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EVV: Operational Impacts on Home Health Agencies

EVV: Operational Impacts on Home Health Agencies

For Home Health providers new to Electronic Visit Verification (EVV) compliance can be daunting. Luckily, EVV expert and home care mogul Scott Brashears shares tricks of the trade and important info to prepare agencies for impending EVV mandates. Our experts advise “EVV affects you now. Start early.” Today we'll share how EVV will affect your daily operations so you're prepared for impending deadlines.

What Data is Required?

Providers have two responsibilities when it comes to EVV – Collecting EVV compliant data at the point of care, and relaying data to state aggregators and Managed Care Organizations (MCOs). At a minimum, the 21st Century Cures act requires the following data for EVV compliance, although some states require more data.

  • Type of Service Provided
  • Individual Receiving the Service
  • Date of Service
  • Location of Service Delivery
  • Individual Providing the Service
  • Time That Service Begins and Ends

Overall Impact on Home Health Agencies:

Unavoidably, EVV will change your workflow. Brashears warns, “This is going to change your workflow. There's no way around it. It's going to change how you manage things. You're going to have stuff that you're used to getting on paper, that will have to change.” With this in mind, here's what you’ll need to do to make sure you are prepared operationally for compliance:

Ensure that documentation is done at the visits - This will ensure visit time is tracked properly. In some instances, you might need to transmit documentation.

Decide if you will pay a stipend for your caregivers to use their own mobile devices - Some agencies provide their caregivers with a mobile device for capturing visits, others have a Bring Your Own Device (BYOD) policy. In this case, it may be beneficial to pay your caregivers a stipend for phone service. This can help minimize turnover and frustration with using mobile devices to document visits.

Keep schedules up to date and integrated with the Aggregator -  Some states will want to see the schedule side of visits. Did the visit time change due to a doctor's appointment or hospitalization? Was there a missed visit? Ensure all schedules are up-to-date to avoid rejections from your state aggregator.

Create a process to handle visits that cannot be captured via mobile technology - Not all visits will be able to be captured via your device. Sometimes phones die, sometimes the aide may not have service at the visit site, a prepaid cell phone may run out of minutes - there are many reasons visits may not be captured via mobile. Check what your state requires in this situation. Some states are very strict like ohio and require a signed time slip from the visit. "From an operational standpoint, you'll have to have a way to recapture that data via mobile. So, when I go out Wednesday I can get them to sign for Monday's visit and then I'll have to have a way to make sure that paper is tracked and in before it's sent to the aggregator for billing"

Dedicate staff to follow up with the aggregator - Assign staff to follow up with the aggregator. Brashears explains  "As we've been working through this with aggregators trying to get what's called a "secondary status," in a lot of cases, they accept your visit because your visit looks right. It had everything we expected on it. It had a task, had an off, etc. but when you go to the end of the week to bill it, there's something holding it up. I had to have a different service or they found a second-level audit. It doesn't get sent back to the EVV Aggregator or the EVV vendor that's sending the data. In some cases, just because a visit is accepted doesn’t mean that it is ready for payment." If you have people on staff prepared to follow up with the aggregator, they can make sure visits are adjusted and fixed after that second-level audit so visits don't fall through the cracks.

Learn to manage rounding rules since you will be capturing real times with EVV

Know your state requirements. Brashears explains  "if I started a visit that I had scheduled it Midnight, and I started the visit at 11:43 PM the night before, do I need to bill that? Is that going to affect my off?" He continues, "I might have to pay stuff that I can't bill. How are you going to manage that whole process when you're looking at rounding? Because again, this is real-time, captured data. So, this isn't the same time slip at the end of the week."

Final Takeaways:

Start early - Make sure you're capturing EVV data before it becomes mandatory. This will minimize rejections

Know what your state requires - get involved and establish a rapport with your state aggregator. The more you communicate, the less likely you'll be to run into issues.

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