District of Columbia: Configure EVV Aggregation

HHAeXchange is certified by the District of Columbia Department of Health Care Finance (DHCF) has certified HHAeXchange to submit Electronic Visit Verification (EVV) data on behalf of providers who render Personal Care Services (PCS) and/or Home Health Care Services (HHCS). Providers are required to use an Electronic Visit Verification (EVV) system to verify visits for each claim submitted.

Providers must complete the steps listed below to configure HHAeXchange for EVV Aggregation. Failure to comply may result in data not being sent to the aggregator.

  1. Go to Admin > Contract Setup > New Contract to create a contract.

    Skip this step if the contract already exists in the system.

  2. Select the appropriate Contract Type value: DHCFP-EPD, DHCFI-FFSI, DHCFP-DD, DHCFP-CDS, AHCDC-MCO, HSCSN-MCO, THPDC-MCO or MSTAR-MCO.

    Contract Type Configuration
    Contract Type Payer Program/Waiver Name
    DHCFP-EPD Elderly, Person’s w/ Disabilities (EPD)
    DHCFI-FFSI Fee For Service I (FFSI)
    DHCFP-DD DD Waiver (DD)
    DHCFP-CDS Participant Directed Services(CDS)
    AHCDC-MCO AmeriHealth Caritas DC (MCO)
    HSCSN-MCO HSCSN (MCO)
    THPDC-MCO CareFirst Community Health Plan District of Columbia (MCO)
    MSTAR-MCO MedStar (MCO)
    UHCDC-MCO United HealthCare (MCO)
    UHCDC-CDS United HealthCare (CDS)

  3. If a Contract Type is not found, go to Admin > Reference Table Management > Contract Type.

    Refer to the Reference Table Management topic for steps on how to add a Contract Type.

  4. Go to Admin > Reference Table Management > Contract Service Code to enter the valid Service Code in the HCPCS Code field. Repeat this step for each applicable contract.

    Refer to the Reference Table Management topic on how to add/edit Contract Service Codes.

  5. Contract Service Code Configuration

    Contract Type

    Applicable HCPCS Codes and Modifiers

    DHCFP-EPD

    T1019:NP:U3

    T1019:52:U3

    T1019:UT:U3

    T1005:U3

    T1005:U3:TU

     

     

    DHCFI-FFSI

    T1019:NP

    T1019:52

    T1019:UT

    T1004

    T1000:TD

    T1000:TE

    G0300

    G0299

    G0153

    G0152

    G0151

    DHCFP-DD

    99509:U4

    99509:U4:22

    99509:U5

    99509:U5:22

    T1005:U3

    T1005:U3:TU

    T1005:U4

    T1005:U4:22

    S9125:U4

    S9125:U4:22

    T2016:U1

    T2016:U1:HI

    T2016:U2

    T2016:U2:HI

    T2016:U3

    T2016:U3:HI

    T2016:U4

    T2016:U4:HI

    T2016:U5

    T2016:U6

    T2016:U6:HI

    T2016:U5:HI

    T2016:U7

    T2016:U7:HI

    T2016:U8

    T2016:U8:HI

    T2016:U9

    T2016:U9:HI

    T2016:UA

    T2016:UA:HI

    T2016:UB

    T2016:UB:HI

    T2017:U1

    T2017:U1:HI

    G0300:U4

    G0299:U4

    G0153:U4

    G0152:U4

    G0151:U4

    T1002:U4

    T1003:U4

    99509:U4:V1

    99509:U4:22:V2

    DHCFP-CDS

    T1019:X1

    		      

    AHCDC-MCO

    T1019

    T1004

    T1000:TE

    T1000:TD

    G0299

    G0300

    G0153

    G0152

    G0151

     

    HSCSN-MCO

    T1019

    T1019:UN

    T1019:UP

    T1005

    T1005:TD

    T1005:TE

    G0299

    G0300

    T1000:TD

    T1000:TE

    G0151

    G0152

    G0153

    THPDC-MCO

    T1019

    		      

    MSTAR-MCO

    T1019

    T1019:UP

    T1019:NP

    T1000:TD

    T1000:TE

    G0151

    G0152

    G0153

    T1004

     

    UHCDC-MCO

    T1005:U3

    T1019:NP

    T1019:NP:U3

    T1004

    T1000:TD

    T1000:TE

    		    
    UHCDC-CDS T1019:X1      

    If the HCPCS code is associated to an incorrect Contract Type, then the EVV visit data associated to the HCPCS code is not sent to the aggregator. Only confirmed visits associated to the above In-ScopeServices Codes with the correct Contract Type are aggregated.

  6. Go to Admin > Reference Table Management > Visit Edit Reason to configure the valid Reason Codes.

    Refer to the Reference Table Management topic on how to add Reason Codes.

    Reason Code

    Description

    		 Note Required?
    100 Member No Show. No
    110 Member Unavailable. No
    120 Member Refused Verification. No
    130 Member Refused Service. No
    140 Member Incapable, Designee Unavailable. No
    150 Caregiver Failed to Call In - Verified Services Were Delivered. No
    160 Caregiver Failed to Call Out - Verified Services Were Delivered. No
    170 Caregiver Failed to Call In and Out - Verified Services Were Delivered. No
    180 Caregiver Called Using an Alternate Phone. No
    190 Caregiver Change. No
    200 Mobile App Issue/Inoperable. No
    210 Telephony. Issue/Inoperable. No
    230 Service Outside the Home. No
    240 Unsafe Environment. Yes
    999 Other. Yes

    A default value of Other is exported with the visit when the Reason Code differs from the table above.

  7. Review all Member Profiles to ensure the Member details are entered correctly.

    Members must be identified by First Name, Last Name, and Medicaid ID. Member Medicaid IDs must be entered in the Member’s Profile > Medicaid ID field. Medicaid ID must be a 10 to 12-digit numeric value, including any leading zeros.

  8. Review all Caregiver profiles to ensure that the Caregiver details are entered correctly.

    Caregivers must be identified by First Name, Last Name, and Full 9-digits of the Social Security number (SSN)Providers can enter the full 9-digit SSN or the last 4-digits using the following format: 000-00-XXXX.

    Member and Caregiver names can consist of alpha letters, hyphens, periods, and apostrophes. All other special characters cause the record to reject.

  9. Once complete, create a ticket via the Client Support Portal > State EVV Aggregation queue to set up the AZ EVV Aggregation interface.

    Once confirmation is received, proceed to the DC State Aggregation Report topic to review exported EVV data.