Champ AI
Healthcare automation

Medicaid EVV exception resolution

Clear EVV exceptions before verified care becomes unpaid care.

Champ finds missing or inconsistent visit records, gathers corrections from caregivers and supervisors, updates the required EVV system, and releases clean visits to billing across each approved state and payer workflow.

HIPAA-ready Managed by Champ Self-healing

EVV billability queue

Every visit, correction, and billing hold

Live
Work itemStatus
01

Missing clock event

Caregiver outreach and evidence requested

Resolving
02

Authorization mismatch

Schedule and approved units compared

Review
03

Aggregator correction

Approved reason code and note submitted

Updated
04

Billing release

Visit passed final validation

Ready

EXECUTION

Continuous

EVIDENCE

Every step

OWNER

Champ

Before billing

exception resolution

One case

per held visit

State-aware

correction paths

The operational bottleneck

Six required visit fields become dozens of exception paths.

The federal data elements are consistent, but states, managed-care plans, aggregators, and EVV vendors implement different validation, correction, documentation, and claim-release procedures.

Bring us your workflow
01

Missed clock-ins, location conflicts, and caregiver mismatches require different evidence

02

Visit data must agree with schedules, authorizations, service plans, and billing records

03

State and vendor portals use different reason codes and correction workflows

04

Caregiver and supervisor follow-up competes with daily service operations

The production workflow

One continuous operation, not another disconnected tool.

Champ coordinates browser, document, API, voice, and human steps around the outcome your team is responsible for.

  1. 01
    Detect the billing hold

    Ingest EVV exceptions and compare the visit with the schedule, authorization, service plan, caregiver, and billing record.

  2. 02
    Collect the missing evidence

    Contact the right caregiver or supervisor, request the approved documentation, and keep follow-up attached to the visit.

  3. 03
    Correct the required system

    Apply the approved reason code and note, update the EVV vendor or aggregator, and retain confirmation of the change.

  4. 04
    Release or escalate

    Run final billability checks, release clean visits, and route authorization, policy, or integrity exceptions to an authorized reviewer.

Why it stays reliable

Built around the work, not a brittle integration map.

Your systems can stay exactly where they are. Champ operates across them, records what happened, and improves the workflow as the process changes.

State and vendor adapters
Keep one operating model while applying the approved codes, fields, evidence, and portal path for each state and EVV environment.
Caregiver follow-up built in
Coordinate messages, calls, forms, and supervisor approvals without separating outreach from the visit exception.
Billability as the outcome
Measure whether the visit is clean and released to billing, not whether a correction task was merely closed.

Works with your stack

If your team can access it, Champ can work in it.

Use APIs where they are dependable and managed browser agents everywhere else. No rip-and-replace required.

State EVV aggregatorsEVV vendor platformsMedicaid portalsManaged-care portalsScheduling systemsAuthorization systemsHome-care billing platformsCaregiver communication tools

Change the operating model

Give your team exceptions, not another queue to babysit.

Manual operation
More volume becomes more repetitive work.
  • Staff reconcile visits across EVV, schedules, and authorizations
  • Caregiver follow-up happens outside the exception record
  • Correction rules are remembered separately for every state and vendor
  • Billing teams wait for status updates before releasing visits
Recommended
Operated by Champ
More volume becomes more completed outcomes.
  • Each held visit opens with the relevant source records attached
  • Outreach, evidence, approval, and correction stay in one case
  • Approved state and vendor logic selects the right correction path
  • A final validation releases clean visits directly to billing

More healthcare workflows

One platform across the back office.

Insurance eligibility & benefits verification
Champ verifies commercial, Medicare, Medicaid, and Medi-Cal coverage across every required source, then completes the plan-specific work that a standard eligibility response leaves behind, including benefits, authorization requirements, and ECM qualification.
Provider credentialing & enrollment
Champ keeps provider profiles complete, submits enrollments across payer portals, follows every application, and sends only true exceptions to your credentialing team.
Referral intake & submission automation
Champ reads incoming referrals, validates the packet, creates the patient record, submits through the required portal or fax channel, and follows every case until it is accepted or needs review.

Medicaid EVV exception resolution FAQ

Questions healthcare operators ask first.

You have more questions?

Send us an email

Do the work of fifty
without hiring one more.

Eligibility
Verification
Claims
Payroll
Carrier check-in
Patient intake
Benefits
Credentialing
Credentialing