EVV: the Medicaid visit record and the export for your state

What EVV is. Electronic visit verification is a Medicaid rule: every Medicaid-paid personal care and home health visit records six details. The type of service (a HCPCS code such as T1019, with up to four modifiers, from the client's authorization), the member (the client's Medicaid ID), the date, the location at clock-in and at clock-out, the worker (their name and your agency's worker ID, with an NPI when they have one), and the time in and the time out. It applies to Medicaid, including a Medicaid managed care plan, not to Medicare.

Which visits. A client's visits are recorded for EVV when the family's billing details say Medicaid or a managed care organization pays, or when your agency ticks Medicaid pays for this client's visits under Clients' EVV details. On such a home the clock reads the phone's position once at the clock-in tap and once at the clock-out tap, never in between, and says so above the clock: Medicaid visit: your location is recorded once when you clock in and once when you clock out. Each tap is compared with the home's saved location, so every visit shows whether the clock-in and clock-out were inside the home's radius.

The EVV page. In the organization panel, EVV (for your administrators and office) lists every Medicaid visit your professionals worked in your client homes for the dates you pick, up to 62 days at a time. Each visit is Ready (all six details), Needs a fix (with exactly what is missing, such as a Medicaid ID, a service code, a worker ID, or a clock-out outside the home's radius), or Exception (a changed time, with its reason and who approved it). Tap a visit to see the six details. Closed sections hold your agency's EVV settings (your state, your Medicaid provider ID and the aggregator your state uses: Sandata, HHAeXchange, Tellus / Netsmart, CareBridge, AuthentiCare or Other), each client's Medicaid ID, service code and modifiers, and each worker's ID. The Medicaid ID is only ever shown as its last four digits; the family can also enter it, with the service code, on its Billing details card.

Exceptions. Every change to a clocked time becomes an EVV exception: the family's Fix the time after Ask the family to fix my time, an edit by the family or your office, and a shift typed in after the fact. Each keeps the times before and after, who changed it, a reason from a short standard list (forgot to clock in or out, phone or GPS failure, visit away from the home with approval, worker unable to use the phone, or other with a note) and who approved it. A change the family or your office made is approved by them; you pick the reason on the visit with Save the reason and approve. A visit whose clock-in or clock-out was outside the home's radius, or recorded no position, can be marked as an exception with Mark as an exception.

The export. Export CSV downloads every visit in the dates with its status, the six details, the position and accuracy at each tap, whether each was inside the radius, and the exceptions. Export for Sandata (JSON) downloads the complete visits (Ready and Exception) in the visit layout of Sandata's Alternate EVV specification: your Medicaid provider ID, the visit ID, the worker ID, the client's Medicaid ID, the service code and modifiers, the time zone, the clocked times in UTC, the hours, a Mobile call with the position for each clock tap, and each exception as a visit change with its reason code (FRGT, GPS, AWAY, NOPH or OTHR, our own codes; your state's addendum may use its own numbers). Fields ExpressAgain does not hold are left out of the file, not sent empty: PayerID and PayerProgram (assigned at your state's set-up), the scheduled start and end, the contingency plan, hours to pay, the memo (a shift note can hold care details, so it is never exported), client sign-off, group visits, the client's other ID, exception acknowledgements, tasks, and telephony fields. Every export is recorded with who downloaded it and when.

Nothing is sent. This page exports files only. Sending to your state's EVV aggregator needs your agency's aggregator credentials and vendor certification, which ExpressAgain arranges with you, so you download the file here and upload it in your aggregator's portal. On an invoice for a Medicaid home, a blank EVV reference fills in with the EVV IDs of its visits.