Electronic Visit Verification (EVV)

As the date for EVV implementation gets closer, we would like to provide the following important clarifications.

  • The date when EVV will go live is January 8, 2018.
  • The first six months of implementation is an opportunity for providers to become proficient with EVV. No edits related to EVV will be used to deny claims during this time. This includes edits looking for the time on claims
  • Providers may want to include times on claims beginning January 8, 2018. This will allow EVV related edits to post to the claim. These edits can be a valuable tool in identifying areas for improvement before claims payment is impacted.

Watch the EVV webpage (http://medicaid.ohio.gov/INITIATIVES/ElectronicVisitVerification.aspx) for updates regarding the use of EVV data in the claims adjudication process after the initial six month period. In addition, please make sure provider email addresses in MITS are current so providers receive all communications related to EVV in the future.

Please contact the EVV mailbox (EVV@medicaid.ohio.gov) with any questions regarding the EVV implementation.

Overview:

The Ohio Department of Medicaid will begin using an Electronic Visit Verification (EVV) system for many home and community-based services in January 2018. EVV is an electronic system that verifies when provider visits occur and documents the precise time services begin and end. It ensures that individuals receive their medically necessary services.

Services to be included in the EVV are State Plan Home Health Aide, State Plan Home Health Nursing, Private Duty Nursing (PDN), Ohio Home Care Waiver Nursing, Ohio Home Care Waiver Personal Care Aide, Home Care Attendant, and RN Assessment.

ODM has contracted with Sandata Technologies LLC to deliver Ohio’s EVV system, as well as to provide program orientation and training to providers.

What does EVV mean for agency and non-agency providers?

  • There is no cost to providers who use Sandata’s EVV system or to the individual.
  • EVV will capture and log visit data (start and end of visit, Global Positioning System (GPS) coordinates, etc.) electronically.
  • The claims submission process will not change but additional information may be required on the claim and new edits related to EVV will be applied.
  • ODM encourages all providers to use Sandata’s EVV system but it is open to agency providers using their own EVV systems. However, alternate EVV systems must meet the ODM interface requirements. All alternate EVV systems must collect visit data, have GPS, and send visit information to Sandata in near-real time. In the future, ODM will phase Managed Care Plans into the EVV system as well.
  • ODM will post all information pertaining to the phase-in of the EVV system on this webpage. Please visit it often.

EVV Presentations
Olmstead Task Force Presentation – 07/12/2017
OCHCH Conference – 09/20/2017
State Plan Presentation – 09/27/2017
Olmstead Task Force – 10/04/2017
EVV Overview – 10/05/2017
Case Management Presentation – 12/08/2017
General Rules and Requirements
Providers must maintain a list of individuals receiving services subject to Electronic Visit Verification, as well as a current list of direct care workers providing those services
Required Data Elements
Alternate EVV Systems

The below vendors have completed certification with their respective agencies. Each agency wishing to use an alternate EVV vendor will need to go through certification regardless of whether the vendor has previously been certified. This list will continually update as more vendors complete the certification process.

Vendors as of 12/11/2017:

ContinuLink
RhinoBill
Alora Health
BrightTree
McKesson
MaximCare Mobile
CellTrak

Resources for Individuals
Director's Welcome to EVV Training
EVV Basics
MVV/TVV Training Video