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Insights From the Experts : Overcoming EVV Challenges


It’s been a busy first quarter for providers, who, on the whole, have made a great deal of progress with EVV implementation. Many agencies are underway with both EVV data collection and relay, and of course, continue to monitor state implementation to keep current on evolving requirements as well as updates to the rollout timeline.

While EVV is far from being in the rear-view mirror, at this point in implementation we have definitely logged significant “road miles” and learned a great deal along the way. We can share insight regarding what challenges we have seen and how to overcome them. We will also pass along a few tips to avoid bumps in the road as you progress towards compliance.

Although implementation varies by state, there are a few common challenges. First, EVV requirements vary by both state and payor, which means that agencies face a myriad of complexity when complying with multiple state and MCO requirements. Second, in addition to requiring the use of EVV, some payors have also mandated changes to billing for affected visits. Third, providers struggle with interoperability between the agency systems and the payor systems, which creates manual work and difficulty with claims reconciliation.

At this point, many providers are taking stock of their EVV implementation. Some are re-evaluating their approach and others are simply fine tuning. I have attended numerous state meetings and heard directly from providers who are living implementation day-to-day. I hosted a panel last month and spoke to several providers who generously agreed to share their insight. So, wherever your agency is in the process, here are a few tips from the experts that can help you as you move forward:


          Choose one EVV system for all visits.

Providers who bill to more than one payor must comply with multiple state and MCO requirements. While each payor may offer a free EVV system, actually implementing multiple systems in practice can introduce confusion for your staff. Asking caregivers to determine which mobile application to use to document a visit based on the patient and payor is frustrating at best. In addition, caregivers that provide both mandated and non-mandated services may be faced with another layer of complexity regarding what tool to use. Our experts agree that choosing one neutral EVV solution that works for all visits with all payors is most efficient.

Consider both the direct and indirect costs of implementing a system.

Often providers focus first on the direct costs of EVV, especially given that it is an unfunded mandate for agencies. However, the indirect costs of the EVV system are typically more significant to the decision-making process. While free systems can be available, they do not integrate with existing agency operations such as payroll and billing and thus create a heavy administrative workload and an unwieldy claims reconciliation process. Our best advice to agencies? Consider your existing operations workflow when determining your approach to EVV compliance. If you face complexity with multiple payors and a variety of services, weigh all costs and consider an integrated system that can help you automate EVV. Many agencies are revisiting their approach and considering a move to a single, integrated system to manage compliance.

Think about how to use EVV to benefit your caregivers and patients.

Many forward-thinking agencies already implemented EVV prior to the mandate. They report that EVV technology provides them operational efficiency and a competitive advantage. But, most compelling is the support they can give caregivers and patients. Caregivers benefit from more accurate payroll and timely payments. Agencies can better support caregivers with efficient communication, helping them stay connected with their distributed workforce. Clients know that if their caregiver is running late with another patient, a replacement will be on the way if needed, and their services will be delivered on time and as scheduled.  

Take advantage of the grace period prior to claims denial.

Now is the time for your agency to get experience with EVV. Change management takes time- to understand multiple requirements, train caregivers, and adjust operations workflow. Focus on making progress now. Most states are in an implementation period that allows for learning and correction before providers will be affected by claims denial.

As you manage through this transition towards EVV compliance, remember to consider all segments of your operational workflow. Focus first on patients and caregivers, support your administrative staff, and allow time for change management. The challenges we discussed today are common, and an integrated solution can help. You might find that for your agency, the free system hasn’t really turned out to be free because of the increased administrative lift that has to happen behind the scenes.   We are here to help you work through this process, so call on us if you would like an expert evaluation of your compliance approach. Together, we are all focused on the single most important goal: improved patient care. That’s the beacon that guides us down the road.


Want more information? CellTrak hosted a panel discussion on EVV where Blacktree Consulting, Addus Homecare, Bayada Home Health, and Tendercare all generously agreed to share their experience and insight. Listen to the full broadcast here

View Panel Recording