Medicaid Billing: Why Agencies Are Struggling (And How to Fix It)

Medicaid billing shouldn’t feel like an uphill battle—but for most home care agencies, it is.

If you’re running a home care agency that accepts Medicaid, you already know the struggle:

? Complex, state-specific rules that seem to change overnight

? Long, unpredictable payment cycles that stretch cash flow thin

? High claim denial rates, often over minor technicalities

? The never-ending burden of compliance documentation

? EVV requirements that create more administrative headaches than solutions

The reality? These challenges aren’t just frustrating—they can make or break an agency’s ability to operate, let alone grow.

The Hidden Cost of Inefficient Medicaid Billing

A single claim error can stall revenue for weeks (or even months). A backlog of denied claims can snowball into a serious cash flow crisis. Agencies spend countless hours on manual billing corrections, resubmissions, and compliance checks—time that should be spent delivering care.

Here’s a stat that puts it into perspective: 83% of home care agencies experience delayed Medicaid payments due to claim errors. When revenue is tied up in billing disputes, it impacts everything—caregiver pay, client services, and the ability to scale.

And then there’s the issue of workforce shortages. Caregiver turnover in home care is as high as 67% annually—and when agencies are stuck chasing payments instead of investing in retention, the cycle only worsens.

What If Medicaid Billing Could Be Predictable?

It’s possible—and we’ve seen it happen.

In a recent case, a home care agency was at risk of losing $350,000 due to unpaid Medicaid claims. They were facing timely filing deadlines, denials, and administrative gridlock. But by streamlining their billing process, applying best practices, and leveraging the right technology, they recovered 75% of those claims—putting $262,000 back into their business.

That’s real money. Real impact.

The Key to Faster Payments & Fewer Denials

Billing success comes down to strategy, automation, and compliance. Our latest white paper, The Intersection of Technology and Care: A Guide to Medicaid Billing Success, breaks it all down:

?? Why Medicaid billing cycles are 30-45 days (and how some agencies cut this to 18 days)

?? The biggest EVV compliance mistakes that lead to claim denials

?? How top-performing agencies reduce billing errors and speed up payments by 25 days

?? The impact of the 80/20 provision on caregiver pay and how to prepare

?? Key considerations when choosing a billing & compliance solution

If you’re ready to stop playing defense with Medicaid billing and start optimizing for success, this is a must-read.

?? Read the full white paper here: CareTime Medicaid Billing Success

?? What’s been your biggest Medicaid billing challenge? Drop a comment below—let’s talk.