ATTENTION: New EVV Claim Remittance Advice Messages

Did you know that a change is coming to Ohio Medicaid in 2025? At the time of this change, claims that require Electronic Visit Verification (EVV) must have a matching EVV visit record. Claims that do not match will be denied.  

To help you prepare for this claims matching, you will start to see warning messages on your claim Remittance Advice. These can be viewed in the ODM Provider Network Management (PNM) portal through the “Self Service Selections”, then choose “Remittance Advice”. More instructions are available here: Accessing Remittance Advice (maximus.com). 

The Remittance Advice will display the following warnings under “Rule Description” for the reasons noted. For help resolving these warning messages, click on the linked text for the help articles: 

• EVV – Provider ID does not match (6291)  

• If you need help getting start, click here: Getting Started Workflow 

• EVV – Recipient ID does not match (6292) 

• EVV – Procedure code does not match (6293) 

• EVV – Unmatched Units (6294) 

To avoid visit errors in the future, we recommend that you use the following resources: 

• Visit Maintenance Help  

• Adjusting Dates and Times Quick Reference Guide 

• Use the Visit Maintenance in module in Sandata EVV to ensure you have no visit exceptions (red dots).  

• Only visits in a Verified or Processed state will be considered for claims matching.  

• Verify the recipient records contain an authorization for the service. 
  
  

Verify the visit has the correct date of service. 

Note: If you are using an Alternate (Alt) EVV vendor for visit capture and management, continue to work with your vendor to maintain compliance. The following resources are available for Alt EVV providers and vendors:  

• Alt EVV Homepage 

• Alt EVV Technical Specifications 

Please contact Sandata’s EVV Provider Hotline at 855-805-3505 so we can help. Office hours are also available for you to stop in for 1:1 assistance. Office hours are available daily at SandataLearn.com. Simply login in or register at SandataLearn.com and then click the Events tab to access Office Hours. 

REMINDER:  The first phase of the claims adjudication process begins with home health services claims billed through State Plan Fee-for-Service (FFS) – where ODM is the payer. Only claims for these services will require complete EVV visit data to receive payment.  The changes will not take place any earlier than January 1, 2025. Additional services will be phased in over time.  

Thank you.