Insurance & Payment for Self-Directed Care

Nevada Medicaid funds Personal Care Services (PCS) provided through the self-directed model once a participant is approved for services. Medicaid determines eligibility, authorizes services and hours, and sets reimbursement, while caregivers are paid for approved hours. Venture Forthe serves as the ISO, managing caregiver enrollment, payroll, tax reporting, and compliance.

Medicaid determines eligibility, completes an assessment, and authorizes a care plan that includes the number of service hours approved.

Once authorized, Medicaid issues a service authorization to the Intermediary Service Organization (ISO) selected by the participant. 

Venture Forthe Inc. supports the financial and administrative processes of the program by:

• Receiving service authorizations from Medicaid
• Processing payroll and issuing caregiver payments
• Supporting EVV (Electronic Visit Verification) and timekeeping requirements
• Managing tax reporting and employer-related responsibilities
• Ensuring compliance with Medicaid program requirements

*Venture Forthe does not determine eligibility, authorize services, or set service hours, all service approvals and funding decisions are made by Nevada Medicaid.