This solution delivers an?all-in-one SaaS platform?enabling Minnesota home healthcare agencies to manage?client care, EVV compliance, caregiver compensation, and Medicaid claim submission?from a single multi-tenant system.
The MVP integrates:
EHR Lite?for clients and caregivers
Scheduling & Authorization management
EVV tracking with HHAeXchange sync
Billing & RCM via Waystar
AI-assisted data validation?to prevent claim denials
The system enables agencies to reduce operational cost, eliminate manual file handoffs, and ensure seamless compliance with?Minnesota DHS 245D requirements.
The objective is to develop a separate Claims management system for automating insurance eligibility verification, claims creation, scrubbing, submission, claims remittance and denial management using EDIs. They have a EMR with the patient data, and need a solution to help empower their business performance, productivity and compliance initiatives. they need:
Claims Management: Speed and ease claims and remittance processing with electronic claims submission powered by an extensive connectivity network.
Eligibility Verification: Determine patient coverage at any time in the revenue cycle to help improve the patient experience and reduce claim denials.
Claim Status: Improve claim visibility during payer processing with claim status from EDI transactions and payer portals.
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