This article will help you deepen your understanding of the Medicaid technical ecosystem, learn ShiftCare’s role in this ecosystem, and understand the various parts involved in the setup and operation of your ShiftCare system to collect and transfer Electronic Visit Verification (EVV) data to your state’s aggregator system.
ShiftCare's Role in the Medicaid Technical Ecosystem
1. ShiftCare – Your EVV Collection Method
You will collect Electronic Visit Verification (EVV) data with ShiftCare before sending it to an aggregator.
EVV is a method of digitally verifying that a caregiver was present to provide care to a Medicaid program participant. With ShiftCare, EVV data is collected using the mobile app equipped with GPS verification. This is checked and verified on each shift at the moment a caregiver clocks in and clocks out.
Clock-in and clock-out will be denied if the caregiver is not at the address indicated on the shift.
2. Aggregator – Where You Send Your EVV Data
You will send the EVV data you collect with ShiftCare to an aggregator on a regular basis.
An aggregator is an intermediary system that collects and stores EVV data for long-term storage and later use in verifying Medicaid claims.
States may use one or more aggregators. Common systems include Sandata and HHAeXchange. Some states mandate a specific aggregator, while others allow approved alternate EVV vendors (like ShiftCare) to integrate with the mandated system.
3. Claims Submission – Where You Submit for Payment
You will submit claims for services performed through your state’s required channel. This is where everything comes together: the claims-processing entity will reconcile your claim with the EVV data stored in the aggregator to confirm that the visit occurred and matches your claim (e.g., Medicaid ID, service codes, clock in/out times).
Claims must include Medicaid service codes for services that require EVV (typically personal care or home health), as defined by your state’s Medicaid guidelines.
It is essential that caregivers clock in and clock out in ShiftCare to ensure there are no issues with reimbursement.
Claims are submitted through an external portal, which may vary depending on your state or program. Claims could go through:
A Fiscal Intermediary (FI) or Financial Management Service (FMS)
A Managed Care Organization (MCO)
Or directly to the state’s Medicaid Management Information System (MMIS)
Medicaid funding comes from federal and state governments, either directly or through one of the channels above.
Setting Up and Operating ShiftCare for Medicaid EVV
There are 3 parts to consider when using your ShiftCare account to collect EVV data for Medicaid in your state of operation:
Registration with the State Aggregator
ShiftCare Account Setup
Day-to-Day Operation & Reporting
These parts are not always completed in the order shown—registration is often the second step if you’re switching from another EVV system to ShiftCare.
Registration with the State Aggregator
You will need to register your organization with your state’s aggregator to authorize ShiftCare as your EVV collection method and receive the credentials required to link ShiftCare to the aggregator system. This step requires you to reach the aggregator directly with a formal request by email.
🔹 Note: Your organization is responsible for completing this registration. Once approved, the aggregator will issue credentials that are entered into ShiftCare to establish a secure data connection. Your ShiftCare representative will provide direct guidance during this process.
ShiftCare Account Setup
To prepare your ShiftCare system for EVV, you must complete account configuration. These steps may vary slightly by state, but generally include:
Setting your correct timezone and enabling Clock in Location Check under Account > Settings in your ShiftCare account
Adding the Medicaid Service Codes you provide
Linking Participant profiles to the state aggregator
Linking Caregiver profiles to the state aggregator
Registering with your state's aggregator can take time. To help you evaluate the platform and get started immediately, ShiftCare allows you to explore our core EVV features before you enter your official aggregator credentials.
Even without an active Sandata or aggregator connection, you can:
Import your state's EVV Price Guide.
Create, edit, and configure your EVV Price Books.
Create and schedule EVV shifts to see exactly how the roster workflow operates.
While you can test scheduling and pricing, you must complete your aggregator connection before you can sync staff and client profiles, verify completed visits, or submit live claims to the state.
Select your State-specific setup guide for the detailed step-by-step instructions:
Day-to-Day Operation & Reporting to Aggregator
Once your account is configured, use the Scheduler to assign shifts between caregivers and clients. It’s critical that caregivers clock in and out of every shift to capture the EVV data needed for claims.
Completed visits will appear in the Reports > EVV section of ShiftCare, where you can submit data to your state’s aggregator.
Read this guide for complete steps on how to manage, resolve, and send visits using ShiftCare’s EVV Reporting feature.
We understand that navigating Medicaid compliance can be complex. Your ShiftCare team is here to support you with ongoing guidance through setup and daily operations to ensure smooth and accurate reporting.
Should you require assistance, feel free to get in touch with your Customer Success Manager or our North American Support team through in-app chat or email us at support.northamerica@shiftcare.com. We’re always just a message away.