Home » Blog Articles » Electronic Visit Verification » How Does the Ohio EVV Mandate Impact Phase 2 Providers?

In the state of Ohio, many agencies and independent providers are already aware of the new electronic visit verification (EVV) requirements. ABCS RCM has been following these developments for some time. In fact, the company is an alternative EVV vendor for agencies that deliver Phase 2 Providers services to individuals with developmental disabilities.

As a company, they provide billing, workforce management software and account management services to a variety of healthcare professionals. In order to continue delivering great service and value to Medicaid waiver provider agencies, they have incorporated the EVV requirements into their workforce management software.

The Origins of the EVV Mandate?

The 21st Century Cures Act (Cures Act) is a federal mandate signed into law on December 2016. The stated goal of the act was to accelerate product development and bring new innovations and healthcare advances to patients. The implementing of Electronic Visit Verification (EVV) for some home and community-based services is in response to these federal requirements.

EVV is an electronic system that verifies key information about the services provided. In accordance with the Cures Act, the system implemented by ODM will record the date of the service, the time the service started and ended, the individual receiving the service, the person providing the service and the location of the service. Both agencies and non-agency providers are impacted by EVV.

Every state in the U.S. must implement EVV under these new regulations. In order to implement these requirements in Ohio, the state awarded a seven-year, $66.5 million contract to New York-based vendor Sandata Technologies. The federal requirement for providers who deliver services to individuals with developmental disabilities to utilize Electronic Visit Verification (EVV) are included in what the state calls Phase II providers.

What does EVV do?

A quick definition of Electronic Visit Verification is the ability to capture a GPS location at the time a service visit starts and end. A stated goal of the EVV requirement is to reduce fraud in the Medicaid Waiver program. This is a noble goal since all individuals in the Medicaid Waiver Program should receive all of the services that they are eligible to receive.

The state of Ohio must be in compliance with the EVV mandate or risk losing federal dollars in the Medicaid program. The EVV mandate applies to home services and has been implemented in phases. The first phase applied to traditional home care services. However, services provided under the Ohio IO Waiver Medicaid program are considered Phase 2.

As the state vendor, Sandata will capture and store the electronic visit data. During this process, the term “aggregator” is used to describe the collection and storage of EVV visits by both agencies and independent service providers.

The state’s EVV aggregator is managed by Sandata. When an agency’s billing file is submitted for payment, the Ohio Department of Development Disabilities (DODD) will compare the units on the submitted billing claim to the EVV data stored on the aggregator. The submitted billing units and EVV data need to match, or they will potentially not receive payment for the hours submitted.

Deadlines for EVV Implementation?

Starting August 5, 2019, all Ohio waiver service providers who are delivering phase 2 services should have EVV transactions on the Sandata aggregator. The state has described this time period as a “Pay-and-Post” period. During this period, providers will be able to see if their claim would have been paid had the state’s EVV validations been turned on.

There are two approaches for agencies to submit service visits to the State’s aggregator. The first is to use the Sandata device. The second option is to use an alternate vendor to submit EVV visits to the state’s aggregator.

Alternative EVV Vendor:

Advanced Billing & Consulting Services (ABCS), in cooperation with eWebSchedule, is becoming a state-approved alternative EVV vendor. They are introducing a web-based application that works in both the Android or Apple platform.

Here is a list of their solution’s features and benefits.

  • The web-based solution will integrate with eWebSchedule’s other features and can be used at all locations. 
  • Unlike Sandata approach, ABCS and eWebSchedule have created a custom solution that integrates with an agency’s billing process. This helps to eliminate the need for staff to document time both on the Sandata device, while also documenting hours in their own system. This eliminates repetitive paperwork.
  • The eWebSchedule solution “knows” what to report to the aggregator and the exceptions to the rule removing this responsibility from your staff.
  • The eWebSchedule solution can detect time spans that are exceptions to EVV requirements. Their solution understands, based on the site and task being documented, whether or not to EVV data should be reported to the state aggregator.
  • EWebSchedule’s Time Card Approval by shift can support reviewing EVV exceptions which allow supervisors to accept or reject the exception. Based on the supervisor input, the solution reports the approved time to the EVV aggregator.
  • The eWebSchedule solution is integrated with a Time Collection and Billing process feature. The solution will never send units for payment that are not supported by EVV data in the state’s aggregator.

About the Company:

ABCS RCM delivers billing and workforce management tools for agencies that provide services to the I-DD community. They also provide revenue cycle management services for a variety of healthcare specialties. These services include insurance credentialing and online marketing assistance. For additional questions about this the EVV mandate in Ohio or California, please contact the staff at Advanced Billing & Consulting Services.

To schedule a free, no obligation demo — call 614-890-9822.

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