Categories
Claims EVV Mandate

PCS EVV to Clean Claims: Fewer Denials, Steadier Cash Flow

If denials, resubmits, and EVV mismatches are eating your week, you’re not alone.

Across Personal Care Services (PCS) agencies, the same pattern keeps showing up: data looks fine in EVV, but payer-specific edits aren’t enforced before submit—so claims bounce back, cash flow wobbles, and staff re-key the same work.

Carehandler was built to break that loop with a simple, reliable path: 

EVV → clean claims → faster reimbursement

Agencies running our workflow report 97% EVV compliance and 99% first-pass claim approval, which translates to fewer touchbacks, fewer surprises, and calmer payroll weeks.


Why denials happen (even when EVV “looks good”)

Most avoidable denials trace back to gaps between EVV data and payer rules:

  • Service codes/modifiers don’t match plan rules

  • Missing authorizations or unit alignment

  • Unscheduled visits or incomplete validations

  • Overlapping/duplicate visits

  • Timestamp windows outside billable ranges

When these are caught after submission, your team eats the delay and the rework. When they’re caught before submission, denials drop—fast.


The Carehandler path: EVV → Clean Claims → Faster Reimbursement

Carehandler enforces the edits that matter before a claim leaves the house:

  • Sandata-friendly, Medicaid Ready PCS workflow

  • Configurable payer edit rules aligned to your EVV data

  • Clean-claim checkpoints you can see and control

  • Audit trails and denial-prep reports when attention is needed

Outcome: Agencies report 99% first-pass claim approval and fewer resubmits, which shows up as steadier DSO and hours back for your billing team.


Proof in practice 

Most recent checks our agencies have received Medium to small agencies. Note: Results vary by payer mix and existing processes. We focus on operational outcomes (denials, first-pass %, hours saved) without requesting PHI by email.


Quick pre-submit checklist (steal this)

Seven checks PCS teams use to cut avoidable denials:

  1. Auth/units aligned to payer rules

  2. Service codes + modifiers match the care plan

  3. Unscheduled/missing validations flagged

  4. Caregiver eligibility/licensure on file

  5. EVV timestamps within billable windows

  6. Duplicate/overlapping visits prevented

  7. Payer-specific edits applied before submission

Carehandler automates these checks so clean claims go out the first time.


What you’ll see in a 30-minute walk-through

  • The EVV checkpoints that matter for clean claims

  • How payer edit rules are configured and enforced

  • Where audit trails explain exactly why a claim is clean

  • How we stay Sandata-friendly and Medicaid Complaint

FAQ (quick hits)

Do we need to change payers or clearinghouses?
No. Carehandler is Sandata-friendly and Medicaid Compliant, and we fit your PCS workflow.

Will you need PHI for the demo?
No. We can demonstrate with de-identified or sample data.

How fast can we see impact?
Most teams start with a few high-impact edit checks; you can see results as early as the first billing cycle.

What about audits and denials that still occur?
You’ll have audit trails and denial-prep reports so your team knows what changed and why.


Bottom line

PCS billing shouldn’t feel like guesswork. When EVV and payer edits line up before submit, denials drop, first-pass rates climb, and cash flow steadies. If that sounds good, let’s walk through it together.

Book a 30-minute walk-through → Sign Me Up

Categories
EVV Mandate

Crucial Decisions: Choosing the Right EVV System for Your Home Care Agency

Crucial Decisions: Choosing the Right EVV System for Your Home Care Agency

Making informed decisions for your home care agency is vital.  One decision you should consider carefully is your company’s Electronic Visit Verification (EVV) system.  Unfortunately, getting good information to find the right system can be a significant challenge.  Not only causing front-end and back-end headaches, a poorly configured EVV can get you in hot water with federal and state regulators.  Too many hard working agencies struggle making a good decision that will keep their organization out of trouble. 

In our commitment to supporting your home care agency, we’re launching an email series focused on key considerations in choosing an Electronic Visit Verification (EVV) system. While we are passionate about showcasing why Carehandler stands as an exemplary solution, our greater commitment is to assist you in reaching a decision that serves your unique needs optimally. Today, we dive into the crucial topic of State Aggregator Compatibility. Beyond this email, we invite you to reach out and schedule a discussion, because regardless of your final choice, our foremost goal is to ensure your agency’s enduring success.

Today’s KEY FACTOR:  State Aggregator Compatibility Now and Into the Future  

This is table stakes right?   Maybe not.  Many experienced homecare providers are disenfranchised with most of the available EVV solutions.  Why? Because of a common misconception that all EVV platforms get this right.  Or,  that their state’s aggregator can provide the optimum EVV solution for their business’ needs.   Unfortunately, this is too often not the case and choosing an EVV system that doesn’t seamlessly integrate with the state aggregator now and into the future leads to operational chaos. Data inconsistencies, duplicate entries, and manual workarounds become the norm rather than the exception. 

Questions you should be asking when choosing an EVV:

What Is the EVV’s Track Record of Successful State Aggregator Integrations?

Inquire about the EVV system provider’s history of successfully integrating with the state’s aggregators. Can they provide examples of past integrations and their outcomes?

Is There Ongoing Support for State Aggregator Integration?

Ask about the level of ongoing support for maintaining and updating the integration with the state aggregator. Does the provider have a team to handle changes in state requirements?

How Does It Handle State-Specific Rules and Changes

Explore how the EVV system accommodates state-specific rules and any future changes in these regulations. Is the system flexible enough to adapt to evolving compliance requirements?

What Is the Data Validation Process for State Reporting?

Understand the data validation mechanisms in place to ensure accuracy when reporting to the state aggregator. How does the system handle potential errors or discrepancies?

Can the System Handle Multiple States if Needed?

If your agency operates in multiple states with different aggregators or requirements, inquire if the EVV system can seamlessly handle this multi-state scenario without added complexity.

Is There a Fail-Safe Mechanism for Data Transmission?

Ask about redundancy and fail-safe measures in case of data transmission issues to the state aggregator. How does the system ensure that data is reliably sent and received?

What’s the Process for Handling Aggregator Updates?

Explore how the EVV system manages updates or changes in the state aggregator’s interface or requirements. Is there a protocol for timely adjustments to maintain compliance?

Can It Automatically Incorporate Changes in State Mandates?

Check if the system can automatically adapt to changes in state mandates without requiring significant manual intervention. A proactive system can save time and effort.

Are There Any Additional Costs Associated with State Aggregator Integration?

Inquire if there are any hidden costs associated with integrating with the state aggregator, such as fees for software updates or compliance-related changes.

Does It Offer Real-Time State Reporting Monitoring?

Ask if the system provides real-time monitoring of state reporting. Can you know at a glance if your organization is compliant? Can you easily track the data being sent to the aggregator and receive alerts for any issues? 

Conclusion

In today’s home care industry, the choice of an Electronic Visit Verification (EVV) system is pivotal—a bit like assembling a complex puzzle where each piece matters. 

We understand that making an uninformed choice can inadvertently lead to operational challenges and potential regulatory pitfalls. Our goal is to be your partner on this journey and help you avoid those pitfalls. 

At Carehandler, we’re more than just an EVV provider; we’re dedicated to building long-term strategic relationships. Our mission extends beyond simply offering a solution; we aim to be your trusted advisor in navigating this critical decision. We want to help you find the right EVV system, one that seamlessly integrates with your state’s aggregator, not only today but well into the future. 

Today, we’ve explored the vital factor of State Aggregator Compatibility, a cornerstone for your agency’s operational stability and compliance. 

Let’s not just read about it—let’s engage in a discussion. Reach out to us, and let’s embark on a conversation about how Carehandler can be your partner in making an informed decision. Our goal is to assist you in avoiding the potential pitfalls of a misinformed EVV choice, regardless of whether that choice leads you to Carehandler or another solution. 

Remember, the consequences of a hastily made or ill-informed EVV decision can be significant. We’re here to ensure your agency’s path to success is well-illuminated and that your choice aligns with your unique needs and goals. 

Choose wisely; choose Carehandler as your trusted partner in EVV solutions. 

Your agency’s future stands at the crossroads, and we’re here to guide you towards a future defined by success.

Categories
Tips & Tricks

Helpful Tips & Tricks for Agency Owners!

Helpful Tips & Tricks for Home Care Agency Owners in Idaho

Just some friendly tips & tricks ????

Signed Information Release, indicates your organization has on file a signed statement by the Participant authorizing release of medical data to other organizations. This is for the automated billing feature. Your patients DO NOT have to accept this. The feature will still work even if you put it as informed, declined release.

You can send a secure message to Gainswell by clicking on the yellow envelope ✉ icon. You can include all denied claims in the message, but you most include the following items for them to view and process your message: Claim #, Pay to NPI, Pay to Name, Member Name, Member Date of Birth, Date of Service, and Total Bill Charges. Include your name, reason for messaging, and the error message you received from Gainswell. This will help you get straight answers on how to fix your claim and get it accepted.

Emails:
Phone Numbers: 208-373-1351 – 208-373-1424
Need the link to the Medicaid handbook? Click here

Make sure to check your Sandata visits in your Sandata dashboard for any error messages. Any error messages you don’t understand, email Sandata or email us the error.

Try to NOT date span when submitting claims. Date spanning can result in EVV and Claim data not matching. Data not matching = denial to your claim!

Some providers, for payroll purposes, are consistently rounding up to the next 15-minute unit. This principle does not apply to visit time. Sandata does not “round” any data that it consumes. Example: a visit clock in is 10:03AM and the clock out time is 10:50AM. Total visit time = 47 minutes. This means that only 3 15-minute units are billable, not 4 units. If the provider bills 4 units, the claim will deny for unit mismatch.

The claims’ engine does not apply “lesser of” billing logic for units mismatch: if provider’s billable hours are 27 units in Sandata, and provider bills 28 on the corresponding claim, currently the claim is denying for unit mismatch. It is critically important that providers’ billed units do not exceed the corresponding billable visit time.
Follow the link here to view all the EVV Idaho Medicaid resources.

Check your visits in Carehandler for any error messages and to ensure that all visits have been sent off successfully to Sandata for processing.

You can now go to the visit’s section of Carehandler, click on “Export Visits Rendered” and export all visit data that included the service code & the total number of units used for that visit! We hope this helps when you are submitting claims. All your data is now is one place 🙂

Caregivers filling out missing appointments will still count towards EVV. Make sure you have your caregivers fill out those shifts, then go into visits and make sure you make any administrative adjusts before hitting submit!

There cannot be any spaces or symbols in an employees or caregivers name! Sandata will reject the visit if they have any. Also, when entering a SSN, make sure to just add the last 5 digits and not any (-) or symbols!

When entering a participant’s address, if they live in an apartment complex, please make sure to put their apartment number in the address line. This will insure no errors come up when caregivers try and click on an address.

Make sure each employee has their SSN filled out so that Sandata can verify the visit. Make sure each profile has been ‘updated’.

The Caregiver will be able to clock in to the current appointment anytime BEFORE the shift end time. For example, if the shift is scheduled to start at 9am and end at 1pm, they have anytime from 9am to 12:59pm to clock into the shift and record their time. The shift stays open in case the caregiver is late by a force they cannot control, they need to start later for reasons given by the participant, or if by administration approval they are able to start later than the start time. Please instruct them that they will need to still work the scheduled hours, not necessarily the scheduled time.

If an employee or participant has an unapproved error from Sandata in their profile, sometimes all it takes is to hit the ‘update’ button in the top right of the participant/employee profile.
Any unknown Sandata error you receive, please forward it on to us by taking a screenshot and giving us a quick message as to what you were trying to accomplish before this error came up. We can help communicate with Sandata’s support team to get some answers for you 🙂

Pending status in visits means the caregiver needs to fill out the appointment in missed appointments. Make sure they give a reason why they missed it or attended the visit at another time OR if there were technical difficulties make sure they put that reason in there.

Make sure location tracking is turned on for the app by going to settings –> carehandler app –> Location –> Always allow or allow while using.

Sometimes on android it can help if your caregivers are not seeing things to clear their app data and cache. Here is a video on how to do that —> View Video

Don’t be afraid to troubleshoot the issue with your team. You can certainly ask us for help, but this helps us get to the bottom of the issue faster if these things are answered first.

Ask questions like this to help get to the bottom of an issue:
Is all the employee and patient information filled out?
Is this email being used with another agency? Does this Caregiver have multiple jobs with another agency using Carehandler?
Is the email correct and spelled correctly?
Did I have my caregiver take a video of what is happening? Did I take screenshots of the error messages and problems I am having?

Home Care Pulse has some great resources on their website to help Home Care agencies tackle the everyday challenges they face. Check them out when you get a chance!

Don’t forget that we are constantly making this app better for you and love getting feedback on the product! Thank you for all your support!

Categories
Idaho Medicaid

New Idaho Medicaid Rates Starting this July!

New Idaho Medicaid Rates Starting this July!

Here it is! The moment we’ve been waiting for!

Our team was able to find what the new Idaho Medicaid Rate increases will be starting this July!

If your agency needs any help understanding how this new rates work and how to fix your billing – do not hesitate to reach out to the Carehandler team!

Click here to view the new rates!

Categories
Content from Home Care Pulse

How to Avoid Losing Clients to Senior Living

How to Avoid Losing Clients to Senior Living

Did you know that 66% of seniors who planned on moving to senior living in 2020 were skeptical of moving due to COVID-19? The decisions behind those moves are difficult to predict if you are not directly involved in the process.

In home care, it’s hard to anticipate when your clients might move. Other than when you are informed of their relocation, you generally don’t know they were even looking. When your revenue is at risk, it’s a challenge to shuffle caregivers onto other shifts without interrupting their schedules.

Click here to continue reading!!

Categories
Content from Home Care Pulse

How to Create the Best Possible Experience for Your Home Care Clients

How to Create the Best Possible Experience for Your Home Care Clients

As we are all seeing, home care is becoming increasingly client-centric. Pandemic or otherwise.

And there is a rising swell of clients who seek such care, in countries around the world.

Competition for their attention, and the ability to attract and retain caregivers, is higher than ever. Meanwhile, fee-for-service is giving way to value-based purchasing, meaning the outcomes of care – not just the delivery of care – really matter.

Click here to continue reading!!

Categories
Training

Health Service Providers Section within Patient Profile

Health Service Providers Section within Patient Profile

You will notice that now you can add each part of your patient’s life on their profile. This section is OPTIONAL, however it is a great place to add where they go to doctor, dentist, their hospice agency. That way, the office staff has a quick way to verify who they need to contact in case the patient needs assistance from one of those locations or if your agency needs to request documentation (or other items) from that location.

Think of that space as a place to store more information about the patient, without having to keep it on a sticky note somewhere!

Categories
Content from Home Care Pulse

6 Recruitment Strategies Every Home Care Agency Owner Needs to Compete in a Competitive Job Market

6 Recruitment Strategies, Every Home Care Agency Owner Needs to Compete in a Competitive Job Market

I remember when I tried to wing my grandpa’s famous Norwegian Krumkake recipe. Growing up, I had seen my mom make them dozens of times, so I relied on my memory for the recipe.

In the process, I forgot multiple ingredients, couldn’t remember the measurements of others, and ended up improvising the tools and length needed to bake them. I was left with a very vague resemblance to the traditional cookie that no one wanted to try and would certainly make my ancestors roll over in their grave.

Needless to say, I’ll be baking with the family recipe book open from now on.
Like baking, successful recruitment requires following a strategy with precise measurements in order to create an irresistible employment opportunity that everyone wants a piece of.

Click here to continue reading!!

Categories
EVV Mandate

2021 Sandata Impact Report

2021 Sandata Impact Report

Carehandler has been working hard to ensure our clients are 100% compliant with the Electronic Visit Verification (EVV) Mandate in the State of Idaho. Our team has been working closely with Sandata Technologies to make that happen. Their team has been very helpful with answering our questions and concerns along the way. They did just share their Impact Report for the year 2021.

We wanted to make sure our followers and customers had a chance to review this document. Thank you!

Sandata Impact Report, 2021

Categories
Content from Home Care Pulse

6 Interview Strategies for Hiring the Best Long-Term Caregivers

6 Interview Strategies for Hiring the Best Long-Term Caregivers

According to the 2021 Annual Benchmarking Study, while 47% of all interviewees were hired as caregivers, turnover rate remained at 65%. A new hire may give your agency a quick win, but it’s clear the existing interview process isn’t identifying dependable, long-term caregivers, and it’s hurting your business. It is costing your agency an average of $2,600 per caregiver—and the headache of replacing over half your employees each year.

Why are good quality applicants making it past the interview but not past one year of employment?

74% of employers believe their biggest recruiting challenge is the lack of qualified candidates to choose from, but 31.4% of workers in the U.S. voluntarily left their job from September 2020 to September 2021. Qualified candidates are ready and available; you just need to know your audience.

Click here to continue reading!!

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