Agencies that provide critical services to individuals with developmental disabilities are aware of the federally mandated electronic visit verification (EVV) requirements. Waiver provider agencies are quickly moving to implement an EVV system that meets all of their needs. But, in doing this, agencies need to select an EVV solution that does more than just provide a proof of visit verification.

The Electronic Visit Verification Mandate:

The Medicaid program has required that every U. S. state must have an EVV system in place for all Medicaid-funded personal care services (PCS). Every state is mandated to use electronic visit verification for PCS claims by January 1, 2020 and January 1, 2023 for HHCS.

The 2016 CURES act contained language that was designed to reduce Medicaid-related waste, fraud and abuse. In the state of Ohio, the Ohio Department of Medicaid (ODM) has partnered with the company Sandata, who has built and help manage the state’s EVV infrastructure for Medicaid providers. It is the responsibility of Medicaid Waiver Agencies to record and send EVV data to the state.

The state of Ohio’s new EVV system will not replace the existing Ohio Medicaid Billing System (MBS). Waiver providers will continue to submit claims through the MBS. However, failure to include EVV data will eventually lead to rejected Medicaid claims and even the loss of Medicaid provider certification.

States that fail to comply with this requirement are subject to a reduction in their federal payments (FMAP). However, if the state has made a “good faith effort” but has experienced unavoidable delays, this date can be extended. For example, the state of Ohio has received a good faith extension until January 1, 2021.

What Makes a Good EVV Platform?

In general, for agencies that deliver services such as homemaker personal care or adult day service, here are some general elements that the EVV platform should provide for agencies.

  • The ability to document any shift worked by direct workers or direct support professionals (DSP). This includes sites that have onsite-oncall (OSOC).
  • Able to automatically detect and report the necessary shifts to the state’s aggregator. This is due to the fact that not all shift visits need to be recorded by state Medicaid EVV systems. However, managers and supervisors would benefit from seeing this information.
  • Should support collecting scheduled visits as well as unscheduled, community, group and non-billable (training) visits.
  • Allows employees to see their assigned schedule as well as any shift notes that were added by their supervisor when the shift was assigned.

Ideally, agencies should see EVV as a helpful tool that can optimize their agency and allow them to become more efficient. Beyond compliance, a good EVV solution allows managers to see if there are any current gaps or redundancies in their staff schedule. The goal is to look for efficiencies.

The best EVV solutions allow supervisors to track the flow and activity of their workforce, while having access to secure lines of employee communication. This is particularly important due to the fact that I-DD agency employees are decentralized and mobile. Good EVV solutions fully integrate with scheduling tools that go far beyond the now outdated paper spreadsheet approach.

The EVV platform should include training and be easy for employees to use. Staff members should not see EVV requirements as a punishment or excessive burden. Even though some states have increased the pay rates for DSP, it is already a challenge to find and keep reliable employees. The goal is to have them learn how to use the EVV feature as quickly as possible. They should not see the technology as a punishment or way to spy on their movements. If anything, the EVV time punch provides a guarantee that they provided services on time and at the appropriate location.

Who We Are:

The staff at eWebSchedule and ABCS will watch how the Smart City investments are used. As a company that uses technology solutions to meet the various needs of healthcare professionals, we understand the importance of innovation. Technology can transform many tasks and create efficiencies that never existed before.

As a software solution , eWebSchedule provides services and tools that optimize the back office of various healthcare agencies. The EVV interface is easy for DSPs to use. The eWebSchedule application works in a variety of settings. The software solution turns the EVV compliance requirement into a valuable feature for agencies. It can be used as a stand-alone tool for EVV and scheduling (time collection) or integrated into a variety of other billing systems.

Contact Advanced Billing & Consulting Services (ABCS RCM) for more information at 614.890.9822 or the eWebSchedule department at 614.882.0726. As an Ohio-based company, they have been providing account management services to the Medicaid waiver provider community since 1997.

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