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Straight answers for owners.
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Scheduling & Payroll
What do I do when a caregiver calls out and I have nobody to cover the shift?Work down a call list in order: the client’s other caregivers, then staff who want extra hours, then your supervisor.…Do I have to pay my home care caregivers overtime?Under the federal rule in place since January 1, 2015, agencies cannot use the companionship or live-in exemptions, so…Do I have to pay caregivers for driving time between clients?Yes, when a caregiver drives from one client to the next for the same employer, that time is work time under the…What is the difference between authorized hours and scheduled hours?Authorized hours are what the state or plan approved for the client. Scheduled hours are what you put on the calendar.…My caregiver stayed longer than the schedule. Can I bill the extra time and do I have to pay it?You must pay a caregiver for time actually worked. Billing is a separate question: you can only bill within the…Should I pay caregivers by the schedule or by what they clock in on EVV?Pay for the time worked, and use the checked-in record as your proof of when it happened. The schedule is the plan. EVV…How do I stop my caregivers from going into overtime?Watch each caregiver’s hours during the week, not after payday. Overtime starts after 40 hours, and travel between…Do I need a scheduler, or can I schedule everything myself?Many owners schedule alone until they hit a few dozen clients, then it takes over their day. The state also expects…How do I handle shift swaps without breaking the rules?Let caregivers swap only with someone trained and cleared for that client, and have a person in your office approve it…If Medicaid rejects or denies a visit, do I still have to pay my caregiver?Generally yes. Wage law looks at the work done, not at whether Medicaid paid you. That is why a clean visit record…Can I make a caregiver stay for a double or 24-hour shift when I have no coverage?Plan so you never have to. In Georgia, a private home care agency that cannot staff a visit must tell the client and…Do I have to enter every visit on the schedule in Georgia’s EVV system?Georgia’s quick start guide tells new agencies to add upcoming scheduled visits in the EVV admin portal, after adding…Who writes the care plan and who approves hours for CCSP and SOURCE clients in Georgia?In CCSP and SOURCE, a care coordinator does the assessment, builds the care plan, and puts the hours on a Service…A caregiver forgot to clock in or out in Georgia EVV. How do I fix the visit?In Georgia EVV, a provider administrator can update the visit by hand and pick a reason code from the list. Use the…
Compliance
What is EVV and do I really have to use it?EVV (electronic visit verification) is a record, made when the visit happens, that shows who gave which service to…Why was my EVV visit or claim rejected, and how do I fix it?Most rejections come from a visit record that is missing, incomplete, or does not match the claim or authorization. In…My caregiver forgot to clock in or out. What do I do?In Georgia, an administrator can enter the missed clock-in or clock-out by hand in the EVV portal. A reason code is…What happens if I don’t use EVV in Georgia?Georgia’s EVV FAQ says claims for EVV-required services submitted without EVV information will be denied. Agencies that…Which EVV system does Georgia use, and can I use my own?Georgia’s official EVV system is Netsmart’s Mobile Caregiver+. Agencies may use a third-party EVV system if it meets…What does EVV have to record? What are the six data points?Federal law says EVV must verify six things: the type of service, who received it, the date, where it was given, who…What background checks do I need on caregivers in Georgia?Georgia’s long-term care background check law requires a fingerprint-based national check for owners and employees with…Do my caregivers need a TB test?Under Georgia’s private home care rule, staff must have a satisfactory TB screening test when they are hired and once a…What training do my caregivers need before they can work in Georgia?For licensed private home care, Georgia’s rule lets a personal care assistant qualify by finishing a 40-hour program:…How long do I have to keep client and caregiver records?Georgia’s private home care rule says client records are kept five years from the last service, and incident and…What do I have to do when there is an incident, and how fast do I report it?Georgia’s waiver manual says critical and non-critical incidents must be reported within 24 hours or one business day.…What do auditors look for in a home care agency, and what happens if Medicaid audits me?Auditors check that the care billed really happened and was allowed. The HHS Inspector General found about 18 percent…Do I need a license to start a home care agency in Georgia?Georgia’s private home care rule says an entity that provides private home care at a patient’s home, directly or…Visits happened before the authorization was approved. Do I still need EVV, and when can I bill?Georgia’s EVV FAQ says visits before authorization still need EVV data, and the claim is submitted after approval. Do…Why did my claim deny for EVV?Georgia denies personal care claims that do not carry EVV visit data. The claim must go through the state EVV system…Can I use my own EVV system in Georgia, or do I have to use the state’s?You can use the state’s Netsmart system or an approved third-party EVV system. A third-party system must meet federal…Which Georgia services need EVV, and what happened on September 14, 2026 for home health?Georgia requires EVV for personal support services and community living supports under the CCSP, SOURCE, ICWP, NOW,…Why was my Georgia claim denied for missing EVV information?Georgia denies claims for EVV-required services when the claim does not carry the visit’s EVV information. Those claims…Who do I call when the Georgia EVV system has a problem?Call the Georgia EVV customer support line at (833) 483-5587, Monday to Friday, 8 a.m. to 7 p.m. Eastern. Netsmart’s…Do adult day centers have to use EVV in Georgia?Not under the state’s published list. Georgia’s EVV FAQ said Adult Day Health and Alternative Living Services under…How long do I have to keep client records for Georgia Medicaid waivers?The EDWP manual says to keep records for six years after the final claim is filed, and clinical records for six years…Which EVV system does [state] Medicaid use?Every state has to use EVV for Medicaid personal care and home health, but each state picks its own setup. Some run one…Who authorizes hours and writes the care plan in [state] Medicaid home care?In most states, a case manager, care coordinator, or the managed care plan writes the plan and sets the hours, not the…My Medicaid claim was rejected or denied in [state]. Who do I call and what should I check first?Read the reason on the remittance or EVV report first. The most common causes are a missing EVV visit, no matching…
Billing
What do Medicaid denial codes mean on my claim?A denial code is the payer’s short reason for not paying a line on your claim. Georgia Medicaid uses four-digit codes.…Why was my claim denied for units or authorization?Medicaid pays only for the units and dates that were authorized. If your claim has more units than the authorization…What is timely filing and how long do I have to bill Georgia Medicaid?Timely filing is the deadline to send a claim. For Georgia Medicaid, state guidance says six months from the month of…What is a clean claim?A clean claim is one the payer can process as sent: right client, right dates, right service code and modifier, an…How long does Medicaid take to pay a home care agency?There is no single number. Federal rules aim at paying most clean claims within 30 days and nearly all within 90, but…How do I read a Medicaid remittance advice (835)?A remittance advice is the payer’s report of what happened to each claim: paid, denied, or adjusted, and why. The…Do I need a clearinghouse to bill Medicaid?Not always. Georgia lets you send claims through its web portal, a batch file, or a clearinghouse or billing agent. You…What is the difference between a rejected claim and a denied claim?A rejected claim never got into the payer’s system because of a data or format problem, so you can fix it and send it…How do I fix and resubmit a denied Medicaid claim?Read the denial code, fix the cause, and resubmit before the deadline. In Georgia, denied claims with missing or wrong…Why does Medicaid say my claim is a duplicate?A duplicate denial means Medicaid already has a claim for the same client, service and date. Georgia lists codes 5646,…Should I do my billing myself or outsource it?Do it yourself if you have few claims, time to work denials weekly, and know the payer rules. Outsource when billing is…How much does a home care billing service cost?Prices vary. Billing services often charge a percentage of money billed or collected, a per-claim fee, or a monthly…What can a billing guarantee cover, and what can it not?A fair billing guarantee covers work the biller controls: sending claims without errors the biller causes, and fixing…Why do my claims keep denying and what is the biggest cause?Most denials trace back to simple mismatches: the client was not eligible on a date, the visit fell outside the…
Communication
How do I keep families updated without calling them all day?Pick one way to update each family and tell them at intake. Send one short note after each visit. Call right away when…A family member is calling: where is the caregiver? What do I tell them?Check first, then call back fast. Look at whether the caregiver has checked in, call the caregiver, and then tell the…A caregiver called off. How do I cover the shift?Call your backup list first, starting with caregivers who already know the client. Offer the shift to nearby staff,…How should I handle a complaint from a client or family?In Georgia, a licensed private home care agency needs a written complaint process. Give each client a written notice of…Can I text my caregivers about clients? Is that a HIPAA problem?HIPAA does not ban texting, but it requires reasonable safeguards. Keep texts short, leave out names, diagnoses and…Can I text or email a client’s family about how the visit went?Usually yes, if the client agrees or does not object and the family member is involved in care. Ask the client first…How do I work with the case manager or nurse when a client’s condition changes?Tell the case manager or nurse the same day, by phone first and then in writing. Say what you saw, when, and what you…What if my client or family doesn’t speak English? Do I have to provide an interpreter?If your agency gets federal money, including through Medicaid, federal rules require reasonable steps to give people…What are the most common complaints about home care agencies, and how do I avoid them?Common complaints include caregivers who seem untrained, schedule changes nobody explained, an office that is hard to…
Documentation
What should be in a client file and a visit note for Medicaid home care?Georgia’s rule for licensed private home care agencies lists what a client file must hold: identifying information, the…What do auditors look for in a Medicaid home care audit?They check that every paid visit has proof: a service authorized in the plan, a worker with documented qualifications,…How often does a nurse have to do a supervisory visit?It depends on your program and license, and we could not confirm one Georgia number. Georgia requires supervisory home…What is a plan of care and who writes it?A plan of care lists the services a client is approved to receive, how often, and for what goals. In Georgia waiver…What do I do when a client’s care needs change or the plan has to change?Do not change what caregivers do or how many hours they work on your own. Tell the care coordinator, document why the…Do clients and caregivers have to sign every visit? Are electronic signatures okay?Georgia’s EVV system captures client sign-off, with reason codes when a client cannot sign. For clinical notes,…What staff paperwork do auditors check?They check that each worker met the program’s qualifications before working: background check, age, training, health…What intake paperwork do I need when a referral comes in?Record the date and source of the referral, get a service agreement, confirm the authorization, and build a service…Who does the nurse assessment, and what must the nurse sign?A nurse licensed in Georgia must do nursing work. Georgia’s rule says personal care assistants may not provide nursing…What happens if I fail an audit or my documentation is not enough?The state can deny or take back payment for visits it cannot support, require a corrective action plan, or take adverse…
Referrals & Reputation
How do I get Medicaid referrals for my home care agency?In Georgia’s CCSP program, clients choose their own agency. A nurse care coordinator offers the choice, may pass on a…I’m enrolled with Medicaid but not getting referrals. Why?Enrollment only lets you accept clients. It does not guarantee referrals. Coordinators look at the client’s choice,…What is rotation, and how does it work in Georgia CCSP?Rotation is how Georgia CCSP care coordinators choose an agency when a client has no preference. The care plan notes…How fast do I need to answer a referral?No rule I found gives agencies a set number of minutes to answer. But Georgia coordinators work on short clocks: 24…What do case managers and families look for when choosing a home care agency?Georgia care coordinators weigh the client’s choice, a doctor’s advice, special needs such as weekends or evenings,…What do I need before I can take Medicaid home care clients in Georgia?You need a Georgia license for the service, a legal business, and enrollment with Georgia Medicaid and, for CCSP, with…Can I give gifts or pay case managers, doctors or hospital staff for referrals?No, not for Medicaid business. Federal law makes it a crime to offer or pay anything of value to get or reward…How do I set up a Google Business Profile for my home care agency?Use your real business name, with no keywords, taglines or phone numbers added. Home care goes to the client, so set up…How do I get more Google reviews from my clients without breaking the rules?You may ask clients and families to review you by sharing your Google link or QR code. You may not offer discounts or…How do I answer a bad Google review without breaking privacy?Reply fast, kindly and short. Don’t confirm the person is a client, and never share any care details, even to defend…Where should my agency be listed so families and case managers can find us?Start with the places that already hold your facts: your Google Business Profile, your Georgia license record, and your…How do Medicaid residents find my personal care home? How do I fill open beds?In the Elderly and Disabled Waiver, the client chooses the home. The care coordinator arranges services and sends the…
Hiring
Where do I find caregivers, and how do I get them to show up for interviews?Ask your best caregivers for referrals, post short plain job ads that say pay, hours and area, and answer applicants…Why is there such a caregiver shortage, and is it going to get worse?The U.S. Bureau of Labor Statistics projects home health and personal care aide jobs to grow 18 percent from 2025 to…How much should I pay my caregivers?The national median for home health and personal care aides was $17.21 an hour in May 2025, per the U.S. Bureau of…What should I check besides a criminal background check before hiring?Check the federal exclusion list (LEIE) before you hire, and keep checking. OIG says an employer who hires an excluded…What is an I-9 and when do I have to finish it for a new caregiver?The I-9 proves a new employee can legally work in the U.S. The worker fills in their part by their first day. You must…Do I have to use E-Verify as a home care agency in Georgia?Georgia law has required private employers with more than ten employees to use E-Verify for new hires since July 2013.…What training do new caregivers need in Georgia before working with clients?For licensed private home care agencies in Georgia, new staff need an orientation before they work with clients.…What goes in a caregiver’s personnel file? What do I need to keep?In Georgia, a private home care agency’s personnel file must include name, address, phone and emergency contacts, a…How long does it take to hire a caregiver, and how can I speed it up?I found no reliable government number for how long hiring takes. Your timeline is set by the slowest step, usually the…What should I look for in an applicant tracking system for a home care agency?Look for a tool that tracks each applicant’s steps, not just resumes. It should show background check status, TB…
Retention
Why do my caregivers keep quitting?Caregivers usually leave over how they are treated, not only pay. In a large Home Care Pulse set of caregiver…How do I keep new caregivers past the first 90 days?Over a quarter of caregivers leave in the first 90 days, so the first weeks matter most. Set clear expectations before…What is the turnover rate for home care aides?PHI reports home care turnover was nearly 75% in 2024. Home Care Pulse’s older research put the typical agency between…How do I give my caregivers more hours?Steady hours come from matching caregivers to clients near them, giving each caregiver a small group of regular…What are good ways to thank and recognize caregivers?Recognition works best when it is planned, specific and from the owner. Lack of recognition was in the top five reasons…How do I stop my caregivers from burning out?Burnout comes from too much work for too little support. Cut the extra paperwork, avoid last-minute schedule changes,…How much does it cost when a caregiver quits?There is no trusted public number, so work out your own. Add the ad and interview time, background check, training…How long should new caregiver orientation be?Georgia’s licensing rule sets a minimum for aide training: 20 of 40 hours before serving clients for personal care…
Training
How many training hours does a home care aide need?It depends on the type of agency. Medicare-certified home health agencies must give aides at least 75 hours of…What training does a Georgia personal support services caregiver need before the first client?Under Georgia’s private home care rule, a personal care aide needs 20 of 40 training hours before serving clients,…Do caregivers need abuse and neglect training?Yes, plan on it. In Georgia, employees of agencies that provide health-related services to elders and disabled adults…Is dementia training required for home care aides?We did not find a Georgia rule that sets dementia training hours for home care aides. Georgia does set hours for staff…What training do Georgia personal care home staff need?The full Georgia personal care home rule is Chapter 111-8-62. We did not open its training section, so confirm hours…How do I track my caregivers’ training and certificates?Keep one list for every caregiver with each course, date, hours, who taught it, and proof. Georgia’s rule asks for…What is a competency check, and who has to sign it?A competency check is when a supervisor watches a caregiver do a task and writes down that she did it right. In Georgia…Can I train my caregivers in another language?We found no Georgia rule that limits the language of caregiver training. What matters is that she understands it and…Does a caregiver need CPR and first aid certification?In Georgia assisted living, hands-on staff need current first aid and CPR certification. For private home care and…
Personal Care Homes
What is a personal care home in Georgia, and how is it different from assisted living?A Georgia personal care home is a home that gives housing, food, and personal help to two or more unrelated adults. An…How do I get a personal care home license in Georgia, and what does it cost?You apply to DCH for a permit. The fee rule lists a $300 application fee plus a license fee based on size: $350 under…Does Georgia Medicaid pay for a personal care home? What about room and board?Georgia’s CCSP and SOURCE waivers can pay for Alternative Living Services in a state-licensed personal care home. The…
Adult Day Health
What is adult day health in Georgia, and does Medicaid pay for it?Adult day health is a daytime program with nursing, social services, therapy and meals. In Georgia, the CCSP, SOURCE…Do I need a license to open an adult day center in Georgia, and what are the rules?Yes. Unless exempt, an adult day center in Georgia needs a license from DCH, one for each center. The fee rule lists…
Case management
What does case management mean in Georgia’s waivers, and who does it?In Georgia’s waivers, case management means assessing needs, writing the care plan, arranging services, and checking…Can the same company do case management and home care in Georgia?In Georgia’s CCSP and SOURCE manual, case management agencies may not also provide direct services in the same…
Medicaid changes
Is Georgia Pathways the same as a home care waiver?No. Georgia Pathways to Coverage is a limited Medicaid coverage program for low-income adults who meet a work or…What is the One Big Beautiful Bill Act, and what does it change for Medicaid home care?The One Big Beautiful Bill Act (OBBBA) is the federal law signed in July 2025. For Medicaid, the first changes begin…Does the Medicaid work requirement apply to my clients in Georgia?Most home care clients are not the target. The federal rule covers adults 19 to 64 in the Medicaid expansion group or…Will my clients lose Medicaid in October 2026?Some may, but it depends on the person and the state. On October 1, 2026, the federal definition of qualified immigrant…What is the Medicaid 80/20 rule for home care, and is it going away?The 80/20 rule is in CMS’s 2024 Medicaid Access Rule. It says at least 80 percent of Medicaid payments for homemaker,…Will the new federal law cut my Medicaid rates, or help me with a new waiver?The law does not set your personal care rates. States do. It freezes and then lowers some provider taxes, and it caps…How will the new federal Medicaid law (OBBBA) affect home care in [state]?It depends on your state. Some changes begin between October 2026 and early 2027, and states choose how and when to…
Choosing and switching
What should I look for in home care agency software?Start with what Medicaid requires: EVV that captures the six federal data elements and works with your state. Then…Is all-in-one software better than using separate tools?All-in-one is usually easier when the money depends on matching: a checked shift becomes pay, a claim and a note.…How do I switch software without stopping my billing?Run the new system beside the old one on real data before you switch. Compare schedules, pay and claims until the…How long does it take to switch software, and what does it cost?It depends on how clean your data is and how many caregivers you have. We found no trusted public figure. Plan for a…Is AI safe to use for Medicaid home care?It can be, if a person stays in charge and the tool follows HIPAA. AI can draft notes, flag errors and suggest answers.…Can AI do EVV or billing for my agency?AI can help with both, but EVV has fixed federal rules. The system must capture six things: service, client, date,…Is AI HIPAA compliant? What do I need from a vendor?HIPAA does not approve tools. It sets duties. If a vendor handles patient information for you, you need a signed…Does my software have to be approved by Georgia Medicaid for EVV?Georgia uses an open model. You can use the state’s EVV system or an alternative one that meets federal rules. The…How long and how much does it take to start a Medicaid home care agency in Georgia?Plan for more than a year. DCH says a license review takes about 60 days, the CCSP/SOURCE manual asks for 12 months in…
Starting and growing
How do I start a Medicaid home care agency?In short: form the business, learn which Medicaid program and service you will offer, get your state license, pass…How much does it cost to start a home care agency in Georgia?One private guide estimates $30,000 to $65,000, including $12,000 to $35,000 in working money, and a license…Where can agency owners learn from other owners?Join a trade association, go to a state meeting, and find two or three owners a few years ahead of you. National groups…Is there a Georgia group for Medicaid waiver home care owners?Yes. The Georgia Association of Community Care Providers (GACCP) represents home and community based service providers…Are there courses or events for new agency owners?Yes. The Home Care Association of America holds a national conference and state chapter days, including one in Georgia.…Can a new agency become a CCSP or SOURCE provider right away?Probably not right away. An older Georgia Division of Aging Services document (2011) says an agency needed an active…
Georgia
What is the difference between CCSP and SOURCE in Georgia?CCSP and SOURCE are the two parts of Georgia’s Elderly and Disabled Waiver Program. Both help older or disabled adults…Which Georgia Medicaid waiver programs pay for in-home care, and who runs each one?Georgia has six main programs: CCSP and SOURCE (older and disabled adults), ICWP (adults 21 to 64 with physical…Who approves hours for NOW, COMP and ICWP clients in Georgia?For NOW and COMP, DBHDD’s regional offices pre-approve services, and your agency must be named on the prior…What is GAPP and how does an agency get approved to serve Georgia Pediatric Program kids?GAPP is Georgia Medicaid’s in-home nursing and personal care program for medically fragile children under 21. Families…Can my agency offer Structured Family Caregiving in Georgia?Structured Family Caregiving is a service in Georgia’s CCSP and SOURCE waivers. A live-in family caregiver is supported…Do Georgia Medicaid care management organizations (Amerigroup, CareSource, Peach State) pay for waiver home care?Georgia Families has three care management organizations: Amerigroup, CareSource, and Peach State Health Plan. For…How much does a private home care license cost in Georgia, and how long does it take?DCH’s fee rule lists a $300 application fee plus a license fee of $250 for each service you offer, up to $750. That is…Should I get a private home care license or a home health agency license in Georgia?Most new non-medical Medicaid home care owners in Georgia start with the Private Home Care Provider license. A home…How do I become a CCSP or SOURCE provider in Georgia?Read Section 601 of the CCSP/SOURCE General Services manual on the Georgia Medicaid portal, hold a full license, attend…How do I enroll as a Georgia Medicaid provider in GAMMIS, and what is revalidation?You apply in the GAMMIS web portal using the Enrollment Wizard. Fill in each panel, write down your Application…What are the home care licensing requirements in [state]?There is no federal home care license. Each state sets its own, and many split non-medical home care from skilled home…How do I enroll as a Medicaid home care provider in [state]?First get your state license and tax numbers. Then apply through your state Medicaid agency’s provider enrollment…Which Medicaid programs pay for home care in [state]?Most states pay for home care through a mix of the regular Medicaid plan and one or more waivers. Waivers serve groups…What does [state] Medicaid pay for personal care per hour or per unit?Each state sets its own rate. It is in a fee schedule or in the waiver provider manual, often under ’rates’ or an…Does [state] use managed care plans for home care, and how do I contract with them?Many states pay for some home care through managed care plans, but plans differ by state and by program. Check your…
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