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Founded in 1995, Acumen Fiscal Agent is one of the largest and most established full-service fiscal management service providers in the U.S. focused on supporting those who choose self-directed care. For information contact us at (877) 211-3738. We provide fiscal agent services throughout the United States.

Family caregiver

Populations We Serve

  • Individuals with developmental disabilities
  • Individuals with intellectual disabilities
  • Individuals with physical disabilities
  • Individuals with brain injuries
  • Aging adults
  • Veterans

New to Fiscal Management Services?

If you’re new to fiscal management services, it’s helpful to understand the terminology in our industry.

Important NOTE: Self-directed services means that participants, or their representatives if applicable, have decision-making authority over certain services and take direct responsibility to manage their services with the assistance of a system of available supports. You in the following descriptions is inclusive and refers to the participant and/or designated representatives.

Terminology Defined


The fiscal agent that helps you manage employer-related financial and other responsibilities pertaining to your self-directed services. Acumen is not the employer.


Documentation that specifies approved services, service codes, and number of units, hours, or dollars for delivery of goods and services included in the Plan of Care.

Case Manager/Support Coordinator:

Person assigned by the program to work with you and facilitate details of your self-directed program (a case manager may be known by other titles, depending on program terminology).


Direct care employees are the people who work for you and provides services to the participant.


Person who hires and supervises staff to provide services to the participant. The employer may also be the participant.


Electronic Visit Verification is used to track the time (as required by law) a caregiver spends caring for a participant.

Fiscal Agent/Fiscal Intermediary:

(Acumen) provides payroll processing, tax services, vendor payments, and other administrative functions authorized by the funding program.


Person receiving services authorized by the funding program. The participant may also be the employer.

Payment/Payroll Services:

Employee-related payments and processing.

Vendor Services:

Vendor-related payments and processing.

Plan of Care:

Plan you create with your case manager/support coordinator to determine the participant’s goals and how to meet them, based on the participant’s preferences, choices, and abilities. It empowers the participant in directing their services. It includes the number, type, and duration of approved goods and services.

Program Administrator or Funding Source:

Entity that manages the program and/or waiver funding.

Helping thousands of people lead more independent lives since 1995.

Why Choose Us

  • One of the largest, most experienced fiscal management entities in the U.S.
  • We prioritize service above self and always work to exceed expectations.
  • Service support based on in-depth understanding of each type of disability.
  • We provide an individualized and personal level of service, through an agent-based model that is tailored to each participant’s needs.
  • National company with a local presence.
  • State-of-the-art technology that meets state and federal requirements including Electronic Visit Verification.

Discover Fiscal Services

Are you a participant ready to explore self-directed support options? As a fiscal intermediary, Acumen is here to assist. Call (877) 211-3738. We provide fiscal services throughout the United States. See our Documents and FAQ pages for more information.

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