Change in Pend Time for Electronic Visit Verification (EVV) Claims

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Change in Pend Time for Electronic Visit Verification (EVV) Claims

We previously announced that Personal Care Services (PCS) claims with dates of service beginning January 1, 2021 would pend for up to 30 days and then deny if no verified EVV record is found. At this time, we are temporarily changing this to 45 days to allow more time to resolve technical issues that some providers have experienced. We will notify you when the pend period returns to 30 days.

As a reminder, 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.

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