Tracking Authorizations and Budgets in Self-Directed Care
Tracking units and tracking dollars are not the same thing, and the gap between them is where most budget overruns are born.
Insights
Practical guidance for the people running fiscal agent back offices — EVV compliance, F/EA responsibilities, X12 billing, and budget administration.
Tracking units and tracking dollars are not the same thing, and the gap between them is where most budget overruns are born.
Three X12 transactions carry most of the money in Medicaid billing. Understanding what each one does — and where the lifecycle breaks — is what separates a clean revenue cycle from a permanent backlog.
F/EA, Agency with Choice, and Fiscal Conduit are not interchangeable labels — they place employer responsibility in different places, and that changes who carries the tax liability.
The Cures Act made Electronic Visit Verification mandatory, but the requirement is narrower than most people assume — and the audit findings come from somewhere else entirely.
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