With a growing number of government and payer mandates calling for home health agencies to validate the accuracy of the care they deliver, Electronic Visit Verification (EVV) has never been more important for the home care industry.
There are four aspects of compliance agencies typically must meet.
Did a Visit Really Happen, and Was the Correct Care Delivered?
The first and most obvious one is visit compliance, which simply means verifying the visit took place. EVV technology facilitates this by providing real-time proof of visit, often based on a GPS signal from a mobile device that pinpoints the time and location of the visit.
GPS tracking also prevents fraudulent “workarounds," such as the risk that a caregiver might ask a client to call in and report that a visit occurred -- when in fact it did not.
The second type of home care compliance covers the specific health care or personal services delivered. Did the caregiver perform the activities he or she was expected to do?
According to Home Health Care News, one of the most common types of home health fraud over the past five years centers around personal care services that were either not necessary or not actually provided. HHCN cited a Missouri case in which a claimant submitted time sheets for more than 130 days, indicating she provided care to four beneficiaries. However, it was found that she was working a full-time job during the same time period.
A comprehensive mobile solution can improve compliance and prevent this type of fraud by going beyond simple visit verification and enabling (or even requiring) digital point-of-care documentation. This has the added benefit of making documentation easier for caregivers to complete.
“I used to spend two to three hours after my shift officially ended just on documenting work,” said one Hospice at Home paraprofessional. Now, by documenting care on site with a mobile app, the whole process takes only about 40 minutes per day.
Do Claims Have the Appropriate Documentation?
This third type of compliance improves the reimbursement process for agencies. The Centers for Medicare & Medicaid Services (CMS) require extensive documentation for submitted claims, and agencies must make sure they have not only accurate, but also comprehensive, documentation of the specific activities performed during each client visit. Not submitting this information all but guarantees a claim will be returned with an Additional Documentation Request (ADR), which no agency wants to see.
A complete mobile solution that goes beyond simple EVV technology can improve compliance here as well. Digital point-of-care documentation that also includes a range of on-device forms, surveys and assessments can greatly help to reduce errors and ensure all information required by CMS and other payers is properly collected.
Moreover, having all relevant data available digitally streamlines the claim submission process for agencies and can reduce the chance a claim will be rejected. Tendercare recently implemented a digital documentation solution, and they were thrilled to have zero ADRs in their most recent review.
Is Visit Documentation Quickly Available for Audits?
Finally, the fourth type of compliance deals with one of the biggest challenges all home care agencies face: the surprise audit. Agencies never know when a CMS surveyor will appear on their doorsteps. But like death and taxes, audits are a way of life in this industry. And surveyors expect agencies to be able to meet any request for documentation quickly.
Digital documentation enables agencies to shine here, too. Additionally, a documentation solution that integrates with the agency's EHR system will provide an important advantage by increasing the comprehensiveness of the agency's records and the ability to pull those accurate records on demand.
By accurately and electronically capturing and storing all relevant data related to visits and care delivery, agencies typically find they can quickly answer even the toughest questions from a surveyor. Just ask the leadership team at Hospice Alliance. A CMS surveyor showed up just five months after implementing a comprehensive EVV solution that also integrated with their EHR -- and the entire audit process went so smoothly, even the surveyor was surprised!
While an EVV solution can easily fulfill your organization’s legislative and payer requirements to prove a visit happened, the right solution can also improve your ability to meet multiple types of home care compliance demands. Learn more about your options with EVV technology to see how you too can go beyond simple proof of visit with a solution that meets all of your needs.