Electronic Visit Verification (EVV) Implementation Reminder and Exceptions Requirement Update

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Implementation Reminder: Electronic Visit Verification (EVV) System for Personal Care Services and Home Health Care Services, CR 75606

 

The deadline for EVV implementation is quickly approaching. The federal deadlines to implement the EVV requirement are January 1, 2021 for Personal Care Services (PCS) and January 1, 2023 for Home Health providers delivering services under Section 40.

 

The current three-day pend process for EVV claims will end on December 31, 2020. For dates of service beginning January 1, 2021, claims without a verified matching EVV record will pend for up to 30 days and then deny if no verified EVV record is found. After January 1, new claims with dates of service from before January 1 will not go through the pend process at all.

 

Please enter EVV visit records in a timely manner as claims are evaluated against EVV records daily. The sooner a visit record is found for a claim, the sooner the claim will process. To avoid the pend period altogether, please make sure your verified EVV record is in the Sandata or alternate EVV system prior to submitting the accompanying claim. If an EVV record is found, the claim will go through the usual claims edit process. Please note that claims may also pend for reasons other than EVV.

 

To meet the upcoming deadlines, we strongly encourage  providers to continue your work toward implementation of the EVV requirements. 

See the EVV webpage for more information, including Frequently Asked Questions (FAQ).

Please contact Provider Services with questions:

  • Email MaineCare's EVV email box
  • Call Provider Services at 1-866-690-5585, option 3  

Electronic Visit Verification (EVV) Exceptions Requirement   

In early 2021, we will remove the requirement to acknowledge the following Exception ID descriptions:   

  • 39 Client Signature Exception – signature does not exist for the member on the visit.   
  • 28 Visit Verification Exception – member did not verify the time in and time out on the visit.     

This applies to providers using Sandata and alternate EVV systems. 

All other exceptions for EVV will remain in place and will continue to require an acknowledgement.  

We will send another message when we have a specific implementation date. Until that time, providers must continue to acknowledge these exceptions.   

Please contact Provider Services with questions: 

  • Email MaineCare's EVV email box.
  • Call the EVV Help Desk at 1-866-690-5585, option 3