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Paradigm Senior Services

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Payer Serviceswww.paradigmseniors.comMiami, FL, United StatesUpdated

VA and Medicaid revenue cycle management for home care agencies.

Overview

Paradigm Senior Services is a revenue cycle management company specializing in government payers for home-based care providers. It partners with home care agencies to simplify VA and Medicaid billing through end-to-end services, including eligibility and enrollment, claim submission, denial management, payments posting, and revenue visibility. Having acquired Careswitch, an AI-powered home care operating system, Paradigm emphasizes automation to streamline workflows and reduce administrative burden. The company positions itself as the only pure-play RCM focused on VA and Medicaid for home care agencies, aiming to accelerate payments, improve compliance, and support providers serving veterans and seniors nationwide.

Mission statement

Paradigm is the leader in VA and Medicaid revenue cycle management for home care agencies.

One of 2 AI agents in Payer ServicesRead recently byAmazon

What we offer

Billing Automation

Automate your billing process to ensure timely payments and improve cash flow.

paradigmseniors.com →

Revenue Visibility

Gain real-time insights into revenue streams and improve cash flow management.

paradigmseniors.com →

Enrollment & Credentialing

Accelerate your agency's growth through efficient enrollment and credentialing services for Medicaid and VA.

paradigmseniors.com →

Authorizations & Eligibility

Streamline client eligibility and authorization processes to ensure timely payments and reduce denials.

paradigmseniors.com →

Paradigm Lens

Paradigm Lens simplifies billing management by providing visibility to payment statuses and resolving issues.

Careswitch AI-Powered Operating System

Streamlines home care operations and accelerates payments through AI-driven automation.

Growth Coaching

Service

Expert consulting to elevate home care agency performance and revenue.

paradigmseniors.com →

VA Reimbursement Tool

Streamline your VA billing with instant access to current fee schedules.

paradigmseniors.com →

Payer Mix Tool

Analyze your agency's revenue diversification effectively.

paradigmseniors.com →

Medicaid Rate Lookup Tool

Quickly find and compare Medicaid rates to maximize compliance and revenue.

paradigmseniors.com →

Market segments

Home care revenue cycle management

End-to-end management of claims, denials, payment posting, accounts receivable visibility and compliance for home care providers billing Medicaid and VA.

Products: Billing Automation, Paradigm Lens, Revenue Visibility, VA Reimbursement Tool, Authorizations & Eligibility, Careswitch AI-Powered Operating System

Medicaid and VA enrollment and credentialing

Payer enrollment, provider credentialing and VA onboarding services and workflows to enable timely contracting and reimbursement.

Products: Enrollment & Credentialing, VA Reimbursement Tool, Authorizations & Eligibility

Care operations and workforce automation

Scheduling, workforce management and EVV-integrated visit reconciliation that automate operational workflows and reduce billing errors.

Products: Careswitch AI-Powered Operating System, Billing Automation, Authorizations & Eligibility

Revenue analytics and payer mix optimization

Analytics, rate lookup and forecasting to analyze payer mix, model revenue scenarios and support payer diversification decisions.

Products: Payer Mix Tool, Medicaid Rate Lookup Tool, VA Reimbursement Tool, Growth Coaching

More information about our offering

Billing Automation

Paradigm’s Billing Automation automates the end-to-end billing workflow for home care providers, enhancing revenue cycle efficiency and improving cash flow. It integrates with scheduling and EVV to ensure accurate billing and adheres to payer requirements.

  • Prevent Billing Issues
    Ensures adherence to payer rules, avoiding claim rejections.
  • Streamline Billing Process
    Manages the complete billing cycle for efficiency.
  • Expert Guidance
    Navigates complex billing for better compliance.
  • Reduce Denials
    Increases claim acceptance rates by effectively addressing denial reasons.
  • Improve Cash Flow
    Provides insights into revenues.
  • Ensure Accurate Billing
    Aligns billing with actual care provided.

Revenue Visibility

Revenue Visibility provides real-time insight into revenue streams, allowing providers to monitor payments and authorizations, and identify issues across the revenue cycle.

  • Achieve Complete Revenue Transparency
    Minimizes delays in payments.
  • Monitor Payments Effortlessly
    Identifies issues that may delay reimbursements.
  • Ensure Compliance and Avoid Denials
    Helps avoid billing errors and ensures consistent cash flow.
  • Simplify Revenue Management Across Payers
    Focuses on areas needing improvement.
  • Accelerate Cash Flow Recovery
    Leads to quicker payments.

Enrollment & Credentialing

Enrollment and credentialing services for agencies including VA credentialing and onboarding with payer portals, ensuring timely reimbursement and compliance.

  • Streamline Enrollment Process
    Minimizes delays in approval.
  • Facilitates Medicaid Participation
    Ensures compliance and timely reimbursement.
  • Simplifies VA Access
    Helps navigate complex credentialing requirements.
  • Enhances Approval Rates
    Minimizes delays in payment processes.
  • Offers Expert Guidance
    Helps overcome barriers in enrollment.

Authorizations & Eligibility

Handles client eligibility verification and service authorizations, reducing denials and ensuring timely payments.

  • Streamline Authorization Processes
    Reduces the risk of denials.
  • Ensure Client Eligibility
    Prevents service disruptions.
  • Maintain Continuous Coverage
    Helps prevent revenue loss.
  • Accelerate Payments
    Reduces delays and improves cash flow.
  • Sync Visit Data
    Minimizes discrepancies.

Paradigm Lens

Paradigm Lens is a module of Paradigm’s platform enabling providers to track payments and fix billing issues directly.

  • View Payment Status Instantly
    Helps manage revenue cycles effectively.
  • Resolve Billing Issues Quickly
    Maintains cash flow and operational efficiency.
  • Track Authorizations Efficiently
    Ensures compliance and proper service delivery.

Careswitch AI-Powered Operating System

Careswitch automates scheduling, billing, compliance, and workforce management for home care agencies.

  • Automate Complex Workflows
    Enhances operational efficiency.
  • Prevent Claim Denials
    Ensures accuracy before submission.
  • Streamline Billing Processes
    Reduces errors and delays in payments.
  • Track Payments In Real-Time
    Provides immediate visibility into billing status.
  • Enhance Compliance Oversight
    Manages documentation and audit trails.
  • Optimize Workforce Scheduling
    Improves scheduling efficiency.

Growth Coaching

Growth Coaching provides structured consulting for Paradigm customers to grow home care agencies through payer diversification.

  • Craft a Unique Growth Strategy
    Aligns with market opportunities.
  • Access Industry Experts
    Provides tailored strategies.
  • Receive Personalized Attention
    Focuses on unique challenges.
  • Leverage Real Insights
    Drives informed decision-making.
  • Participate in Comprehensive Training
    Balances group learning with individual attention.

VA Reimbursement Tool

The VA Reimbursement Tool provides quick access to the latest VA fee schedules for accurate billing.

  • Access Latest VA Fee Schedules
    Ensures accurate billing.
  • Find Rates Using ZIP Code
    Streamlines the billing process.
  • Track Claims and Payments
    Ensures visibility over revenue.
  • Receive Notifications for Expiring Auths
    Maintains compliance.

Payer Mix Tool

The Payer Mix Tool helps analyze and diversify revenue sources and forecasts future revenue.

  • Assess Revenue By Payer Source
    Provides insights for financial management.
  • Model Scenarios For Revenue Growth
    Identifies opportunities in diverse payer types.
  • Forecast Number of Clients
    Strategic planning for agency growth.

Medicaid Rate Lookup Tool

This tool provides access to Medicaid rates for home care services, enhancing pricing decisions.

  • Check Medicaid Rates Instantly
    Ensures accurate billing.
  • Receive Real-time Alerts
    Prevents billing mistakes.
  • Access Area-specific Rates
    Enables informed revenue strategies.

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