Unlocking Medicaid's Potential: How Paradigm Simplifies Home Care Success in Mississippi
Mississippi Medicaid is an incredibly advantageous opportunity for agencies. However, despite the promising market outlook, many providers struggle with the administrative complexities of running an agency. The intricate billing processes, multiple portals, and Electronic Visit Verification (EVV) requirements can be overwhelming, causing providers to hesitate before entering the lucrative Medicaid market. This is where Paradigm steps in. By taking over back-office tasks such as automating billing, streamlining EVV operations, payment posting, and client eligibility checks, Paradigm alleviates these administrative burdens. Our cutting-edge solutions empower agencies to focus on growth and success, fully leveraging the market potential and positively impacting the lives of their clients.
How Paradigm Helps.
Billing
Enrollments
Eligibility
EVV Support
Training
MedicaidinMississippi.
Electronic Visit Verification
Electronic Visit Verification (EVV) is a system that verifies whether home or community-based services have been provided. It ensures services are delivered as promised and providers only bill for the services they perform. Understanding the intricacies of EVV and Medicaid’s billing regulations can be challenging for providers, so we’ve put together a breakdown of the key details to help clarify these issues.
EVV Requirements:
Mississippi operates Medicaid under an open model, which means that providers may choose to use the state sponsored aggregator HHAeXchange or any other EVV that integrates with it.
EVV Aggregator:
HHAeXchange handles the transmission of all EVV data to the payer. All claims must follow EVV guidelines to ensure compliance and prevent payment and audit issues.
Billing Process:
Providers submit claims directly to the state portal MESA or through third-party clearinghouses.
Rates
Medicaid reimbursement rates in Mississippi range between $13.64 and $24.76.
CCOs may negotiate rates with home care agencies that differ from the state fee schedule, and as such, agencies must thoroughly review their individual contracts to ensure compliance and secure optimal reimbursement rates.
Payers
Medicaid in Mississippi is managed by the Mississippi Division of Medicaid (DOM), which also offers the Elderly and Disabled Waiver designed to increase Medicaid coverage.
Additionally, there are 3 CCOs (Coordinated Care Organizations) for personal care services in Mississippi: Molina Healthcare, Magnolia Health, and United Healthcare.
