This guide explains how to set up your ShiftCare account to work with Paradigm, making claim submission to Medicaid, Veterans Affairs (VA), and other payers convenient.
Note: ShiftCare does not directly manage Medicaid/VA billing workflows. Instead, we integrate with Paradigm to accelerate your claim submission timeline.
Setup: Requirements Before You Begin
Before you can submit claims to Paradigm, you’ll need to ensure the following setup is complete:
Your account location must be set to the United States.
EVV (Electronic Visit Verification) must be enabled. This can be turned on in Account > Settings.
Your account must have a pricebook with EVV enabled, as well as the correct HCPCS code and modifiers. Create a new price book in Account > Prices.
Your organization must have a valid Tax ID recorded in ShiftCare (linked to HHAX). This can be set in the EVV section in Account > Settings.
Make sure client funds are added with the fund type set to 'Medicaid'. Funds can be added in the client's details page.
The price book being used must be connected to the funding source that is set to Medicaid. This can be configured in the Price Books section in the client's details page.
Sending Claims to Paradigm
Once your setup is complete, follow these steps to submit a claim to Paradigm via ShiftCare:
Create an EVV-compliant shift by using a pricebook that is EVV-enabled. The correct Medicaid funding source will automatically apply based on the setup guide you followed above. Publish the shift (if applicable).
Navigate to Invoices > Generate from the sidebar menu and select the relevant invoice(s). Click 'Generate'. Alternatively, you can also generate a client's invoice from their Billing Report page.
Go to 'Medicaid and VA Claims' from the sidebar menu and click 'Submit New Claim'.
Tick the invoice(s) you want to submit and click 'Submit Selected Claims'.
The claim will now be submitted to Paradigm for processing.
For further assistance with Paradigm Integration: Setting Up and Submitting Medicaid Claims, please contact our Support team using online chat when you're logged into ShiftCare or email our Support team at support.northamerica@shiftcare.com.