HHAeXchange EVV VMUR Process for Program Providers, FMSAs, and CDS Employers

A program provider, financial management services agency (FMSA), or consumer directed services (CDS) employer begins the Visit Maintenance Unlock Request (VMUR) process by completing the VMUR form that is specific to their service delivery option and payer for EVV visits.

If Texas Health and Human Services (HHSC) is the payer: Program providers, FMSA, and consumer directed services (CDS) employers must follow the instructions on the following VMUR Excel templates located on the HHSC website:

• For program providers and FMSAs (Excel)

• For CDS employers (Excel)

If a managed care organization (MCO) is the payer: Program providers, FMSAs, and CDS employers must complete the VMUR form that is specific to their service delivery option located on the MCO’s website.

After the appropriate VMUR form has been completed, the program provider, FMSA, or CDS employer will email the completed form to their payer for review and approval. This request must be sent securely, and include the following contact information for the representative of the program provider, FMSA, or CDS employer:

• Contact name

• Email address

• Phone number

Once received, the payer will have 10 business days to process the VMUR. The payer will submit the VMUR within 3 business days of designating approval to HHAeXchange for visit maintenance to be performed.

The payer must submit the approved VMUR to HHAeXchange at txpayervmur@hhaexchange.com. Payers should ensure that all pertinent staff and provider contacts are copied on the email so that HHAeXchange is able to communicate updates on the VMUR’s status to all parties.

HHAeXchange will proceed to unlock the visit transactions that were approved by the payer within 10 business days. HHAeXchange will send an email to the payer and included contacts that:

• Confirms the visits are unlocked, and

• Visit maintenance can be performed.

If the information submitted by the program provider, FMSA or CDS employer is incorrect, invalid or missing data elements, HHAeXchange will:

• Not unlock EVV visit transaction(s) for visit maintenance,

• Return the VMUR to the program provider, FMSA or CDS employer, and

• Notify the payer and the program provider, FMSA or CDS employer of the reason the EVV visit transaction(s) cannot be unlocked for visit maintenance.

Once the confirmation email is received, the program provider, FMSA, or CDS employer is allowed 20 calendar days to complete visit maintenance.

If visit maintenance cannot be completed within 20 calendar days, the program provider, FMSA, or CDS employer may reply to the HHAeXchange unlock confirmation email to request an extension to complete visit maintenance and include the reasoning that an extension is needed.