Electronic Visit Verification (EVV)

Electronic Visit Verification began on 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.
  • Please email EVV@medicaid.ohio.gov with any questions regarding the EVV implementation. If you are a provider and need help troubleshooting, please call the EVV Provider Hotline at 855-805-3505.

Watch the EVV webpage  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 and phone numbers in MITS are current to ensure you have the ability to access the EVV System, as well as receive future communications related to EVV.

Overview:
The Ohio Department of Medicaid began 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 included in the first phase of the EVV program 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. Only services provided through the fee for service Medicaid program are included. Services reimbursed through a managed care plan are not part of the EVV program at this time.

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, ODA, DODD, and MCO’s 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
January Stakeholder Meeting – 01/30/2018
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 vendors listed below have completed certification with at least one agency. They may or may not currently be working with providers using their systems as alternate data collection modules. When selecting a vendor for an alternate data collection module, providers should explore the system functionality thoroughly to ensure that it meets the agency’s business needs.

Vendors as of 2/07/2018:
Alora Health
McKesson
MaximCare Mobile
CellTrak
ContinuLink
RhinoBill
Complia Health - ContinuLink
Ampersand International, Inc
Maxim

* This list will be updated as additional vendors complete the certification process.

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