Operations Partners for Medicaid-Primary Home Care

You keep caregivers in homes.
We make sure every visit gets paid.

We become your back office for Medicaid home care. Our team manages EVV exceptions, Medicaid billing, denied claims, caregiver compliance, scheduling support, and operational workflows so your staff can focus on patients — not paperwork.

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EVV exceptions
Visits stuck in your aggregator instead of becoming revenue.
Rejected claims
Claims waiting weeks for someone to work them.
Missed revalidations
Expired authorizations delaying payments.
Caregiver files
Missing documentation putting compliance at risk.
The wedge

Medicaid billing & EVV exception management

Every unresolved EVV exception and rejected claim is money your agency already earned but isn't collecting. We start with a free assessment: we review your exceptions and rejections and show you exactly what you're losing.

The average agency has thousands of dollars sitting in unresolved exceptions — every month.
Book the assessment
Unit calculation and verification against the plan of care
EVV exception audits, visit by visit — Sandata, HHAeXchange, AuthentiCare, or your state's own system
Submit clean claims faster with proactive error resolution
Daily payer follow-up to accelerate reimbursements
Reconciliation and denial resolution
The unbilled unit

A unit of care you delivered, staffed, and paid for — never collected.

A shift becomes an EVV record, the record a verified visit, the visit units, the units a claim, the claim a payment. Six links — any one breaks and the units go unpaid. It happens in four ways:

01

Rejected units

Delivered and paid for in wages, then denied — or never submitted, because the visit sat unverified past the filing window.
02

Reworked units

Fixed eventually, at about twelve minutes of office time each — paying a second time to collect on units you already paid for once.
03

Unconfirmed units

Submitted, pending, unknown. You can't plan hiring or rates on numbers you don't have, so you manage on the bank balance.
04

Rounded units

A 9:07 clock-in on a 9:00 shift bills eleven units instead of twelve. It pays clean, flags nothing, and nobody ever chases it.

We're not going to tell you what the average agency loses.

We don't know your rate, your census, your authorization mix, or your state's rounding rule — and anyone quoting an industry average is selling a number they made up. Here's the arithmetic on a worked example. Run it with your own inputs.

The line that surprises every owner is the rounded one — a third of the total, and it has never appeared on a single report they've run.

On $1.5 million of annual billing, $71,400 is 4.6% of gross revenue. At the net margins this industry actually runs on, unbilled units are frequently most of the profit.

Count mine — free assessment

Worked example. A 30-caregiver agency: roughly 4,000 service hours a month — 16,000 units, about 1,330 visits. Unit rate $8. Loaded office cost $28 an hour.

Rejected
8% of visits flag an exception; a third never get resubmitted → 428 units × $8 = $3,424 a month · $41,088 a year
Reworked
The other 71 exceptions get worked at 12 minutes each → 14 office hours × $28 = $398 a month · $4,776 a year
Rounded
20% of visits verify one unit short → 266 units × $8 = $2,128 a month · $25,536 a year
Total
roughly $71,400 a year
An illustration with plausible inputs, not a benchmark — an 8% exception rate is a reasonably well-run agency. Yours will be different.
Systems we work in

Every state has different EVV rules, aggregators, edit windows, and rejection codes.

We already know them, so your team doesn't have to. A coordinator who learned one aggregator has learned one state — we work in all of them daily, and we know which failures are the system's fault and which are yours.

Sandata

The most widely mandated aggregator — roughly 20 states

HHAeXchange

Sole aggregator in 7 states, shared in 6 more

AuthentiCare

Netsmart’s aggregator platform — 5 states

Therap

Common where I/DD and waiver services overlap — 3 states

Netsmart

Direct EVV deployments in 3 states

CareBridge

Managed-care-driven EVV in 2 states

State-built systems

AZ, LA, MD, OR, UT and WA each run their own

Open-model states

Where the state mandates no aggregator, we work your vendor of record
Results

What changes when we take over

Every engagement is measured in the same units you are: verified visits, paid claims, days to cash. We help agencies:

Reduce EVV backlog

Exception queues worked visit by visit, down to zero and kept there.

Recover denied claims

Denials corrected, resubmitted, and followed until they pay.

Improve clean claim rates

Errors caught before submission instead of after rejection.

Reduce payroll delays

Verified visits reconcile faster, so caregivers are paid on time.

Speed up caregiver onboarding

Complete, audit-ready files from day one on the job.
What we run

The full back office, module by module

01

Medicaid Billing & EVV

Wedge offer
Unit calculation and verification against the plan of care, EVV exception audits in your state's aggregator, and clean claims submission with proactive error resolution.
02

Claims Recovery

Denial resolution and resubmission, daily payer follow-up, AR aging review, prior authorization tracking, remittance reconciliation — including claims your team has written off.
03

Hiring Compliance

Applicant tracking and screening, video interviews, credential auditing — TB tests, drug screens, background checks, fingerprinting, competency tests — and OSHA compliance.
04

Caregiver Scheduling

Shift coordination, cancellation management, payroll support.
05

Client Intake

Plan of care assistance, Medicaid LTSS navigation, caseworker coordination, private pay setup.
06

Marketing & Growth

Lead capture, local SEO, aggregator management, speed-to-lead follow-up.
07

Operations

Fully managed daily operations, policies and procedures — the turn-key option.
How it works

Start small. Expand when the work proves itself.

01

Free assessment

30 minutes. We review your EVV exceptions and rejected claims with you.
02

Identify revenue leaks

You get a number: what’s recoverable now and what the leaks cost you monthly.
03

Build your operations plan

Scope, handoffs, and reporting cadence — sized to your agency.
04

We run it

Your team keeps caregivers in homes. We make sure every visit gets paid.
Step one

The 30-day pilot

One module, fixed scope, flat fee. We take on your EVV exception backlog or your rejected-claims queue and work it for 30 days. You see the recovered dollars before any retainer is discussed.
Step two

The retainer

If the pilot pays for itself, we scope a flat monthly retainer — one module or the full back office, always below the cost of the same scope in-house.
Why Martin & Young

Hire the function, not another vendor

01

Operators, not a call center

Run by an operator with over ten years in US Medicaid home care back office — more than six of them on EVV reconciliation. We sell operational competence, not seats.

02

Priced against a coordinator's salary

We're priced against the cost of an in-house billing and EVV coordinator, not against a software subscription.

03

Built for Medicaid-primary agencies

Sandata, HHAeXchange, AuthentiCare, Therap, Netsmart, CareBridge, or a state-built system — we work in whichever one your state runs.

Martin & Young is a US-registered firm with a fully remote team. We work on your systems, on your business hours — nothing about your operation moves.

Where we work every day
Sandata · HHAeXchange · AuthentiCare · Therap · Netsmart · CareBridge · Office Ally · Availity · NaviNet
Who we serve

Owners and administrators of Medicaid-primary home care agencies with 30 or more caregivers.

If your agency is losing revenue to unresolved EVV exceptions, rejected claims, or a hiring pipeline that can't keep pace, that's the work we do — in your state's EVV system and your payers' portals.

FAQ

Questions owners ask

What is EVV exception management?
Every Medicaid home care visit must be electronically verified — who gave care, where, and when. When a clock-in fails, a GPS point doesn’t match, or a schedule changes, the visit lands as an exception in your state’s aggregator and can’t bill until it’s corrected. We audit, correct, and clear those exceptions so verified visits become paid claims.

How long does Medicaid billing take?
A clean claim usually pays inside the payer’s normal cycle — one to three weeks. The delays that hurt agencies come from rework: exceptions, rejections, and resubmissions that add weeks or months. Our job is submitting claims clean the first time and working the rework queue daily.

Which EVV systems do you support?
Sandata, HHAeXchange, AuthentiCare, Therap, Netsmart, CareBridge, and state-built systems. If your state runs it, we work in it.

Can you work with our existing software?
Yes. We work inside the systems you already have — your EVV aggregator, your clearinghouse, your scheduling platform. No migration, nothing new to buy.

Do you replace our billing department?
Only if you want us to. Some agencies hand us the whole function; others use us to clear backlog and backstop a coordinator. Either way, we’re priced against the cost of doing it in-house.

Which states do you support?
Any state. EVV rules and aggregators differ in each one — that’s exactly the problem we’re built for.

How do you price your services?
A flat monthly fee, sized to your agency and the scope we run — always below the cost of the same work in-house. It starts with a free assessment, then a fixed-fee 30-day pilot. Exact numbers come out of the assessment.
The assessment

Rather skip the call? Send the reports.

Send 30 days of EVV exception and rejection data, exported straight from your aggregator and clearinghouse. De-identified is fine — and if it's easier to send as-is, we sign a BAA first. You get a written assessment back, usually within three business days:

Recoverable units

What's still inside timely filing, with a dollar figure at your rate.

Rounded units

Scheduled versus verified time across the period — the number most owners have never seen.

Rework cost

What your team spends collecting the portion that does get fixed.

Root causes, ranked

Which link in the chain is breaking hardest, and what fixing it takes.

It's a document, not a pitch deck. If your operation is running clean, we'll tell you that — and nothing happens afterwards unless you want it to.

Prefer to talk it through live? Book the free assessment.

See what your agency is leaving on the table

30 minutes. We review your EVV exceptions and rejected claims and show you the recoverable amount. No commitment.

Book a free assessment
Prefer to skip the call? Request the written assessment
MARTIN & YOUNG
Free claims & EVV assessment
30 minutes  ·  No commitment
We review your EVV exceptions and rejected claims live, and show you the recoverable amount. A Google Meet link is sent when you book.

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Trouble with the widget? Open it in a new tab, or email hello@martinandyoung.org and we'll send times.