The True Cost of “Free” EVV: What Agencies Aren’t Told About State Systems

At first glance, state-provided EVV systems seem like a great deal. They’re free to use, pre-approved by Medicaid programs, and available in many states with little to no upfront setup. For agencies focused on staying compliant without taking on more software costs, this can sound like an easy win.

But what looks simple on the surface often leads to more complexity behind the scenes. These platforms were designed to satisfy state requirements, not necessarily to meet the real-world needs of agencies managing schedules, staff, and billing. That gap often forces teams to juggle extra tools, manual workarounds, and support headaches just to get through the week.

Where State Systems Break Down

1. Glitches That Disrupt Clock-Ins
   Generic state aggregators are often buggy.  When caregivers can't log in or clock in, visits go unverified. That alone can lead to missed billing opportunities and added administrative work.
2. No Real Billing Integration
   Many state EVV platforms are just that - EVV. They don’t connect to your billing system. So once the visit is verified, someone still must manually build the claim, track the payment, and handle any denials.
3. Lack of Insight into Claim Rejections
   Rejected claims are inevitable. But many state systems offer no clear reason codes or user-friendly dashboards to help you quickly identify and fix the problem. That leaves you chasing answers and missing revenue.
4. Extra Work for Admins and Coordinators
   Most state systems weren’t designed with agencies in mind. They focus on compliance, not usability. That means more time checking records, following up on missed punches, or fielding caregiver complaints about app issues.

What Agencies Can Do Instead

You don’t need to ditch your state system entirely, but you do need to build better systems around it:

• Audit EVV reports weekly to catch trends in missed clock-ins or inconsistent documentation
• Train caregivers on the specific steps and common pitfalls in your EVV app
• Create internal workflows that help you quickly move from verified visits to clean claims
• Track how much time is spent manually fixing visit or billing data to reveal whether your current system is really saving you money

Don't Confuse Compliance with Efficiency

Just because a system checks the compliance box doesn’t mean it helps your agency run smoothly. If your team is spending hours every week chasing down issues, fixing rejections, or trying to make EVV data usable for billing, that “free” system is actually costing you a lot.

It’s important to be honest about whether your current EVV setup supports your team or just creates more work for them.

If small process tweaks aren’t improving the situation, it may be time to consider a platform that integrates your EVV and billing more closely. One that cuts down the manual steps and gives your team back hours each week.

The Ideal Setup: Add a True Operational Layer

One of the most effective ways agencies are improving their EVV workflows is by layering a purpose-built solution on top of the state aggregator. This approach allows agencies to maintain compliance through the state system while gaining full control and visibility over their operations.

With the right platform, verified visit data can be prescreened before it's submitted to the aggregator. That means fewer rejections, automated claim creation, real-time tracking, and faster payments. Admin teams get cleaner data, caregivers spend less time troubleshooting tech issues, and billing becomes something you can trust - not something you dread.

The ideal solution is to use a system like CareTime as the operational platform, while the aggregator handles the final transmission. This setup ensures data is accurate before submission, eliminates manual rework, and supports real-time compliance, efficient billing, and smoother cash flow.

If small process tweaks aren’t improving the situation, it may be time to consider adding a layer that handles the workflow end-to-end and not just the compliance piece.