The Billing workflow is designed to prevent errors before submission through visit review, individual readiness, DSP readiness, EVV validation, Sandata submission, rejections, claims, and payment tracking.
Review completed visits before billing.
Validate service, GPS, signature, units and exceptions.
Prepare Client, Employee and Visit feed data.
Track claims, payer responses and payments.
This section explains the operational value behind the diagram and how the workflow supports real provider use cases, EVV readiness, billing accuracy, and long-term SaaS scalability.
Completed visits are reviewed before billing to confirm service delivery, units, duration, GPS timestamps, signatures and exceptions.
Individual and DSP readiness checks reduce common EVV rejections by confirming required client and caregiver data first.
Validated records can be organized into submission batches aligned with Client, Employee and Visit data structures.
After acceptance, visits move into claim creation, claim tracking, payer response monitoring and payment tracking.
The diagram below can be shared with provider leadership, compliance teams, billing teams, IT reviewers, and EVV integration stakeholders.
It catches missing or incorrect visit, client, employee and service information before it becomes a denial or rejection.
Readiness and validation steps are designed to reduce common issues such as client not found, worker not found and invalid service code scenarios.
Download the five-page Pennsylvania Alternate EVV Technical Solution Overview PDF.