Private duty home care software built for how agencies actually run
A client gets four visits a week. Two are covered by a Medicaid waiver, one is private pay, one is billed to a long-term care policy. One caregiver covers all four. On Friday your coordinator is working out which hours go where, whether the waiver authorization still has room in it, and why one visit has no clock-out.
- MonMedicaid waiver
- WedMedicaid waiver
- SatPrivate pay
- ThuLTC policyNo clock-out
- Medicaid waiver2 visits
- Private pay1 visit
- LTC policy1 visit
What private duty agencies need from software
Private duty home care software has to handle multiple payers against one client record, track authorized hours as they are used, capture electronic visit verification where the payer requires it, schedule against caregiver continuity rather than availability alone, and pay caregivers from verified visit records instead of submitted timesheets.
Five requirements. Each one breaks in a specific way.
Multiple payers on one client
Private pay, Medicaid waiver programs, long-term care insurance, and VA benefits each have their own rates, billing formats, and documentation expectations. Agencies that manage this in separate systems end up entering the same client twice and reconciling by hand.
Authorization tracking against hours delivered
A waiver authorization covers a set number of hours over a set period. Software should show what remains before the hours are gone, not after a claim is denied.
EVV where it applies, and not where it doesn't
Medicaid-funded visits require electronic visit verification. Private pay and most long-term care insurance visits do not. Software that forces EVV onto every visit creates work nobody is asking for.
Scheduling built around continuity
Private duty clients notice who walks through the door. A schedule that fills a shift with whoever is free, ignoring who the client knows, produces complaints that arrive as cancellations. Covering a call-off without breaking continuity is its own problem.
Payroll from verified visits
When payroll is rebuilt from memory at the end of the week, hours drift. Caregivers are paid from what someone remembers rather than what was recorded, and a visit nobody can prove is a visit nobody gets paid for.
Federal requirement
Six things every Medicaid visit has to prove
Section 12006 of the 21st Century Cures Act requires electronic visit verification for Medicaid personal care and home health visits. A complete record captures all six.
01
Type of service
Personal care, 2 hrs
02
Who received it
Client on record
03
Date of service
Thu 14 Aug
04
Location
Client residence
05
Who provided it
Caregiver on shift
- 06Incomplete
Start and end time
9:00 — no clock-out
Five out of six is not a record. A visit that comes through incomplete is a visit you cannot prove.
Why private duty is different from home health
The two categories share a workforce and almost nothing else operationally.
Home health has edges
A 60-day certification period with a start gate, documentation checkpoints, and an end.
Private duty does not
Individual visits across an open timeline, each one billed to whichever payer covers it.
| Home health | Private duty | |
|---|---|---|
| Billing unit | Episode of care | Individual visit |
| Care plan type | Clinical orders | Task-based plan |
| Payer mix | Medicare dominant | Medicaid, private pay, LTC, VA |
| Documentation | Gates billing | Verifies the visit |
| Boundary | 60-day certification period | None, care is ongoing |
Personal care software and home health software rarely substitute for one another, and private duty nursing needs both at once.
How Rivana handles it
Rivana keeps one record per client and moves the information along with them through every stage of care.
- 1
Intake
Preferences, care requirements, and funding details are captured once at inquiry and stay attached.
- 2
Care plan
A change to the plan routes to the caregiver working the next visit, not to an inbox nobody opens.
- 3
Scheduling
Recurring visits are built from the care plan, so the schedule reflects what was agreed rather than what was available.
- 4
Visit verification
Check-in and check-out are captured at the visit. Where a visit came through incomplete, it appears on a short list the same day.
- 5
Payroll
Caregiver hours are paid from the verified visit record, not from a timesheet reconstructed on Friday.
- 6
Compliance
Credential and license expiry alerts fire before a lapse, and every record carries an audit trail.
Role-based views
All of it draws on the same client record, and each role sees only what their work requires.
- CoordinatorSees exceptions, not everything.
- CaregiverSees the visit ahead of them.
- FamilySees that someone came.
- Agency leadSees patterns across the operation.
Both service lines, one record
Most systems make you pick a lane. Rivana keeps the client whole.
Eleanor M.
Client record · opened 3 Feb
Skilled home health
Episode · days 12 of 60
RN visit · Tue
PT visit · Thu
Documentation gate open
Billed to Medicare
Personal care
Ongoing · 4 visits a week
Task-based care plan
EVV captured on site
Same caregiver, both lines
Billed to waiver and private pay
Illustrative data
When the episode closes, personal care continues on the same record. The caregiver, the history, and the family's view all stay where they were.
Common questions
Software that manages non-medical and skilled care delivered in a client's home on a per-visit basis, across mixed funding sources. It typically covers intake, care planning, caregiver scheduling, visit verification, billing to multiple payers, and payroll. It differs from home health software, which is built around Medicare episodes and clinical documentation.
See Rivana with your own client mix
A 20-minute walkthrough covering intake, scheduling, visit verification, and payroll across your payers.