How Shifa Home Care scaled Medicaid operations without expanding admin teams

Shifa Home Care Inc., based in the Chicago area, Illinois, and recently expanded with a new branch, provides in-home support services primarily for Medicaid and MCO clients. The agency manages 23 active clients with a lean team of 3 administrative staff, ensuring compliant and high-quality care delivery.

The agency uses CareSmartz360 as its centralized platform to manage Medicaid and MCO billing, scheduling, and care planning. Caregivers rely on integrated EVV tools – including the mobile app and telephony (IVR) – to accurately log visits and meet state compliance requirements.

As operations expanded, the need for a system that could handle complex billing, ensure EVV compliance & eliminate manual processes became critical. CareSmartz360 allowed the transition to digital care plans and centralized workflows, reducing administrative effort and improving operational clarity.

With automated EDI billing and real-time visibility into care delivery, the agency can scale efficiently while focusing on client care & compliance.

As Shifa Home Care Inc. expanded operations & opened a new branch, many operational challenges began impacting efficiency and scalability:

• Complex Medicaid & MCO billing – Managing payer-specific billing configurations became increasingly difficult to handle manually.
• Manual care planning processes – Paper-based client assessments slowed down care plan creation & increased administrative workload.
• EVV compliance challenges – Ensuring accurate, real time visit verification across caregivers with varying tech comfort levels remained a constant challenge.
• Limited admin bandwidth for growth – A small administrative team faced difficulty scaling operations without adding complexity or workload.