Medicaid Home Care Billing Software
Medicaid and waiver billing depends on authorizations and EVV visit data matching the claim. Porchlight bills from verified visits and checks the claim against the authorization before submission.
How Medicaid billing works
The path is the same shape in each program: an authorization, a visit, a claim, then payment back. Rules vary by state and program. This page does not list state-by-state claim rules.
- An authorization is stored on the client.
- A visit must be EVV-verified before a claim is built. Billing uses that verified visit.
- Porchlight builds a claim from that visit and runs pre-submission claim checks against the authorization.
- The payer returns a remittance, and an 835 can be posted.
What Porchlight checks before submission
Pre-submission claim checks compare the claim with the authorization and the verified visit.
- Units against the authorization
- Rate
- Service code
- EVV match
- Eligibility dates
After submission
After the claim leaves the agency, Porchlight keeps the follow-up on that claim.
- A rejection can be tracked
- A rejected claim can be corrected and resubmitted
- An 835 remittance can be posted
EVV
A visit has to be EVV-verified before a claim is built. Billing uses that verified visit. Rules vary by state and program. Porchlight does not publish a list of aggregators or states.
Medicaid billing sits inside home care billing software. Private pay, long-term care insurance, and VA billing are covered by private duty home care billing software. What it costs is on home care billing software pricing.