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Electronic Visit Verification (EVV)

Comply with government EVV mandates and beyond with home care’s most powerful end-to-end software

The Basics

In accordance with federal requirements, many States have implemented an electronic visit verification (EVV) system to document personal care services. Medicaid providers of the Personal Care Services (PCS) and Home Health Care Services (HHCS) must utilize associated billing codes that are subject to Federal and State Electronic Visit Verification (EVV) requirements. Providers must implement and put into use an EVV system to capture the required data points as identified by their State (type of service performed, individual receiving service, date of service, location of service delivery, individual providing service, and time the service begins and ends) for services billed under their State codes which are then sent to the State’s data aggregator.

The electronic visit verification (EVV) aggregator is a centralized database that collects, validates, & stores statewide EVV visit data transmitted by an HHSC-approved EVV system. Each time an agency’s care provider clocks in and out of a visit where an EVV service was provided, the visit information is sent to the aggregator. The state uses this information in the aggregator to compare to the claims you submit for reimbursement. This process is in place to prevent fraud and abuse and only applies to services requiring EVV. Non EVV services do not get sent to the aggregator.

Electronic Visit Verification (EVV) is used by caregivers for some home and community-based services to document the time services begin and end. Some State departments provide an EVV system at no cost to their providers, while others allow for agency providers to choose to use an alternate EVV system. Alternate EVV systems that are built into homecare technology may come at an additional cost to the agency provider. Check with your State Department to confirm which EVV systems are available for your agency.

Legislation in the 21st Century Cures Act mandated that all home care agencies receiving reimbursement need to prove “electronically” that their visits were completed in accordance with what was claimed. States must require EVV use for all Medicaid-funded PCS by January 1, 2020 and HHCS by January 1, 2023. Otherwise, the state is subject to incremental FMAP reductions up to 1% unless the state has both made a “good faith effort” to comply and has encountered “unavoidable delays.” States and territories were required to self-report their EVV implementation status using a web-based survey, which the Centers for Medicare & Medicaid Services (CMS) used to determine compliance with the EVV requirements included in Section 12006(a) of the 21st Century Cures Act. View EVV compliance status for personal care services by State or Territory on the website.

There are a number of ways to achieve EVV compliance, which are determined by each State. The most common ways to achieve EVV compliance include voice telephony, mobile app and Fixed Object (FOB). If a client does not have a home phone and the caregiver does not have a smart phone, an alternative is a FOB device that is secured in the client’s home. A FOB is a small device used for EVV that generates an 8-digit passcode which must be entered when a Caregiver Clocks In and Out.

The Fixed Object (FOB) is a small device placed in the home of the care recipient and physically connected in the home. The FOB is used for EVV and when activated, the FOB will generate an 8-digit passcode that reflects the current date and time and must be entered when a Caregiver Clocks In and Out.

When a care provider visits the home of a client receiving support services, that care provider must report that visit into a system for documentation and verification. This includes the start time and end time of the service, the date of service, the type of service being performed, the provider’s name and the location in which the service was provided.  

A care provider can use one of three methods to make the report: a home landline telephone, a small alternative device or a mobile application.  

Using a landline telephone, a care provider will simply call a toll-free number issued by the vendor to clock in, and at the end of the service call the same number to clock out.  

If the care provider is using a small alternative device, they will locate a specific device in the home and write down a code the device displayed at the beginning of service and the code displayed at the end of service.  

Finally, the most popular solution is a mobile application using Global Positioning Services (GPS) to verify the location of the care provider the clock in and clock out time of the visit. 

AlayaCare’s integrated EVV solution is built into our native mobile app, resulting in seamless clock-in, clock-out functionality, GPS verification and an offline mode for areas out of cellular or Wi-Fi range.

EVV stands for Electronic Visit Verification, which is a system that knows when you clock in and clock out for home and community-based services, including self-direction programs.

Section 1903(l)(5)(A) provides that the system must be able to electronically verify, with respect to visits conducted as part of personal care services or home health care services, the following:  

1) the type of service performed;  

2) the individual receiving the service;  

3) the date of the service;  

4) the location of service delivery;  

5) the individual providing the service; and  

6) the time the service begins and ends 

EVV can be tracked via technology that uses Global Positioning Services (GPS) to verify the location of the care provider when they clock in and clock out for their visit. Services either starting or stopping in the individual’s home are subject to EVV requirements, and capturing the location in which the service is started and stopped is sufficient for meeting the minimum requirements specified in the Cures Act. Individual states may choose to require more information as a factor to control for fraud, waste, and abuse; please check with your State Medicaid Agency for specific details.

Each state has its own exemption criteria, please check with your state for the information applicable to your home and community care business.  

Section 12006 of the 21St Century Cures Act (the Cures Act), P.L. 114-255, added Section 1903(l) of the Social Security Act (SSA). Section 1903(l) provides that states must require the use of an electronic visit verification (EVV) system for personal care services (PCS) and home health care services (HHCS) that require an in-home visit by a provider.