Your caregivers did the visits. Then an ID mismatch, an Electronic Visit Verification (EVV) exception or a lapsed authorization stopped the payment. ClaimRudder finds every one of those overnight and drafts the fix. Your staff approve it.
Built to HIPAA Security Rule requirements. Business Associate Agreement (BAA) before any data moves. US-only storage. No patient data goes to an AI provider without a BAA. A person approves every fix.
For Personal Attendant Services (PAS), Primary Home Care (PHC), Community Attendant Services (CAS) and Home and Community-based Services (HCS) providers working with STAR+PLUS health plans. Flat monthly fees.
Texas health plans pay only when the EVV visit, the authorization and the claim all agree. These are the gaps we see most, in the words agency owners use.
The caregiver, provider or client Medicaid ID on the claim doesn't match the EVV record. Usually a new hire or a new client set up slightly differently in two systems.
The service code, modifier, units or date on the claim differ from what the visit recorded.
Calls from a phone not registered to the client's home, GPS outside the address, a schedule changed but not updated. Each needs a reason code before the plan's deadline, or the visit can never be billed.
The authorization expired or ran out of units, or the client lost Medicaid at renewal, and nobody caught it until the denials came back.
The visit is verified in EVV, but no claim went out: added late, edited, or on a new client. After the filing limit it is gone for good.
A plan paid an old or lower rate on some lines. Deposits look normal, so nobody checks line by line.
Sunrise is a made-up Texas agency: 120 Medicaid clients, 70 caregivers, about $310,000 billed a month. Run the same month without ClaimRudder, then with it. Click each step.
Illustrative example. The dollar amounts are made up to show how the gaps add up; they are not a customer result.
Agencies rarely see this number, because it never shows up as a line on a report. Put in your own billing and see what a small leak adds up to.
Not sure? Start at 3–5%. Your free summary replaces this guess with your real number.
This shows the analysis a Revenue Leak Audit delivers, run on a fictional agency with generated records. Pick an agency size, rerun the analysis, click any finding to see the drafted fix, and approve it the way your biller would.
| Client | Service date | Finding | Recommended fix | Amount | Status |
|---|
All names, IDs, rates and amounts in this demo are generated. The demo uses an illustrative rate of $21.50 per attendant hour; your agency's rates come from your health plan contracts.
These files are the actual engine output for a fictional 120-client agency: every EVV visit, claim, payment, authorization, state EVV record and payroll line checked. Nothing here is a mock-up.
How we know it works: the fictional agencies are generated with problems planted on purpose and an answer key. On every test run the engine has to find every planted problem and report nothing else, across five different agency software layouts, before a release ships.
Create your account and accept the business associate agreement on screen, before any data moves.
Your EVV visit export, 835 payment files (the plans’ electronic payment records), authorizations and payroll. Your systems already produce them.
See the free summary, then unlock the worklists. Every drafted fix waits for your staff's approval; nothing is sent without it.
Fixed scope, flat fees, month to month. We never charge a percentage of what you bill or collect.
The price you see is the price you pay. Buy, upgrade or cancel any plan yourself, inside the app, at any time. Fees never depend on referrals, patient volume, or the amount you bill or collect.
You are trusting us with patient information and with your Medicaid revenue. Here is exactly what we do, what we never do, and which documents you can review before signing.
Last updated October 24, 2026
Risk analysis, safeguards, BAAs, breach procedures
In progressOur security controls mapped to its six functions
In progressHow we govern, test and monitor our AI
In progressIndependent CPA audit of our controls over time
PlannedHealthcare certification, when we serve health plans
PlannedNo government agency certifies HIPAA compliance, and NIST does not certify companies. We show where we stand on each standard and update the status, with the date and the assessor's name, when an independent review is complete.
Every outside service that can touch your data. Each one signs a business associate agreement with us before it is used, and stores data in the United States only.
| Service | What it does | Data location | BAA |
|---|---|---|---|
| Cloud hosting | Stores files and runs our matching software | US regions only | Provider selection in progress |
| AI model provider | Reads exports and drafts fixes; no training on your data | US | Required before first use |
| Email and documents | Secure messages and shared reports | US | Required before first use |
| Secure file transfer | Encrypted upload of your exports | US regions only | Required before first use |
| Document | What it covers | Status |
|---|---|---|
| Security overview | Controls listed above, in detail | On this page |
| AI-use policy | What AI does, human review, logging, accuracy checks | On this page |
| Business associate agreement | HIPAA obligations, breach notice, data return | On request |
| Service agreement | Scope, flat fees, term, cancellation | On request |
| Certificate of insurance | Professional and cyber liability | In preparation |
| Exclusion screening | Monthly OIG, SAM and Texas HHS-OIG checks of our own team | On request |
| Subprocessor list | Every outside service that can touch your data | On this page |
| Security questionnaire answers | Pre-filled answers to common healthcare vendor questionnaires | In preparation |
| Penetration test summary | Yearly outside test of our systems | Planned |
AI proposes, a person decides, and everything is logged. That is the rule for every claim we touch.
We are a new company, so we are offering the first three agencies a reduced rate in exchange for honest feedback while we grow.
Best fit: Texas agencies serving 50 to 300 Medicaid clients through STAR+PLUS, using an EVV system that can export visits.
Claim a founding slotClaimRudder is a Texas company that builds revenue and compliance software for Medicaid home-care agencies. Our team comes from AI, risk, governance and security work in regulated industries, and it shows in how we operate: controls first, every decision traceable, nothing automated that a person should decide.
We serve agencies across Texas, remotely or in person, and every engagement has a named contact on our team.
No. We work from the standard exports your systems already produce: the EVV visit export, 835 remittance files and your authorization list.
Only with your approval. We prepare corrected claims, appeals and renewal requests; your biller or administrator approves each one. Submission can stay with your team if you prefer.
Flat fees keep our incentives clean and avoid Medicaid rules on billing agents being paid a share of what is billed or collected. You know the cost up front.
That is normal. The audit tells you exactly where the gaps are. If cleanup goes beyond the agreed scope, we quote it separately before doing it.
No. Every name, ID and amount in the demo is generated. We never use client data in demos or marketing.
No sales call, no demo to book. Set it up yourself and see what is waiting for your agency, in dollars, before you pay anything.
Most answers are in the questions above. For anything else, email us and we reply within one business day.