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 matters before the shift ends. Confirm your duty to pay with the Department of Labor or an employment lawyer, and ask your state about fixing the claim.
Many new owners are surprised by this one. Your caregiver did the work. Your claim was rejected. Who carries the loss?
In general, the employer carries it. Wage law is about hours worked. Medicaid payment is a separate matter between you and the state or health plan. No agency page we saw spells out the wage side for Medicaid rejections, so confirm this with the Department of Labor Wage and Hour Division or an employment lawyer.
What you can do to reduce the risk:
- Catch problems the same day. Look at missed check-ins and open visits each afternoon.
- Fix real errors with a reason code and a note. Georgia’s EVV rules allow an administrator to complete a missed clock-in or clock-out with a reason code.
- Check the authorization before you schedule.
- If a claim is rejected, use the claims tools in Georgia’s EVV system to correct and resubmit, and call Netsmart Customer Support if you cannot resolve it.
Keep a small cash cushion for the weeks when payments run late. It is one of the most common reasons agencies get into trouble.
How CareBravo® helps
A rejected EVV record comes back explained in plain words and is resubmitted after your Go ahead.
Sources
- Electronic Visit Verification (EVV) Provider-Related FAQs · Georgia DCH
- EVV Common Provider Issues and Support Cheat Sheet · Georgia DCH
- Home Care: Information for Agencies · U.S. Department of Labor, Wage and Hour Division
Reviewed by Beth Bledsoe, Care Business Advisor®, 28 Oct 2026. Rules change. Confirm with your state Medicaid agency before you act.
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