What does EVV stand for and why is it in the news? EVV stands for Electronic Visit Verification. It’s essentially just a system that’s used in home health care services and community based services to digitally verify in-home care visits. 

It’s basically a method to verify home healthcare visits, making sure patients get the care they need and cutting down on fraudulently documented home visits. The EVV system works by confirming that each scheduled visit actually happened and it captures details like:

– Date

– Time

– Patient

– Caregiver

– Location

All EVV data is protected by privacy rules – for example, EVV tools comply with the Health Insurance Portability and Accountability Act (HIPAA) to safeguard patient information.

Now many states call their programs EVV or eVisit, but they all have to follow the same rules. EVV was introduced under Medicaid to protect clients receiving personal care and home health services. 

For example, if an elderly patient is supposed to get daily shower assistance at home, EVV ensures the visit actually occurred. It replaces handwritten notes or phone trees, which gives everyone confidence that the service performed matches what was billed. That’s the main idea behind EVV.

Federal Mandate and EVV Requirements

A relatively new federal law that started in 2016 changed home care billing. The 21st Century Cures Act (federal law) requires states to implement EVV by set deadlines. Providers of Medicaid personal care services had to be using EVV by January 1, 2020, and providers of home health care services by January 1, 2023. 

So in practice, this essentially means that any Medicaid-funded personal care or home health services that’s delivered in a patient’s home has to be logged with an EVV system or solution. 

That means it’s crucial that your practice meets these new rules or you’d face penalties. States that don’t comply risk losing part of their federal Medicaid funding. In short, any Medicaid services delivered at home must meet EVV rules. Overall, meeting these federal EVV requirements is mandatory.

How EVV Works: Key Data Collection

EVV systems capture specific service delivery information for each visit. Federal guidelines specify six required EVV data elements. These include:

 – Type of service performed

 – Individual receiving the service

 – Date of the service

 – Location of service delivery

 – Individual providing the service

 – Time the service begins and ends

For example, when a caregiver clocks in at 9 AM and clocks out at 12 PM for a shower visit, the EVV system logs 3 hours of that specific service at the patient’s home. That automated record then just replaces the guesswork of paper logs and ensures the service performed matches the claim exactly. 

As you might imagine, capturing all these elements is crucial. Once EVV data collection is complete, the visit record is attached to the claim. States and payers can then cross-check each claim against a verified visit. The claim may be flagged or denied if a required EVV data element is missing.

Benefits of EVV: Accountability and Efficiency

– EVV data brings new insights for agencies. Administrators can track visit durations and ensure staff are deployed where needed, improving scheduling and resource use over time. 

– EVV means more accountability and better care

– EVV systems help ensure timely service delivery by verifying home healthcare visits and recording details like time and location. If a caregiver is late or misses a visit, the agency can see it right away and correct it. 

– Patients benefit because care starts as scheduled and is properly documented. 

– Insurers and taxpayers benefit because EVV cuts waste.

– It drastically reduces fraud and improper billing. For example, EVV was explicitly designed to reduce fraudulently documented home visits while keeping legitimate payments flowing.

EVV Technology in Practice

Generally speaking, most EVV solutions out there just use mobile apps or simple devices at most. For example, a home health aide might tap a smartphone EVV app when arriving and leaving each patient’s home. The app uses GPS or a PIN code to verify the visit’s time and location. That’s good because it means it’s highly accessible and doesn’t require expensive investments or anything like that.

Other solutions rely on phone systems or small GPS “fobs” that caregivers check in with. Once a caregiver starts the visit, the EVV system automatically logs who started and ended the service. This digital verification replaces all those long timesheets and paperwork. In practice, that means fewer billing errors and more time with patients. 

And EVV technology is often just built into scheduling or payroll software so caregivers barely notice it – it just becomes part of their workflow.

Outsourcing Billing and Coding for Small Practices

Running a small medical practice means juggling patient care with mountains of paperwork. We appreciate that not every practice has the staff to handle all that, so that’s why many providers outsource medical billing and coding. 

PMN is a medical billing and coding company with over 20 years of experience. We specialize across a range of medical fields so we can help keep your practice organized and compliant.

We also manage all the administrative paperwork, so that lets us ensure that all your claims are accurate and denials are prevented (and we double-check each claim to secure prompt reimbursements). 

Want to learn more about what we do? Give us a call at 949-215-5044 or email info@pmninc.biz. Alternatively, you can schedule an appointment at our office in Laguna Hills, Orange County, California.

FAQs

Who Needs to Use EVV?

Any home care provider, of course, billing Medicaid must use EVV for personal care or home health services delivered at home. In practice that covers almost all Medicaid-funded home healthcare and community based services. If Medicaid pays for it, EVV program rules apply and an EVV system must verify each visit.

How Does EVV Help Prevent Fraud?

EVV verifies each visit by recording who, what, when and where. This drastically reduces fake claims. EVV was literally built to prevent fraudulently documented home visits. Only real, properly timed care is billed, so Medicaid payments go only to actual services billed.