We manage Elderly Waiver and CADI Waiver billing end-to-end, so Minnesota providers get paid accurately on time and fully within DHS requirements. No chasing claims. No billing surprises at all.
The Elderly Waiver program allows seniors aged 65 and older to receive care in homes and communities rather than nursing facilities. For providers, this is meaningful work. But billing for EW services is overwhelming. A single eligibility gap, incorrect service code, or missing authorization holds up payment for weeks.
Our billing specialists manage every step on your behalf, from waiver enrollment verification, service documentation review, MMIS claim submission, and real-time tracking to denial resolution. We make sure you get paid for it accurately and on time.
The Community Access for Disability Inclusion (CADI) Waiver supports individuals under 65 with disabilities who require nursing-level care but live in community settings. Billing CADI claims correctly demands daily familiarity with Minnesota DHS 245D regulations, Electronic Visit Verification (EVV) requirements, and service authorization workflows, not occasional familiarity.
Our specialists work in waiver billing. That means fewer denials on first submission, faster reimbursements, and a billing partner who catches problems before they reach the payer, not after.
We actively track every claim through the full MMIS processing cycle. This reduces the time between service delivery and payment hitting your account.
Pre-submission eligibility checks and documentation audits eliminate the errors that cause denials before the claim reaches DHS.
Our team applies the current 245D rules and DHS billing requirements to every claim, so you stay compliant without having to track regulation changes yourself.
Fewer payment gaps mean your agency operates with financial confidence instead of chasing reimbursements to cover operating costs.
You work directly with one billing specialist who knows your account, responds same-day, and resolves issues without you waiting in a support queue.
All data handling, claim transmission, and reporting meet HIPAA standards. This protects your agency and your patients throughout the billing process.
Before a single claim is submitted, we confirm active waiver enrollment, verify current service authorization, and cross-check all supporting documentation against DHS requirements. This upfront step is what prevents most denials.
Claims are submitted directly to Minnesota MMIS. We monitor every claim through each stage of processing, addressing DHS flags and discrepancies immediately, not after a denial has already been issued.
When a claim is denied, we correct and resubmit within 48 hours. Every month, you receive a report identifying denial patterns across your claims, so your team can prevent recurring issues before they start.
We eliminate the most common causes of waiver claim denials, including eligibility errors, documentation gaps, and incorrect service codes, before submission. The result is a higher first-pass approval rate, faster payment cycles, and more predictable cash flow for your agency.
Yes, always. Every claim goes through an eligibility and authorization check before it leaves our system. We confirm active waiver enrollment and current service authorization directly against DHS records, because a claim submitted on expired eligibility is a denial waiting to happen.
We correct and resubmit denied claims within 48 hours. We also log every denial and its root cause so that monthly reports can identify patterns. This helps your agency address upstream documentation or intake issues that feed recurring denials.
Our specialists monitor Minnesota DHS updates, 245D rule changes, and EVV requirement shifts continuously, and apply those changes to your claims immediately, without you needing to track them.
Yes. All data handling, claim transmission, and reporting meet HIPAA standards. We treat the privacy and security of your clients’ information with the same rigor your agency does.
Billing errors, slow reimbursements, and compliance missteps cost Minnesota waiver providers thousands in delayed and lost revenue every year. We handle the billing complexity so you can focus on delivering quality care.
Start with a free billing assessment. No commitment at all. Just clarity on where your claims stand and what we can do to improve them.