Georgia home health agencies and personal care providers face mounting Medicaid audit pressure — EVV exception rates, caregiver exclusion exposure, and HCBS documentation gaps that compound quietly until a state audit or MCO clawback makes them visible. We built this practice to find those gaps first.
From a one-time EVV exception audit to ongoing monthly monitoring, caregiver exclusion screening, and full Medicaid waiver compliance review — each service is built for the specific audit exposure Georgia home health and PCS agencies carry.
We analyze 90 days of your Sandata EVV export and flag every exception — location mismatches, duration outliers, missing fields, unmatched claims. You receive a branded exception log with dollar exposure estimates before the state does.
Ongoing exception review delivered as a monthly report. We ingest your EVV export on a set schedule, flag new exceptions, and track resolution status so your compliance posture improves month over month.
Every caregiver billing Medicaid must be screened against OIG LEIE, SAM.gov, and applicable state exclusion lists at hire and monthly. We run your full roster and issue a branded compliance certificate — no PHI required.
For CCSP, SOURCE, and self-directed care programs in Georgia — we audit documentation, EVV alignment, service authorization compliance, and caregiver qualification records against DCH and CMS requirements.
Georgia's Sandata EVV system became fully enforced for PCS providers in 2023. MCOs and the GA DCH are actively cross-referencing EVV data against claims. Exceptions that aren't caught internally become recoupment targets.
Federal law prohibits payment for any item or service furnished by an excluded individual. That obligation applies to every caregiver on your roster — including self-directed family caregivers enrolled through Medicaid waivers.
Georgia's CCSP and SOURCE waivers are expanding. As more agencies enroll, OIG and CMS scrutiny of Georgia's HCBS programs is increasing. Agencies without proactive compliance infrastructure are the ones that receive demand letters.
A complete walkthrough of Georgia's Electronic Visit Verification requirements — the six required data points, Sandata's role, and how enforcement works.
A provider reference guide to every Sandata exception type, what triggers it, and how to document resolution for audit defense.
How MCO recoupment actually works, which exception types carry the highest risk, and how to prevent it before it starts.
A 20-minute conversation is enough to tell you whether an EVV exception audit, a caregiver roster screen, or a full waiver compliance review is the right place to start.