6 Questions on How to Implement EVV With a Seasoned Home Care Provider
Becoming compliant with the 21st-Century Cures Act is a lengthy process. Between selecting the correct EVV solution, implementing the solution, and training field staff, EVV compliance can take months to fully come into effect. It takes time, manpower, communication, and a lot of trial and error. So, what are some best practices to implement EVV in your business? We had the opportunity to sit down with Richard Butler, COO of Etairos Health – a long-time CellTrak customer – to hear about their experience implementing EVV. This blog post is an excerpt from our webinar. Click the link at the bottom of this page to see the full interview.
Richard, thank you for sitting down with us. In implementing EVV, what were some of the hurdles you faced, and how did you overcome those hurdles?
The aggregator implementation was probably the hardest [transition for EVV]. We currently work with two aggregators, Tellus, and HHAeXchange. Each one had their own set of challenges that we had to work through, in addition to the challenges that they were having with the payers, and the information they did that they needed.
Those challenges consist of different reason codes set up and required for each payer, challenges with getting the agency set up.
one of the things that that we encountered with Tellus was that they were not prepared to handle an agency with multiple locations and multiple divisions under one umbrella. Even as simple as having more than one location or NPI. It was somewhat foreign to them.
What are some best practices you have found in helping caregivers make the transition to EVV compliance?
The training and the guidance were a challenge with some of the caregivers. You have the younger caregivers that deal with technology, and it was pretty simple to teach them how to download the app and then walk them through the clock and clock out process. Then you have caregivers that may not be great with technology.
We took two different approaches when training with those folks. We had in-person training in our offices, we also had virtual trainings. We've created a video that we posted on our YouTube channel That covers anything from how to download the app, to how to properly clock in and clock out, how to use the app with respect to directions, and how to complete the care plans inside.
How Does This Training Process Work When Hiring New Team Members?
In the beginning, we would just hand them a sheet of paper. It had all the instruction instructions on it, and then they would leap. And what we were finding was, there was noncompliance with the usage of the app, there were technical issues or challenges with downloading it.
Now, we set up a test patient for them. They can login, they can see the clock in and clock out functionality. They can see a care plan in all of that has to be coordinated upfront for all new hires prior to them walking in on day one.
even though we made it [orientation] mandatory, we had our fair share of problems with folks saying they can't clock, and they can't clock out. But, as it turns out, they never downloaded the application and didn't know how to use it.
one of the things that we did across the board was that we didn't look at just EVV mandated payers when going live with CellTrak. We went live with CellTrak across every single payer, regardless of the EVV mandate. And we believe that that was also a best practice to make it [implementation] that much easier.
What are some of the things that agencies can do upfront to try to prevent issues later?
Over-communicate with the aggregators. If you have an established relationship, whether it's an account manager, work with your aggregator to establish a relationship upfront.
That starts with choosing your EVV provider like in the case for us CellTrak, choosing them early on. And then, at the same time, utilize CellTrak inside that partnership.
They are working hand in hand with the aggregators, to make sure that the data is transmitted, timed appropriately, and is correct. I can tell you that, that CellTrak has really become a true partner of ours during this time because of the amount of work [ to set up implementation]
I would suggest that if you're talking to your Account Manager at the aggregator level, and they're telling you your account is set up properly, it's probably not. Have a call with them, make them send you screenshots or data records, indicating that your locations are set up. if you can convince them [your aggregator] to do real-time testing, push them to do that, have them on the phone, send the records to them, have them confirm it. Don’t hesitate to push them as far as you can inside of your testing.
Are there some things providers can do to mitigate the risk of claims denial?
One of the areas that we failed early on, is that the claims are the records would go from CellTrak to the aggregator. We would confirm it in the portal and aggregators [to make sure we were compliant]. I would encourage you [to] take it all the way through three components [CellTrak, the portal, aggregators], and make sure that it aligns.
Make sure you understand what patient ID record is required for each one of the aggregators and the payers that they're looking for. That was a significant change for one of our aggregators with specific payors where they came back. We had to make an internal change from our intake process to prevent rejections from going to the aggregator and the payor.
[…] We're still working through it. As of yesterday, we're at a 98% acceptance rate at the payer level. So, there's still a 2% gap of rejected claims that we have to work through for various reasons. 99.9% of them are invalid rejections, but it is something that we have to work through change. And it's typically driven by the rejection from the payer back to the aggregator.
When you started to operationalize EVV, did you have an existing EMR and payroll system, and how important is interoperability between those systems and your EVV solution to you today, as you are well into implementation?
Prior to EVV, we did have a central EMR, and payroll, which for us is ADP and Netsmart Home Care. As we were evaluating the EVV partner, we considered the implementation and the integration with our EMR.
[…] We selected CellTrak because of their ability to integrate with not only our EMR, but other EMRs. That integration has been instrumental in streamlining the process and preventing data from going back and forth between any EVV aggregator. we looked at Tellus, one of the aggregators, and they just didn't have the same functionality and mobility that CellTrak offered by allowing those records that come straight from CellTrak into our EMR, And then out of our EMR, back to ADP, for Payroll processing. It really streamlined and eliminated concerns that we had with respect to EVV implementation.
But, most importantly, make sure you understand the integration that each one can offer. And personally, I wouldn't do it any other way other than full implementation and integration with your EMR.
We hope you were able to gain some knowledge about best practices for EVV in this Q and A with Richard Butler, and if you enjoyed this excerpt, check out the full interview in our webinar here or click below.