What is EVV?
EVV is an abbreviation coined for the term “electronic visit verification” and refers to the process of using electronic options, like computers, mobile apps, or fobs to document home visits. Home health and human services agencies have been abuzz about EVV and the changes that are required due to the new regulations being imposed. Although states have certain verification policies required for businesses, EVV is a national mandate. To continue to provide services, businesses must abide by the EVV regulations. For more information click here.
History of EVV
In December 2016, President Barack Obama signed the 21st Century Cures Act into law. The 21st Century Cures Act states that any home health or provider agency that receives reimbursement from the government must have an electronic visit verification system in place. States must require EVV for Medicaid-funded home services for people with intellectual or developmental disabilities no later than January 1, 2020. The development of the EVV system stemmed from the federal government looking for ways to reduce incidences of fraud and abuse. Medicaid and Medicare fraud cases have been on the rise—potentially costing the government millions and millions of dollars. As just one example, in June of 2016, the Medicare Fraud Strike Force charged 301 individuals from across the nation with filing approximately $900 million in false billings. With EVV, filing false paper-based attendant timesheets would not be possible.
Six Required Components for EVV Collection
- The type of service performed
- The individual receiving the service
- The date of the service
- The location of the service delivery
- The individual providing the service
- The time the service begins and ends
State Models
DCI acts as an alternate EVV vendor in many states. EVV vendor options fall under either an “Open”, “Closed”, or “Hybrid” model. These options exist to cater to different state requirements and agencies that utilize electronic visit verification. For information on EVV vendor options by state, view your state website for requirements.
Closed Model States
In a closed model, the Medicaid program in each state will choose a single EVV vendor and require all companies to utilize that particular EVV system.
Within the 5 EVV options, these are the ones that would be considered closed:
- State Mandated In-House Model
- State Mandated External Vendor Model
The closed EVV model creates a uniform system in which all providers comply with standardization across the board. There are several benefits to a closed EVV model, such as:
- More efficient internal processes
- Digital transformation from manual to digital processes
- Greater management and support for agencies as the state is responsible for the training and education
Hybrid Model States
In a hybrid EVV model, the state offers an EVV solution while allowing the provider to choose which EVV system they want to use. The provider must select a solution that meets or exceeds government regulations. Within the 5 EVV options, the one model that would be considered hybrid:
Open Vendor Model
The benefits of the hybrid model include:
- The provider has the choice of which solution it will use.
- States will often provide a solution at no cost.
- A centralized platform is readily available and easy to use.
- Some platforms can integrate into existing systems.
Open Model States
The open vendor model allows companies to utilize a state EVV vendor or operate their system. The state-contracted vendor system will act as the default system. In addition, vendors may choose the state system or select an EVV vendor. States will set minimum regulations and standards for all EVV vendors. Some states may also require some type of integration between the state EVV and the provider’s EVV vendor of choice. Within the 5 EVV options, the two remaining models that would be considered open:
- MCP Choice Model
- Provider Choice Model
Vendor Responsibilities
Send daily EVV Aggregation Reports via email
Report any issues with your EVV visit aggregation
Communicate if any system updates are required for state-directed changes
Provide support for any technical issues with the DCI web portal or mobile app
Provider Best Practices
Identify team member(s) responsible for EVV visit maintenance
Log in to your aggregator portal daily
View EVV visits and aggregation status in the aggregator portal
- Triage EVV errors with your state and/or aggregator as a first point of contact
Review DCI EVV Aggregation reports that are emailed to you daily
Perform visit maintenance in DCI to correct visit errors
Review all six required aggregation requirements
Type of service performed
Individual receiving the service
Date of the service
Location of the service
Individual providing the service
Time the service begins and ends
- If the error in DCI can not be resolved independently, submit a help desk ticket (Zendesk) for DCI
DCI Generated EVV Aggregation Reports
EVV entries are aggregated daily generating a daily report by DCI to inform each organization on their entries aggregation status. The DCI aggregation report may vary by each organization based on the required data per aggregator. An example of columns that may be included are listed below:
- Date of Service - Date the punch entry was created
- Punch Entry ID - An unique id # for the punch entry in DCI
- Punch Class - Type of service i.e., hourly, group service
- Punch Type - status of the punch i.e., new, update
- Client Profile ID - An unique id # for the client profile in DCI
- Employee Profile ID - An unique id # for the employee profile in DCI
- Bill Code - Billing codes used in DCI for each funding source.
- Result - Result of the aggregation for each punch entry id i.e., Success, Failure
- Result Reason - If the punch entry id has a result of failure, the reason for aggregation failure will be listed in this column
The ID number for each object is located in the URL of the object entries page. Please see the article, How to view the details page by changing the URL? for additional information.
EVV Aggregation by State
Click on your state to see more state specific information.
Submitting a DCI Support Ticket for EVV Aggregation Issues & Resolutions
As a reminder, your organization must log in to the Aggregator portal and review your aggregation results daily. The Aggregator will always be your first point of contact to triage any rejections, as they are the experts on visit failures, reasoning, and verbiage. If the visits require DCI intervention to re-aggregate, please submit a Help Desk support ticket (Zendesk). Please see the help center article for detail instructions, Submitting a DCI Support Ticket for EVV Aggregation Issues & Resolutions.
EVV and EVV Compliant Field
For information on this topic please view the following article: What do the fields EVV and EVV Compliant mean in DCI?