EVV Setup Package
4-6 weeks
- State and payer requirement mapping
- EVV configuration and workflow design
- Go-live checklist and quality controls
EVV Implementation + Billing Recovery
Build a compliant EVV operation and recover the revenue your agency already earned.
We partner with home care leadership teams to stabilize EVV workflows, resolve rejected claims, and restore financial confidence — from initial setup through the hardest denial backlogs. We've been doing this since the original federal EVV mandate.
No obligation. We'll tell you honestly if we can help.
$10M+in corrected & recovered billing
200+franchises supported nationwide
2020active since the original EVV mandate
Who we are
A firm built around one problem, not a dozen.
EVV Consulting Group works on one thing: getting EVV compliance and the billing that depends on it right. We are not a general revenue-cycle shop that added EVV as a line item — every engagement is staffed by senior specialists who have worked EVV compliance and claims recovery since the original federal mandate took effect. That focus is why agencies bring us in when the stakes are highest: stuck backlogs, cash pressure, and audits that cannot afford errors.
Specialization
EVV and the billing built on top of it — nothing else. That focus means faster root-cause diagnosis and fewer blind spots than a generalist billing vendor.
Continuity
The senior specialists who scope your engagement are the same people doing the work through close-out — no hand-off to a junior team once the contract is signed.
Transparency
You get direct findings, including when the honest answer is that your team does not need us for a particular problem.
The problem
Where EVV billing quietly breaks down.
Most agencies don't lose revenue in one dramatic event. It leaks out in small, compounding ways until the backlog is too large to ignore.
Visit data doesn’t match what gets billed
GPS gaps, missed clock-outs, and aggregator mismatches turn clean visits into denied claims — often without anyone noticing until the backlog is already large.
No single owner for stuck claims
Exceptions sit in a queue nobody is accountable for, aging past timely-filing windows while cash that was already earned stays unbilled.
Workflows live in someone’s head
Payer-specific rules and EVV exception handling depend on one or two tenured staff. When they leave, the process leaves with them.
Leadership finds out too late
Without claim-age visibility, executives learn about revenue exposure only after it threatens payroll — not while it is still fixable.
What we do
Advisory support focused on execution, not theory.
Whatever stage your EVV operation is in — first setup, deep in denials, or ready to scale — we bring a team that has handled it before.
01
EVV setup & configuration
Stand up or rebuild your EVV system from the ground up — state and payer requirement mapping, aggregator connections, and caregiver-facing workflows that capture clean, verifiable visit data.
- State and payer requirement mapping across every jurisdiction you operate in
- Aggregator and EVV vendor configuration, tested end-to-end before go-live
- Caregiver-facing workflow design that captures clean data from day one
02
Denial management & claim recovery
Root-cause every denial category, prioritize high-value stuck claims, and run recovery sprints against payer-specific resubmission and escalation playbooks.
- Denial-code taxonomy and root-cause analysis by payer
- Prioritized recovery sprints targeting the highest-dollar claims first
- Payer escalation scripts and resubmission playbooks your team can reuse
03
Billing cleanup & A/R reconciliation
Full aging analysis across payers, isolation of write-off risk, and a claim-by-claim remediation plan that turns backlog into booked cash.
- Aging analysis segmented by payer, age, and dollar exposure
- Write-off risk isolated before timely-filing windows close
- Claim-by-claim remediation plan with clear internal ownership
04
Compliance & audit readiness
Tighten visit-to-claim integrity, document exception handling, and build the audit trail your state Medicaid program and payers expect to see.
- Visit-to-claim integrity checks against state EVV requirements
- Documented exception-handling procedures for every workflow
- Audit trail preparation for state Medicaid and payer reviews
05
Team training & enablement
Role-based training for schedulers, caregivers, and billing staff, backed by written SOPs so correct handling survives staff turnover.
- Role-based training tracks for schedulers, caregivers, and billers
- Written SOPs that make correct handling the default, not the exception
- Manager-level scripts for coaching exception handling in real time
06
Fractional EVV advisory
Ongoing, embedded guidance for leadership — a standing partner for vendor changes, new-state expansion, and policy shifts as EVV requirements evolve.
- Standing monthly cadence with your leadership team
- Guidance through vendor changes, state expansion, and policy shifts
- On-call support when a new EVV rule lands without warning
Why agencies choose us
The difference between managing denials and eliminating them.
Handling it in-house
Partnering with EVV Consulting Group
Denials get reworked one at a time, if at all
Root-cause analysis by denial category with prioritized recovery sprints
EVV and billing teams troubleshoot in isolation
One integrated view from visit capture through paid claim
Process knowledge lives with one or two staff
Documented SOPs and training that outlast any single hire
Leadership sees cash pressure but not the cause
Executive-ready reporting on claim age, denial mix, and recovery
Packages
Choose focused support based on your current bottleneck.
Billing Unblock Package
6-10 weeks
- A/R aging and denial root-cause analysis
- High-value stuck claim recovery sprints
- Payer escalation and resubmission playbook
Team Training Package
2-4 weeks
- Role-based training for schedulers and billers
- SOP documentation and exception handling scripts
- Leadership cadence for performance reviews
Impact
Built for organizations that cannot afford billing leakage.
Revenue visibility
Executive dashboards and claim-age analysis expose where cash flow is blocked.
Compliance confidence
EVV process controls reduce audit risk while improving visit-to-claim integrity.
Sustainable operations
Teams leave with repeatable workflows that keep denial rates and rework low.
How we work
A practical four-phase engagement model.
- 01Weeks 1-2
Diagnose
Rapid assessment of EVV data quality, billing backlog, and denial root causes.
- Full EVV data quality audit across payers and locations
- Denial and A/R aging analysis to quantify at-risk revenue
- Root-cause findings presented directly to leadership
- 02Weeks 2-4
Stabilize
Triage the highest-value stuck claims first, so cash flow relief starts before the full engagement is complete.
- Recovery sprint on the highest-value stuck claims
- Immediate fixes to the most damaging EVV-to-claim handoff gaps
- First cash recovered before the engagement concludes
- 03Weeks 4-8
Correct
Targeted intervention across EVV workflows, submission quality, and payer escalation to recover what is owed.
- Payer-specific resubmission and escalation execution
- EVV workflow and configuration corrections implemented
- Submission quality controls installed to stop new denials
- 04Ongoing
Institutionalize
Training and a leadership reporting cadence that protects the gains and prevents the backlog from returning.
- Role-based training delivered to schedulers and billing staff
- SOPs documented and handed off, not just verbally explained
- Leadership reporting cadence established to protect the gains
Performance snapshot
Visualize where revenue is recovered and where claims still get blocked.
Recovered billing trend
Illustrative six-month view of recovered claims after cleanup and governance cadence.
Claim status mix
Typical portfolio distribution after implementing process controls and monitoring.
In their words
What leadership teams say after we unblock the backlog.
“They showed us where the money was stuck, why it was happening, and fixed it fast enough to save the company.”
“This is where they come in: unblock the billing, install the process, and make sure issues are caught before revenue is lost again.”
Frequently asked
Straight answers before you talk to us.
What is EVV, and who is required to use it?
Electronic Visit Verification (EVV) is a federal requirement under the 21st Century Cures Act for state Medicaid programs to electronically verify caregiver visits for personal care and home health services — confirming who provided the service, to whom, and when. It applies to Medicaid-funded home care and home health providers nationwide, with each state administering its own EVV system or aggregator.
When did EVV become mandatory?
The federal mandate took effect January 1, 2020 for Medicaid personal care services and January 1, 2023 for home health services, though enforcement timelines and exemption processes varied by state during rollout. We have been working with agencies through every phase of that transition.
Why do EVV-related claims get denied?
The most common causes are visit data that does not match billed units, missing or incomplete clock-in/clock-out records, aggregator-to-payer transmission errors, and payer-specific submission rules that were never documented. We start every engagement by isolating which of these is actually driving your denial rate.
How fast can you unblock claims that are already stuck?
It depends on volume and payer mix, but our highest-priority recovery sprints are designed to move on the highest-value stuck claims within days of engagement start — not months. Full backlog cleanup timelines are scoped during the discovery call.
Do you work with our specific EVV vendor or state aggregator?
Yes. Our approach is vendor- and aggregator-agnostic — we have worked across the major state Medicaid EVV systems and third-party EVV platforms. The diagnostics and workflow fixes are built around your existing stack, not a specific vendor.
What does an engagement cost, and how do we get started?
Engagements are scoped to the problem — setup, billing recovery, or training — and priced accordingly after a discovery call reviews your current EVV and billing picture. Start by requesting a consultation and we will recommend the right starting point.
What actually happens on the discovery call?
We review your current EVV setup, claim aging, and denial trends together, then tell you which package — or whether any package — fits the problem you actually have. It is a working session, not a generic sales pitch.
How do you measure success on an engagement?
Every engagement is scoped against specific, agreed metrics before it starts — usually dollars recovered, denial rate reduction, or claim-age improvement — and we report against them throughout, not just at the end.
We are already mid-engagement with another vendor. Can you take over?
Yes. We regularly step into engagements already in progress, particularly billing recovery work that has stalled. The discovery call tells us quickly how much groundwork already exists and what can be salvaged versus redone.
Next step
Schedule a focused review of your EVV and billing performance.
Bring your current denial trends, aging reports, and EVV challenges. We'll map a clear path to recovery — and tell you honestly if we're the right fit.