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

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What We Handle

We'll guide you through the same processes as hundreds of our clients before you.

VA Authorizations

Submission of renewall 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 1000th rodeo. We proactively run checks on the information most likely to cause denials, escalate appeals rapidly when needed, and keep 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.

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Frequently Asked Questions

VA Authorizations
Medicaid Authorizations
What happens if an 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 referral, with documentation support to justify the increase based on veteran needs.
Do autherizations expire?
Yes, typically every 6 to 12 months. We track that timeline and initiate renewals so your 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 agencies denied?
Usually: 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 aren’t just paperwork—they’re the foundation of cash flow. We’ll make sure it’s solid.

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