North Carolina: Configure FFS EVV Aggregation

The North Carolina Department of Health Benefits (DHB) 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 must complete the steps outlined below to configure HHAeXchange for EVV Aggregation. Failure to comply may result in no data sent to the aggregator.

Register all NPI(s) with the NC DHB by completing the North Carolina DHHS Alternate EVV New Provider Registration Form. Refer to the NC DHB’s Website for more information.

Inform Sandata of the decision to use AltEV. Fill out the missing information using the table below. Email this information to NCaltevv@sandata.com.

OH AltEVV Vendor Selection and Information
Agency Information
Agency Name  
Medicaid ID Number  
Current STX#  
Contact Name  
Contact Phone Number  
Contact Email  
Vendor Information:
Vendor HHAeXchange
EVV Vendor Contact Name HHAeXchange EVV Aggregation Support
EVV Vendor Contact Email EASTeam@hhaexchange.com
EVV Vendor Contact Phone Number 855-400-4429
EVV Product Name HHAeXchange

  1. Go to Admin > Contract Setup > New Contract to create an FSS contract.

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

  2. Select the appropriate Contract Type value:

    Linked Contract

    Contract Type

    NC Medicaid Direct

    DHBFFS

    NC Medicaid Direct HHCS

    DHBFFS

  3. If Linked Contract is not found, configure with the following Contract Type:

    Internal Contract Contract Type
    Private contracts managed by the agency

    DHBFFS-PCS

    DHBFFS-CAPC

    DHBFFS-CAPDA

    DHBFFS-CAPCD

    DHBFFSHHTHER

    DHBFFS-HHSNV

    DHBFFS-HHAID
    Contract Type Configuration
    Contract Type Payer Program/Waiver Name
    DHBFFS-PCS Personal Care Services.
    DHBFFS-CAPC Community Alternatives Program for Children.
    DHBFFS-CAPDA Community Alternatives Program for Disabled Adults.
    DHBFFS-CAPCD Community Alternatives Program for Disabled Adults - Consumer Directed.
    DHBFFS-HHTHER Home Health Services Therapy.
    DHBFFS-HHSNV Home Health Services Skilled Nursing Visits.
    DHBFFS-HHAID Home Health Services Aide.

  4. If 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.

  5. Go to Admin > Reference Table Management > Contract Service Code to enter a valid Service Code in the Export Code field.

    Repeat this step for each contract.

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

    Contract Service Code Configuration
    Contract Type Applicable Export Codes and Modifiers
    DHBFFS-PCS

    99509:HA – PCS Under Twenty One

    99509:HB – PCS Adults
    DHBFFS-CAPDA

    S5125 – CAPDA Attendant Care Service 15m

    S5125:UN – CAPDA Attendant Care Cong 15m

    S5135 – CAPDA Fill-in Attendant Care

    S5150 – CAPDA In-Home Respite 15m
    DHBFFS-CAPC

    S5125 – CAPC In-Home Aide

    S5150 – CAPC In-Home Respite 15m

    S9122:TF – CAPC In-Home Respite Cong 15m

    S9122:TG – PNA Respite Cong 15m

    T1004 – PNA In-Home Respite 15m

    T1019 – PNA Asst 15m

    T2027 – CAPC Personal Care Assist 15m

    T2027:TF – CAPC Personal Care Asst Cong
    DHBFFS-CAPCD

    S5125 – CAPCD Attendant Care 15m

    S5125:UN – CAPCD Attendant Care Cong 15m S5135 – CAPCD Personal Care Assist 15m S5135:UN – CAPCD Personal Care Assist Cong 15m

    S5150 – CAPCD In-Home Respite 15m
    DHBFFS-HHTHER

    RC420 – FFS Physical Therapy

    RC424 – FFS PT Evaluation

    RC430 – FFS Occupational Therapy

    RC434 – FFS OT Evaluation

    RC440 – FFS Speech Therapy

    RC444 – FFS ST Evaluation
    DHBFFS-HHSNV

    RC550 – FFS SN Assessment

    RC551 – FFS SN Treatment/Observation

    RC559 – FFS SN Dual Elig/NonMedicare

    RC580 – FFS SN Venipuncture

    RC581 – FFS SN Med Asst
    DHBFFS-HHAID RC570 – FFS Home Health Aide Visit

    If an Export 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 the confirmed visits associated to the above in-scope Services Codes and 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 for steps on how to add Reason Codes.

    Reason Code

    Description
    1 Caregiver Error.
    2 Beneficiary Suspended.
    3 Mobile Device Issue.
    4 Telephony Issue.
    5 Beneficiary in Hospital.
    6 Unsafe Environment.
    7 Beneficiary Refused Service.
    8 Beneficiary No Show.
    9 Caregiver No Show.
    10 FVV Device Not Available.
    11 Legally Responsible Party Refused Service.
    12 Other.

    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 MemberProfile > Medicaid ID field. Medicaid ID must be a 10-digit value.

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

    Caregivers must be identified by First Name, Last Name, and Last 5-digits of the Social Security number (SSN). Providers can enter the full 9-digit SSN or the last 5-digits using the following format: 000-0X-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 Missouri EVV Aggregation interface.

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