EVV Compliance Management

This feature is activated by HHAeXchange System Administration. Contact HHAeXchange Support Team for details, setup, and guidance.

Electronic Visit Verification (EVV) is a computer-based system that electronically documents and verifies service delivery information, such as date, time, service type and location for certain Medicaid service visits.

Electronic Visit Verification (EVV) is a federal requirement in the United States, mandated by the 21st Century Cures Act, requiring accurate tracking and reporting of home care services provided to Medicaid beneficiaries.

HHAeXchange provides reporting to support the tracking of EVV compliance via Exception Reports. Below is an overview of HHAeXchange’s methodology in calculating EVV compliance within that reporting.

  • EVV compliance is calculated only for confirmed visits.

  • Unconfirmed and missed visits are excluded from the EVV compliance calculation.

The following criteria are verified against a visit to determine if the visit meets the requirement for EVV compliance. If any of these data elements are missing, the visit is considered non-compliant and the provider’s compliance percentage decreases.

  • EVV clock in: If a visit is missing a clock in, it is considered non-compliant.

  • EVV clock out: If a visit is missing a clock out, it is considered non-compliant.

  • EVV clock in/out: If a visit is missing a clock in and clock out, it is considered non-compliant.

  • Caregiver: If a visit is tagged to a temporary caregiver, it is considered non-compliant.

  • Caller ID (when visit is confirmed via IVR): If a visit is missing a phone number on the call in OR the call out when utilizing IVR, it is considered non-compliant.

  • GPS coordinates (when visit is confirmed via mobile application): If a visit is missing GPS coordinates on the call in OR the call out when utilizing the mobile application, it is considered non-compliant.

  • Manual edit of visit start time AND/OR visit end time: A visit is considered manually edited when the visit start time and EVV call in or the visit end time and EVV call out are not matching. If this occurs, the visit is considered non-compliant.

  • EVV compliance percentage (%) = (Compliant visits/Confirmed visits) * 100

    Example:

    • Compliant visits = 60

    • Confirmed visits = 100

    • Compliance percentage (%) = 60%

  • HHAeXchange Configurations Impacting Compliance:

    • HHAeXchange offers a contract-level configuration called Disable Visit Confirmation Rounding.

    • When the configuration is unchecked, visit in and out times, as well as EVV in and out times, are rounded individually and unmatched times are considered a manual edit and decreases compliance rates.

    • When the configuration is checked, visit in and out times, as well as EVV in and out times, matches and visits are considered compliant.

    • When this configuration is changed from checked to unchecked or vice versa, EVV compliance rates only impact visits from the day of the configuration change and forward.

Follow these steps to boost your EVV Compliance Rates:

  • Regularly review EVV Compliance and Exception Reports to identify non-compliant visits.

  • Correct missing or incorrect visit data, such as missing clock-ins/outs or GPS/Caller ID. For a complete list of data that can affect your EVV Compliance, see the EVV Compliance Criteria dropdown above.

  • Correct flagged exceptions quickly to boost your compliance percentage.

The following webinars provide helpful information about improving your EVV Compliance Rates:

EVV Compliance Reporting:

Raising the Bar: How to Reach A 90% (or Higher) EVV Compliance Rate:

What You've Always Wanted to Know About EVV and Billing Compliance:

The following blog posts provide helpful information about EVV Compliance: