veterans affairs

VA Claims Management for Home Care Agencies

Serving the veteran community can be both lucrative and rewarding. Unfortunately, billing the VA is often a daunting maze of red tape, delays and denied claims. Paradigm guides you through the complexity of VA billing and helps you get paid on time, every time.

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Bar chart showing VA Revenue growth from January to July, peaking at nearly $1M in July, with an error of repeating 'Feb' label.
VA Revenue
All Payers / Veterans Affairs
Date Range: This Year
$1M
0
JanFebMarchAprilMayJunJuly

How it Works

We only charge you for successful VA claims paid and our revenue depends on yours, so we’re invested in your success.

We take the claims off your plate

We run your VA claims management like we’re your in-house billing department

Claims table showing four entries with totals ranging from $2,207.69 to $2,400.00 USD, all with invoice number IFMMBJB1-003 and clients Eleanor Shellstrop, Chidi Anagonye, Tahani Al-Jamil, and Jason Mendoza, each marked Open.
Chart showing goal to increase monthly revenue by 20%, with current revenue at $32,500 and target at $39,000, indicated by an upward trending arrow.

Provider coaching built-in

Our experienced provider coaches help you grow your census and increase revenue

We can help get you going with the VA

We help you get enrolled with the VA, if you aren’t already

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Don’t Risk Your Revenue

We’ve mastered the art and science of protecting your revenue at every stage of the VA claims process.

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Common
Challenges

Missing or incomplete referrals
Claims not submitted
Overbilling SEOC hour caps
Incorrect HCPCS or modifiers
Delayed claim submission
Vague or unclear denials
Duplicate claim submissions
Mismatch between consult and SEOC
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Risk to
Revenue

Thousands lost on hours delivered without a valid referral
Tens of thousands of dollars in care never invoiced or reimbursed
Hours of care erased by authorization caps that flew under the radar
Claims bounce back unpaid due to preventable code errors
Clock runs out on claims sitting in internal backlogs
Cashflow locked in limbo while staff chases vague denials
Rejections pile up from unintentional claim duplicates
Shifts denied when staff follow clinical intent over billing rules
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Our
Solution

We validate and interpret referrals across all sources
We reconcile and submit claims weekly to prevent loss
We map shifts to SEOC caps and alert stakeholders before overages
We automatically scrub claims with AI to prevent code-related denials
We submit weekly and flag missing items proactively
We resolve denials using payer logic and historic cases
We block duplicate claims using submission history logic
We align consults with SEOC limits to ensure compliance
Solutions

We Handle It All

It’ll feel like you’ve gained a team of coworkers who’ve spent their whole careers learning to speak the VA’s language.

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Billing
Automation
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Authorizations
& Eligibility
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Enrollment &
Credentialing
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Revenue
Visibility
Billing Automation

Full-service revenue cycle management built for home care agencies billing the VA.

Clean claim submission
Denial management
Dedicated support
Learn More
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Authorizations & Eligibility

Keep every hour of care authorized and payable.

Real-time tracking
Expiration alerts
Eligibility checks—no gaps in coverage or payment
Learn More
Person holding a smartphone with floating screens showing real-time tracking of eligibility check verified, payers, accepted payments $520,017 with 35% increase, and claim update with 18% approval rate.
Enrollment & Credentialing

Rapid enrollment support from folks who have done it thousands of times.

State-specific guidance
TPA relationship guidance
Faster approvals
Learn More
Digital enrollment table showing status and payers with active statuses for Medicaid and Veterans Affairs, and in process for Medicaid Advantage.
Revenue Visibility

AI-powered workflows and tracking to reduce uncertainty and improve forecasting.

Daily claim updates
Payment dashboards
Trend reporting
Learn More
Paradigm Dashboard for Financial Reporting for home care agencies.
Expert Coaching

Grow Faster with
Expert Growth Coaching

Our revenue grows with yours, so we provide free growth coaching to our customers. Our veteran coaching team includes former agency owners, franchise trainers, sales coaches, and more.

Grow Faster With
Expert Growth Coaching.

Our growth depends on your growth. So we assembled a team of home care experts to help you out.
The coaching team includes former agency owners, franchise coaches, sales coaches, and more.

One-on-one coaching

Group training sessions

Business operation audits

Get in Touch
Support

Frequently Asked Questions

Can Paradigm help me get VA referrals?
Yes, but we don’t provide them directly. We guide agencies through HSRM and Ensocare setup, and coach you on how to connect with VA case managers.
Do I need to be credentialed with the VA first?
No. We’ll handle your TriWest or Optum enrollment from start to finish.
Which TPAs does Paradigm support?
We support both TriWest and Optum, including their different systems, processes, and billing rules.
Can Paradigm bill the VA directly in my agency management software?
Yes. We work with AMS platforms like WellSky, AxisCare, AlayaCare, and others.
How does Paradigm charge for VA billing services?
We operate on a pay-for-performance model—no setup fees, no monthly minimums.
Can you help if I’m already credentialed but struggling to get paid from the VA?
Yes. We’ll take over your claims process seamlessly, fix billing issues, and ensure compliance moving forward.
Does Paradigm provide training on VA Billing for my staff?
Yes. We offer VA billing education, compliance training, and ongoing support for your care coordinators.

No Setup Fees. No Monthly Minimums. Just Proven Results.

Got questions about our VA billing services? Let’s talk.

Book A Demo

Solutions

Billing AutomationAuthorizations & EligibilityEnrollment & Credentialing Revenue VisibilityGrowth Coaching

Tools

VA Reimbursement ToolPayer Mix ToolMedicaid Rate Lookup Tool

Company

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Support

Support & Issue Reportingsupport@paradigmseniors.com

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