How it runs for home care and home health agencies
After the run, we book the payroll journal by department, reconcile the payroll clearing account, and compare paid hours to billed hours so unbilled time is caught the same week. Payroll taxes, garnishments and benefit deductions are tracked as liabilities until the provider remits them.
What is payroll processing outsourcing?
Payroll processing outsourcing means a remote team prepares each pay run inside your payroll software: reconciling hours, entering changes, checking deductions and producing the run for the employer to approve. The employer keeps the payroll account, the bank authority and the legal responsibility. The provider posts the payroll journal and reconciles it, so payroll and the books agree.
What we handle for home care and home health agencies
- Assemble caregiver hours from EVV-verified schedules for each pay period
- Check overtime, travel time and live-in rules before the register is approved
- Book payroll journals split by department and reconcile the clearing account
- Compare paid hours to billed hours and list any unbilled paid time
- Track tax, garnishment and benefit liabilities until the provider remits them
The KPI that matters here
Paid hours reconciled to billed hours every pay period, with unbilled paid time listed within two business days.
Home care compliance notes
EVV
The 21st Century Cures Act requires electronic visit verification for Medicaid personal-care and home-health visits, captured through state aggregators such as HHAeXchange or Sandata. We bill only from verified visits and keep an exception log for visits that need a manual correction before they can be claimed.
HIPAA
Client names, diagnoses and authorizations are protected health information. We sign a BAA, our staff are HIPAA-trained, access is limited to the roles that need it, and PHI never appears in ledger memos or emailed spreadsheets.
State Medicaid and MCO rules
Each state waiver and each managed-care organization sets its own authorization limits, unit rounding, timely-filing window and recoupment process. We track authorizations against billed units and record recoupments as reductions to the original claim, not as unexplained bank debits.
FLSA Home Care Rule
Most agency caregivers are entitled to minimum wage and overtime, and travel time between clients counts. Your payroll provider computes the pay; we make sure the ledger and the labor-cost reports reflect it correctly and that live-in and sleep-time arrangements are coded as your counsel directs.
Home care software we work in
- QuickBooks Online
- Gusto
- ADP
- Bill.com
- AxisCare
- WellSky
- Alora
- HHAeXchange
- All 50 platforms
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Frequently asked questions
Do you run payroll or just support it?
We prepare and review the run inside your payroll provider and you approve it; the provider pays the caregivers and remits taxes. We never move money. Our part is the hours assembly, overtime and travel-time checks, the journal entry, the clearing-account reconciliation and the paid-versus-billed comparison that most agencies skip because there is no time.
How do you handle overtime across multiple clients?
FLSA overtime is based on total hours for the agency, not per client, and time traveling between clients in the same day counts as hours worked. We total each caregiver's verified hours across all clients, flag anyone over 40 in the workweek, and confirm the payroll provider is applying the right rate. Live-in or sleep-time arrangements follow the rules your counsel has set.
Why compare paid hours to billed hours?
Because it is the fastest way to find lost revenue. If a caregiver was paid for 38 hours and only 34 were billed, either an EVV exception is blocking a claim, a visit exceeded the authorization, or a private-pay visit was never invoiced. We list those gaps each pay period so the scheduler can fix them while the visit is still recent.
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