veterans affairs

VA Claims Management For Home Care Agencies

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

How It Works

We only charge you for successful claims 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

Revenue coaching built-in

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

We can help get you going

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

Don’t Risk Your Revenue

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

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

Risk to
Revenue

Thousands lost on hours delivered without a valid referral
Tens of thousands 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
Revenue locked in limbo while staff chase vague denials
Rejections pile up from unintentional claim duplicates
Shifts denied when staff follow clinical intent over billing rules

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 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.

Billing Automation

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

Clean claim submission
Denial management
Dedicated support
Authorizations & Eligibility

Keep every hour of care authorized and payable.

Real-time tracking
Expiration alerts
Eligibility checks—no gaps in coverage or payment
Enrollment & Credentialing

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

State-specific guidance
TPA relationship guidance
Faster approvals
Revenue Visibility

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

Daily claim updates
Payment dashboards
Trend reporting
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

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 directly in my agency management software?
Yes. We work with platforms like WellSky, AxisCare, AlayaCare, and others.
How does Paradigm charge for VA billing?
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?
Yes. We’ll take over your claims process, fix billing issues, and ensure compliance moving forward.
Does Paradigm provide training 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? Let’s talk.