Electronic Visit Verification (EVV) Claim Pend Process Implementation: October 1, 2020 

Electronic Visit Verification (EVV) Claim Pend Process Implementation: October 1, 2020 

The federal deadlines to implement the Electronic Visit Verification (EVV) requirement are January 1, 2021 for Personal Care Services (PCS) and January 1, 2023 for Home Health providers delivering services under Section 40. CMS has not changed these federal deadlines due to the COVID-19 Public Health Emergency. 

The Department delayed its previously planned  implementation of EVV for PCS from July 1, 2020 to January 1, 2021 due to COVID-19. In order to ensure providers are on a path to successfully meet the federal January 1, 2021 deadline for PCS, MaineCare will implement the EVV pend process on October 1, 2020 for PCS claims. This will give providers a “soft launch” opportunity during which claims that do not meet the EVV requirements will first be subject to a claims pend, or delay in processing, instead of denying. This means claims with dates of service beginning on October 1, 2020 will be subject to an EVV claim edit. We previously communicated that we would give ten business days’ notice before implementing the pend process, but we hope that providing you with this ample advance notice helps you to mitigate potential delays in payment. 

Beginning October 1, 2020, claims subject to EVV requirements will pend for a three-day recycle period unless a matching EVV record is found. After the pend period, claims will then process to pay unless denied for other reasons.  

We strongly encourage you to continue working toward implementation of the EVV requirements ahead of the impending October 1, 2020 PCS soft launch as well as the January 1, 2021 PCS deadline for full implementation. 

Providers Using Alternate or 3rd Party EVV Systems 

If you are planning to utilize an Alternate or 3rd Party EVV system, we encourage you to use the State EVV system until you’ve completed the Alternate EVV System Integration process. 

To begin using the State EVV System, please follow the instructions in the EVV System Set-Up Options section of the EVV webpage. If you have not yet logged into the State EVV System, your account may require a password reset. Please contact Provider Services for assistance at 1-866-690-5585, option 3. 

Increased Frequency of EVV Training and Forums   

We will soon resume offering weekly online EVV trainings and forums. Trainings cover a variety of topics related to EVV, including administrative functions available on the Sandata portal, and are available to help providers prepare for the implementation of EVV requirements. The purpose of the forums is to answer technical questions regarding the State EVV system and Alternate EVV System Integration process. We will share more details, including dates and times of these events, as soon as they are scheduled.