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EVV Provider

Readiness Advisory

GroupWebinar: EVV Basics

August 24th, 2018

Webinar Hosts

Joe Russell, Executive Director

Ohio Council for Home Care and Hospice

Andrew Yogmour, Policy and Advocacy Director

Ohio Council for Home Care and Hospice

Provider Expert

Kim King, Chief Operating Officer

Home Care Network

ODM Technical Consultants

Julie Evers, EVV Policy

Ohio Department of Medicaid

Kristy Wathen, EVV Operations

Ohio Department of Medicaid

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EVV Provider Readiness Advisory

Group

Earlier this year, a group of stakeholders impacted by

electronic visit verification (EVV), including associations

and providers, joined together with state agencies to create

the EVV Provider Readiness Advisory Group.

The intent of the group is to work towards determining and

ensuring providers and state agencies are prepared for

EVV.

Toolkit and Webinars

Over the course of the coming months, the EVV Provider

Readiness Advisory Group will continue its work to:

1. Determine stakeholders are prepared to comply with state

and federal requirements of EVV; and

2. Give them resources and knowledge to assist with their

efforts to comply with state and federal requirements of

EVV.

As part of the group’s work, various information and

documents will be provided in conjunction with webinar

presentations. Ultimately, the documents will come together to

form a toolkit that can be referenced and utilized in the future.

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Webinar: EVV Basics

You will learn about:

1. Background, Timelines, and Vendors

2. Updating MITS

3. Getting Started

4. Billing with Units

5. Exception Codes and Reason Codes

6. Best Practices

7. Training and Resources

The content in this webinar applies to a wide variety of providers. There will be

information you might already know, but this is the first webinar from the EVV Provider

Readiness Advisory Group to help providers with implementation. Hopefully, at the

conclusion of the webinar, you will have learned something new that will help you.

Background, Timelines, and

Vendors

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What is EVV?

Electronic Visit Verification (EVV) is mandated by the federal government as a tool for electronically capturing point-of-service information for certain home and community-based services.

EVV in Ohio is meant to:

Promote quality outcomes for individuals (Quality of Care)

Greater opportunity for enhanced care coordination and data sharing

Improve payment accuracy (Program Integrity)

Electronically verifies that a caregiver is physically present for a visit

Collecting Data

Confidential visit information is collected through the use of a

GPS enabled Mobile Device, used to sign in and sign out.

Every EVV System must have two backup methods for

collecting data.

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When did the federal government

implement this requirement?

On December 13th, 2016, the 21st Century Cures Act became

law.

In accordance with this federal legislation, the Centers for

Medicare and Medicaid Services (CMS) established

requirements for all states to use an EVV system.

If states do not meet certain implementation deadlines,

CMS may use its discretion to reduce their Federal Medical

Assistance Percentage. (FMAP).

What must be verified through EVV

under the 21st Century Cures Act?

In regards to personal care and home health services, EVV means a system that electronically verifies information related to visits with respect to:

The type of service performed

The individual receiving the service

The time the service begins and ends

The location of service delivery

The date of the service

The individual providing the service

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What were the original EVV

implementation deadlines under the

21st Century Cures Act?

Personal Care Services:

January 1, 2019

Home Health Care Services:

January 1, 2023

Congressional Action

Due to concerns of meeting the January 1st, 2019 deadline, efforts were made by members of Congress to provide states with more flexibility regarding timelines and move the initial deadline that would dictate whether or not CMS could penalize states by reducing their FMAP.

One of the bills, H.R. 6042, successfully made it’s way through the federal process and became law near the end of July.

The changes to the law extends the January 1st, 2019 deadline for compliance by one year to January 1, 2020.

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Ohio Specific EVV Information

The Ohio Department of Medicaid is responsible

for implementation.

Three implementation phases

ODM previously made adjustments to the

implementation timelines.

Sandata Technologies is the ODM vendor

Certain alternative EVV vendors are acceptable

Near real-time processing capability

GPS-based system with telephony and manual

entry workarounds to use as needed

Phase 1 Services (Fee for Service)

State Plan Home Health Aide

State Plan Home Health Nursing

State Plan RN Assessment

Private Duty Nursing (PDN)

Ohio Home Care Waiver Nursing

Ohio Home Care Waiver Personal Care Aide

Ohio Home Care Waiver Home Care Attendant

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Phase 1 Timeline

November, 2017: Training begins

January 8th, 2018: Go-live

July 8th, 2018: All data became subject to audit – visit data

as well as data integrity.

August 15th, 2018: Units conversion became live in EVV,

and EVV related edits began being posted for Phase 1

providers on their EOBs.

November, 2018: ODM will begin denying Phase 1 claims

that do not have a corresponding EVV visit. Providers will

need to clear all exceptions and ensure units match.

Phase 2 Services (Fee for Service)

PASSPORT (ODA)

Nursing

Personal Care

Home Care Attendant

Individual Options and Level One

Homemaker Personal Care

Nursing

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Phase 2 Services (Managed Care)

Home Health Nursing

Home Health Aide

Private Duty Nursing

RN Assessment

MyCare Waiver Nursing

MyCare Waiver Homecare Attendant

MyCare Waiver Personal Care Aide

Phase 2 Timeline

Feb to May 2019: Go-live and provider training

May 6th, 2019: Phase 2 services mandated to use EVV by

rule

Summer/Fall 2019: ODM will begin denying Phase 2

claims that do not have a corresponding EVV visit.

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Phase 3 Services

Self-Direction

Home-Based Therapy

Any other remaining Cures Act requirements

Phase 3 Timeline

May 2020: Go-live

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How will the passage of H.R. 6042

impact Ohio’s timeline?

At this time, ODM has indicated there is no plan to move the

current timeline. In accordance with the phases in which they

provide services, providers should continue implementing the

system.

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Sandata Technologies

Mobile devices are provided free of charge

CAT

LG

Santrax aggregator

Contracted with the State of Ohio as the preferred vendor

for EVV

As of August 1st, a mobile application became available as

an option for providers to use in worker and provider

devices.

Sandata Application

As of August 1st, a mobile device became available.

The blue icon in Apple and Google application stores is the

one Ohio providers need to use.

DO NOT use the application with the green icon.

Keep the application updated.

If providers used the application prior to August 1st, visits in

MITS may need corrected; they might not match ODM

requirements.

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Alternative Vendors (As of 8/21/2018)

Alora Health

Axxess

McKesson

MaximCare Mobile

CellTrak

ContinuLink

Complia Health –

ContinuLink

Ampersand International,

Inc

Maxim

Brightstar

Salo Solutions

PointClickCare

Alternative EVV Considerations

Non-agency providers CANNOT use an alternative EVV

system.

It’s the provider’s responsibility to make sure an alternate

EVV system satisfies all ODM requirements.

The provider, NOT THE VENDOR, must initiate the

certification process.

ODM can require recertification as the agency deems

necessary.

New data elements (Future Phases)

Compliance issues related to the provider

Compliance issues related to the vendor

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Alternative EVV Requirements

Must meet ODM system specifications

Provide the same data elements as the Sandata system

Be able to share the data elements seamlessly with ODM

via the Aggregator at least daily

Agencies must be able to edit claims in the alternative

system, because they cannot do it in the Sandata system.

Alternate systems must calculate the same “exceptions that

the Sandata system calculates” and give providers the

opportunity to clear those exceptions.

Aggregator (Santrax)

Captures:

Sandata provider portal data

Sandata visit data

Alternative vendor portal data

Alternative vendor visit data

The aggregator makes the data uniform and turns it into usable data for ODM.

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Questions?

Updating MITS

Quick Reference Document

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Keep Information Up-To-Date

The email address in MITS is critical to successful

implementation of EVV in your business processes.

ODM and Sandata use it for many things, including:

Communicating EVV program changes;

Providing information related to the Sandata EVV system,

including enhancements that become available; and

Providing access to the Welcome Kit after training.

All providers should use the MITS provider portal to

verify their email addresses.

Changing your email address in the MyOhio system

will not update your information in MITS.

Changing Information in MITS

1. Log onto your MITS Secure portal.

2. Enter your Ohio Medicaid provider ID into the Provider ID field.

3. Click Search.

4. Click on the demographic maintenance tab and select the Location Name Address link.

5. You will now see four Address Types listed: Home Office, Mail To, Pay To, and Service Location. In order to update your email address completely in MITS, you must click each of these Address Types and update your email address in each field. Change the service location email for purposes of EVV.

*Save the new email address that you enter in eachaddress type, before moving on to the next address type.

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Questions?

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Getting Started

To get started, providers

need to:1. Update contact information for service location in MITS

2. Complete mandated training

3. Set-up eTRAC account

4. Access Welcome Kit through eTRAC (cannot access Sandata system

without)

5. Provide/update information in Sandata account

6. Request devices

7. Create records for the individuals they serve and their employees

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Setting-up eTrac

1. Visit the eTRAC website: https://etraconline.net

2. Click Register

3. Enter your Medicaid provider ID twice

4. Enter the email address on file with ODM (Needs to match

Medicaid provider ID email address)

5. Fill out information, choose a password, check the confirm

box, and click Register Account.

The first person to create an account for the provider is the

provider’s Security Administrator in eTrac. Providers can add

more people, as permitted by the Security Administrator.

Create Additional Logins in eTrac

This process can only be completed after a provider’s Security

Administration is assigned a pin through the initial account

set-up.

1. Visit the eTRAC website: https://etraconline.net

2. Click Register

3. Enter your Medicaid provider ID twice

4. Enter the email address on file with ODM (Needs to match

Medicaid provider ID email address)

5. The Provider ID has already had a registered user, so

eTRAC will ask for the Provider ID’s 4-digit PIN

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eTrac Set-up – Visual Demonstration

Please visit:

http://medicaid.ohio.gov/Portals/0/Initiatives/EVV/Presentation/

JanuaryStakeholderMeeting.pdf?ver=2018-01-31-144940-900

eTRAC Quick Reference Document

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Questions?

Billing with Units

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Units and Visits

The EVV system logs visits and is capable (As of

August, 15th) of recognizing and calculating units.

Billing must continue to be done in units, but times

of a visit in MITS are optional.

Beginning in mid-November, claims will be denied

if units billed do not match units in the EVV system.

For basic billing information from ODM please

reference:

Basic Billing

Explanation of Units

Unit Table Quick Reference

Document

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What data is the Sandata EVV system

matching to claims?

Provider Medicaid ID

Client Medicaid ID

Service

Start Date of Service

Units Billed

Remittance Advice

All claims that have been processed are available in the

MITS portal

Weekly reports are available on Wednesdays

If EVV system is not throwing codes, but there are still

problems in MITS, look for a problem somewhere else.

http://medicaid.ohio.gov/Portals/0/Initiatives/EVV/Remittance-

Advice.pdf

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Questions?

Exception Codes and Reason

Codes

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Exception Codes

http://medicaid.ohio.gov/Portals/0/Initiatives/EVV/ExceptionCo

deListing.pdf

Reason Codes

http://medicaid.ohio.gov/Portals/0/Initiatives/EVV/ReasonCod

eListing.pdf

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Questions?

Best Practices

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Falsifying Data Points

There have been reports of providers entering false data in

fields in the EVV system. (Ex. Entering 000-000-1000 or 111-

111-1111 for employee Social Security numbers)

THIS IS FRAUD!

ENTER INFORMATION ACCURATELY

Document in the Care Setting

Only time with the client providing services is billable.

If you document after the visit, you are NOT allowed to bill

for that time.

Benefits:

Fresh information, ensuring information isn’t forgotten

More time in the patient’s home equals more information

gathered

Family time in the evenings rather than documentation catch

up

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Quick Reference ID Card

Quick Reference ID Card

EVV Call Reference Guide

Included in medical

record and copy left

in home

Reference Guide

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EVV Process Standards Document

Included in medical record and copy left in home

This reference document summarizes steps for basic EVV

functions

Standards Document

Office Staff Toolkits and Binders

Guide for how to answer field staff questions ensures

continuity of knowledge across all staff.

Screen shots in the binder means the office staff do NOT

have to memorize the screens to answer clinician questions

about the device or processes.

Binders can be used to train office and field staff.

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Locked Out of Account

When a caregiver gets locked out of the device either an agency EVV administrator has to unlock their account (for agency employees only) or you have to call or email Sandata’s support to get their account unlocked.

HELPFUL HINT: Train your employees to call in to have their password reset after two failed attempts.

You can reset their passwords by going into their account, unchecking the MVV box, save, then recheck the MVV box and save again. It will send them a new temporary password and they can retry getting into the device.

Doing it this way prevents us from having to make a call to the Sandata support team.

Contact Email Tips

Use billing staff email for MITS

Keep contact emails up-to-date and uniform across

ODM systems

Used for updates and confidential communication from

ODM

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Other Tips Your company ID on the device does not start with

STX. It is your office’s ID #.

Carry your client and employee info with you.

If you open a case with Sandata, ask for a ticket number and report this to a key staff member with a description of the issue. This is especially important with recurring issues.

Educate staff that if they are about to press a grey button they should probably call you. Blue is the new green light!

Device reboots if you turn it over in the process of starting a visit. It often locks the user out during this process.

Questions?

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EVV Training and Resources

Medicaid Resources

http://medicaid.ohio.gov/INITIATIVES/Electronic-Visit-Verification

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Provider Training – Medicaid and

Sandata

EVV Provider Refresher Training - Visit Maintenance and Reports - 04/25/2018

MVV Client Search Configuration Change - 02/22/2018

Agency EVV Training Manual - 11/02/2017

Non-Agency EVV Training Manual - 11/02/2017

Agency EVV Training Registration

Non-Agency EVV Training Registration

Agency Training Registration Reference - 10/02/2017

Non-Agency Training Registration Reference - 10/02/2017

Trading Partners - 05/17/2017

Frequently Asked Questions

ODM FAQ – August, 2018 Version

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Important Contact Information

Provider Assistance:

For general questions about the EVV program, send questions to: EVV@medicaid.ohio.gov

Ohio Medicaid Provider Hotline: 1 (800) 686-1516

Technical questions about using the Sandata EVV system or an alternate EVV system contact EVV:

Customer Care: 1 (855) 805-3505

Assistance for Individuals Using Long Term Services and Supports Subject to EVV Requirements:

EVV@medicaid.ohio.gov

Ohio Medicaid Consumer Hotline: 1 (800) 324-8680

Questions?