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Electronic Visit Verification Newsletter

November/December 2024

In This Issue:

• Wishing You and Yours a Joyful Holiday Season!
• On March 1, Ohio Medicaid Claims Validation Processes Will Begin for Electronic Visit Verification Phase 1 Providers
• Electronic Visit Verification Office Hours: Opportunities for Providers
• January Alternate Electronic Visit Verification Vendor Town Hall Virtual Meeting
• Provider Lookup Dashboard Launched
• Webpage Redesign Simplifies User Navigation
• Common Electonic Visit Verification Questions
• Electronic Visit Verification Training Opportunities for Providers
• October 2024 Sandata Releases
• Who to Contact with Questions

Wishing You and Yours a Joyful Holiday Season!

“Blessed is the season which engages the whole

world in a conspiracy of love.”

– Hamilton Wright Mabie

For your partnership in helping Ohioans thrive, we thank you!

Wishing you and your loved ones a joyful holiday season!

On March 1, Ohio Medicaid Claims Validation Processes Will Begin for Electronic Visit Verification Phase 1 Providers

The Phase 1 Roll Out Impacts Home Health Services Claims Billed to Ohio Medicaid.

Over the past several months, the Ohio Department of Medicaid (ODM) has been working with Sandata, ODM’s Electronic Visit Verification (EVV) vendor, to prepare providers for changes coming to the EVV claims adjudication process. As ODM previously announced, to make this transition as smooth as possible for providers, the department will stagger the roll out of claims validation by phases.  

The first phase will apply to home health services claims billed to ODM and consists of the following service codes:

For details, please review the full December 5 email notice shared with EVV providers. For a list of services subject to EVV, please review the ODM EVV Program and Service Code Guide.

NOTE: If you are using an Alternate EVV vendor, your vendor may not be sending modifiers with the service codes on visits. Please check the Aggregator and review your visits to ensure any service code that should have a modifier added was sent over to the Aggregator correctly. It is important to note that there are only two services that have a variation with and without a modifier (G0493/G0493 U9 and T1001/T1001 U9).

Electronic Visit Verification Office Hours: Opportunities for Providers

Daily Office Hours for Claims Validation Support Sandata is offering office hours daily to provide support with electronic visit verifications as we move closer to claims validation. Please click here to register for a session.

January Alternate Electronic Visit Verification Vendor Town Hall Virtual Meeting

ODM will be hosting an Alternate EVV Town Hall in January to offer guidance to Alternate EVV vendors in Ohio and those providers who use an alternate vendor for visit submission.

Visit the new Electronic Visit Verification webpage to find updates on the Town Hall. We’ll also email invites with a link to register attendance once the date is set.

Provider Lookup Dashboard Launched

Online tool offers visibility into past claims oversights as you prepare for claims adjudication requirements coming in 2025.

To help you prepare, Ohio Medicaid created the Electronic Visit Verification Provider Look-Up Dashboard that gives providers one convenient place to view a summary of your claim and visit data.

About the dashboard:

• Provider claim information is included in the "Provider Lookup Dashboard" if you are a certified Medicaid home health agency with at least one paid and processed fee-for-service claim for services subject to EVV that took place after July 2023.
• Sandata data on the "Error Diagnostic Dashboard" reflects visit dates through October 2024 but does not include claims paid by the Ohio Department of Medicaid, the Ohio Department of Aging, and some claims paid by the Department of Developmental Disabilities for August and September.

Refer to the Navigating the EVV Provider Look-Up Dashboard user guide to learn more about the dashboard and how to look up a summary of your claims.

Please note:

• You are not required to correct data errors associated with historic claims/visits.
• Any updates that are needed for your EVV visit records should be made in your EVV system – whether it is the Sandata system or an Alternate EVV system.
• Users who enter a valid Medicaid ID - one containing no extra spaces or characters - should see a dashboard response within a minute of entry. Those entering an invalid ID will see no response from the dashboard tool.
• Users who enter a valid Medicaid ID without claims impacted by Phase 1 of the claim adjudication project will see no response from the dashboard tool.

Webpage Redesign Simplifies User Navigation

The Ohio Department of Medicaid launched its redesigned Electronic Visit Verification webpage, making it easier to find the information needed to meet program policies and requirements.

The new webpage combines all EVV information into a single-page layout with six interactive tiles and quick links to make it easier for visitors to navigate and access information. Key components include:

• EVV program resources including a new fact sheet, frequently asked questions, service code guide and EVV forms.
• External links to Sandata training guides and materials as well as information specific to Department of Development Disabilities and Department of Aging EVV programs.
• Quick links that address specific provider issues or notices regarding compliance.
• Provider news highlighting new resources and supports available.
• Provider Network Management module quick links.

You can also find insight into state and federal rules regulating the program, on-demand training resources, information for members who receive services requiring EVV compliance, links to all 2024 EVV Newsletters, and who to contact if you have questions.

NOTE: if you previously bookmarked specific ODM EVV webpages, those links may not work. Fortunately, you should be able to find all the information you need on the new webpage.

Common Electonic Visit Verification Questions

Agency Providers: 

Question: I am sure our Agency is logging visits correctly, but a lot of our visits are not changing to Processed status after billing. What is happening?  

Answer: The EVV team has recently worked with a few agency providers having this issue. Agency providers can have more than one EVV account. Each agency provider EVV account has one provider Medicaid ID. It is important to make sure the EVV account with your visits has the same provider Medicaid ID as your claim for reimbursement. This will help increase the number of visits switching to a processed status. 

Question: I'm an agency administrator responsible for more than one provider Medicaid ID and EVV account. Am I able to see more than one EVV account when I log into the EVV web portal? 

Answer: Yes, if your email address is associated with each account.

Question: How do Direct Care Workers and Employees find Recipients in the Sandata Mobile Connect app?

Answer: Keep in mind that only “Active” Recipients are available in the Sandata Mobile Connect app. Any Recipient in a “Pending” status will not be available.

To locate “Pending” Recipients, navigate to the Recipients module in the EVV portal, open the Filters, and search “Pending” to find all Recipients with a status of “Pending.”

From there, open the Recipient you need to update, then open the Program tab. Use the Status dropdown in the upper right corner of the Program tab to change the status to “Active.”

For more information, see Creating a New Recipient in Sandata On-Demand.

Electronic Visit Verification Training Opportunities for Providers

Electronic Visit Verification System Enhancements Training

Description: This two-hour course will guide agencies and independent providers through enhancements made to the EVV system.

Intended Audience: Agency administrative staff and independent providers using the Sandata system. This training is not intended for agency-employed direct care workers or participant-directed only providers who receive payment through a financial management service. 

Aggregator Training 

Description: This one-hour course will guide agency providers using an alternate vendor through the recently implemented changes to reporting and sign-in. 

Intended Audience: Agency provider administrative staff using an alternate vendor. 

Optional Scheduling Training 

Description:  Scheduling is an optional feature in the Sandata EVV system. This one-hour course will show users how to create and manage schedules for direct care workers. Using this feature reduces the need for direct care workers to enter the client or recipient ID for each participant and allows them to see their schedule directly in the Sandata Mobile Connect application.

Intended Audience:  Agency administrative staff and independent providers who use the Sandata EVV system to capture visits.

Please note: Trainings are not intended for agency-employed direct care workers or participant-directed only providers who receive payment through a financial management service. 

October 2024 Sandata Releases

Sandata regularly updates its EVV software via releases to ensure it runs smoothly. Below are the changes introduced in the Sandata EVV web portal and Sandata Mobile Connect app in October.

Sandata Release Notes are available but require a Zendesk EVV account to view.

Questions about releases or the system should be directed to the Sandata EVV Provider Hotline at 855-805-3505 or ODMCustomerCareemail@sandata.com. 

To stay updated on ODM EVV program communications, sign up for notifications by clicking Subscribe to Medicaid News on the Ohio Medicaid website.

Who to Contact with Questions

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