Billing
Evidence becomes Medicaid billing documentation
Every visit is already timestamped, signed, and locked the moment it happens. Turning that into a clean claim is the easy part — and you do not have to change how you bill to get there.
The most important thing to know
AdultDayGenie is not a second billing system
It is the proof underneath the one you already have. Many centers already run a billing platform or an EHR. We don't ask you to replace it, migrate your history into it, or route claims through it — the attendance-evidence layer runs alongside whatever you use today, backing adult day care Medicaid compliance without adding a second system to log into.
Your existing system
Billing platform or EHR — unchanged
AdultDayGenie
Attendance evidence layer, running alongside it
A backed claim
Submitted the way you already submit it
No rip-and-replace. No re-training. One more proof point.
No rip-and-replace
Keep the billing platform or EHR you already run, exactly as it is today.
No re-training your billers
They keep working the way they already work. Evidence is there to export when they need it.
One more proof point
Not one more system to log into, reconcile, or keep in sync by hand.
From a locked event to a submitted claim
Attendance locks in
Every check-in and check-out is captured with a timestamp, a signature or a face match, and appended to that member's record for the day — before anyone thinks about billing it.
A claim file is generated
AdultDayGenie can generate a standards-compliant 837 Professional claim file (the HIPAA X12 005010X222A1 format) from your billing records, ready to hand to your clearinghouse.
Eligibility gets checked — for Pennsylvania today
For Pennsylvania Medicaid, AdultDayGenie supports real-time 270/271 eligibility verification against PROMISe through the state's Gainwell EDI gateway, so a claim isn't built against a recipient who isn't eligible that day.
Responses come back to the same record
A 999 acknowledgment confirms the claim file passed HIPAA X12 syntax validation — not that the payer has accepted it for payment. Remittance advice, when it arrives, flows back into claim status next to the attendance evidence that backed the claim in the first place.
The second-tool question, answered directly
Requirements vary by state and program, but the common thread is a verifiable record: member name, date, and start and end times, retained for audit. In New York, MLTC Policy 25.05 requires managed long-term care plans to collect and review exactly that for SADC attendance. AdultDayGenie's attendance events capture all of it automatically, timestamped and locked the moment they happen — meeting the adult day care Medicaid audit's baseline documentation requirement without a separate paper process.
No. AdultDayGenie runs alongside it. Attendance evidence is captured independently and made available to export — you decide how it fits into the claims workflow you already have.
No. When AdultDayGenie generates an 837P claim file, it's built for submission through your clearinghouse the same way your claims already move today.
Real-time PROMISe eligibility checking is built for Pennsylvania today. 837P claim file generation follows the standard HIPAA X12 format used broadly across Medicaid programs, but always confirm current requirements with your own state program and clearinghouse.
Attendance evidence is already captured at check-in, not re-entered later. There's no duplicate data entry added to the billing process — only a source of proof that wasn't there before.
No. A 999 only confirms the claim file passed X12 syntax and implementation validation. Payer acceptance and payment are separate steps, reflected later in remittance advice.
One more proof point. Not one more system.
See what it costs to run alongside what you already have.