Billing Portals, EVV, and the Ping-Pong Game No One Signed Up For

If you’ve ever spent your morning bouncing between billing portals, EVV dashboards, and spreadsheets just to figure out why a claim didn’t go through - this is for you. 

In today’s home care world, your time is too valuable to waste chasing down rejection codes or logging into five different systems just to piece together a paper trail. Home care businesses across the country face these same challenges, navigating complex regulations and billing requirements that impact their ability to deliver care efficiently. And yet, portal ping-pong has become the norm for so many Medicaid-heavy home care agencies. 

Let’s talk about what’s really going on, and why it doesn’t have to be this way. Home care is about helping patients maintain independence and quality of life, while also supporting clients and their families through compassionate, coordinated care. But when you’re sending caregivers out for in-home visits, the stakes are high and not just for care quality, but also for compliance with federal and state requirements. That’s why advanced home health software and electronic visit verification (EVV) are so important. Comprehensive home care software offers an all-in-one solution to streamline workflows, ensure compliance, and simplify billing processes. With the right tools, agencies can focus less on administrative headaches. Integrated systems help businesses better serve clients and streamline operations, improving outcomes for everyone involved. 

A Quick Primer: What Home Care Really Is 

Home care is all about bringing essential care services directly to people where they feel most comfortable, at home. Whether it’s personal care, private duty home care, hospice support, or skilled home health care services, the goal is to help patients maintain independence and quality of life. Home care agencies coordinate a range of services, from helping with daily activities like bathing and dressing to managing medications and providing specialized clinical care. 

But it’s not just about sending caregivers out for in home visits. Today’s leading agencies rely on advanced home health software and electronic visit verification (EVV) to ensure every visit is tracked, every shift is verified, and every patient receives the right care at the right time. These solutions streamline operations, reduce paperwork, and help agencies deliver quality care more efficiently. With the right tools, agencies can focus less on administrative headaches and more on what matters most: supporting patients and families with compassionate, reliable care. 

When Electronic Visit Verification and Other “Digital Tools” Work Against You 

The home care industry is flooded with technology that was supposed to make operations smoother. Instead, most agencies find themselves using a patchwork of disconnected tools. Each one solves a narrow slice of the workflow, but none of them talk to each other. There is a growing need to integrate these systems to enable seamless operations, data sharing, and care coordination. 

So instead of gaining efficiency, teams now face a mess of manual checks: 

• Pulling EVV data from one portal 

• Verifying shifts and units in another 

• Checking authorization status in a third 

• Submitting claims in yet another system, often struggling to submit claims efficiently to various payers. 

• Tracking rejections and remits somewhere else entirely. 

Providers need better access to integrated data and resources to streamline these processes and reduce the administrative burden. 

It’s exhausting. What was meant to simplify billing has made it more fragmented and fragile, making it critical for providers to be able to access and submit claims to all payers from a single platform. 

Caught in the Crossfire: Agencies, Regulations, and the Real-World Maze 

If you run a home care agency, you know the rules are always changing, and they’re never simple. Between state Medicaid programs, Medicare Advantage plans, managed care organizations, and the 21st Century Cures Act’s EVV mandate, agencies are constantly navigating a maze of requirements just to stay in business. Every payer has its own set of rules for home health care services, personal care, and billing and compliance, making compliance a full-time job. 

That’s where the right home care software comes in. By using mobile-optimized, integrated care software, agencies can automate administrative tasks, keep up with regulatory changes, and ensure every claim is submitted accurately. These solutions help boost productivity, improve communication between teams, and streamline the revenue cycle, so you can spend less time worrying about compliance and more time focusing on delivering quality care. In a world where regulations can change overnight, having the right resources and technology isn’t just helpful, it’s essential for survival. 

What This Game Is Really Costing You 

Let’s move beyond the annoyance. Portal ping-pong isn’t just inefficient, it’s expensive. The process of billing for each service becomes more complex and error-prone, increasing the risk of mistakes and denials. 

• Delayed payments: Every extra day a claim sits unsubmitted or unresolved strains cash flow. 

• Manual errors: Re-entering the same data across multiple portals invites mismatched units, incorrect dates, or missing documentation, which can affect the ability to bill insurance and other payers correctly. 

• Staff burnout: Teams spend hours tracking down rejections and calling MCOs - often without answers. 

• Compliance risks: Low EVV match rates can lead to denied claims or put Medicaid eligibility in jeopardy. 

These inefficiencies can negatively impact clients by delaying services or reimbursement for the care they need. 

And it is not just the billing department that feels it. When back-office systems are scattered, frontline care suffers too, making accurate service documentation essential for both clients and payers. 

The Root Issue: Fragmented Systems, Fragmented Results 

The problem isn’t your staff; it’s the structure they’ve been given. Providers delivering Medicaid personal care services must follow a complex process to ensure compliance with federal and state regulations, including requirements set by the 21st Century Cures Act for Electronic Visit Verification (EVV). 

When data lives across different portals with no shared logic or real-time validation, it creates gaps that humans are expected to fill manually. And that’s simply not scalable. 

What home care agencies truly need is billing that’s tied directly to care delivery: 

• Claims that reflect actual, verified shifts. 

• A process for submitting a request to correct visit data in most states, which often involves secure communication and compliance with HIPAA regulations. 

• Built-in checks for visit mismatches or expired authorizations 

• One unified source of data, not six 

The less time you spend stitching systems together, the more time you must manage your business, and actually get paid. Most states require providers to follow specific processes for Medicaid personal care services billing and data correction to maintain compliance and secure reimbursement. 

Regulatory Compliance and Accreditation: The Unseen Burden 

Behind every successful home care agency is a mountain of compliance work that rarely gets into the spotlight. From tracking caregiver credentials to ensuring every claim meets payer requirements, regulatory compliance and accreditation are non-negotiable, but they can also drain time, money, and energy. Agencies must juggle billing, claims, and documentation, all while maintaining high standards for patient care and operational needs. 

The good news? Modern homecare software solutions are designed to take the weight off your shoulders. By integrating clinical, financial, and operational processes into one all-in-one solution, agencies can manage compliance, reduce costs, and improve financial performance without sacrificing quality care. These tools help agencies stay ahead of audits, avoid costly errors, and deliver better care to patients while also strengthening their reputation in a competitive market. With the right software solution, compliance becomes less of a burden and more of a strategic advantage, empowering agencies to focus on what they do best: caring for their communities. 

What Real Efficiency Looks Like 

Let’s stop pretending that toggling between five tabs is “normal.” 

Efficiency should look like this: 

• Submitting claims with confidence because your data is accurate and complete. 

• Seeing an issue before it becomes a denial. 

• Letting systems automate the repetitive tasks, so your team can focus on what matters. 

• Billing from a place of clarity, not chaos 

Tracking referral sources can further improve operational efficiency and help businesses grow by providing insight into where your referrals originate and optimizing those relationships. 

It’s not about working faster, it’s about working smarter, with fewer moving parts and more visibility. 

No One Signed Up for This Game 

This was never supposed to be the job. Billing staff shouldn’t have to be detectives. Operators shouldn’t have to manage revenue with a whiteboard and a prayer. And agencies shouldn’t have to cross their fingers every time they log into a billing portal. 

But that’s exactly what happens when the tools we rely on are fragmented, outdated, or not built with real Medicaid workflows in mind. 

The good news? You’re not alone. And change is possible. 

If you're still bouncing between EVV, authorizations, and billing portals like it’s a game of tech whack-a-mole, it’s time to step back and ask: Why are we still doing it this way? 

Because of this game? 

It’s rigged. 

And you don’t have to keep playing.