According to the 21st Century Cures Act, states are now mandated to use Electronic Visit Verification (EVV) for all Medicaid personal care and home health services that require in-home visits by a home care agency or provider.
As of January 2020, states were required to implement EVV use for all Medicaid-funded personal care services. Additionally, that same requirement goes into effect January 1, 2023 for all Medicaid-funded home health care services.
Due to these requirements, it is paramount that home care agencies fully understand how to use their caregiver management software and its EVV tools.
Rosemark System’s customer care team has put together the following best practices for using EVV:
Proper Configuration for EVV
For EVV to function properly, users need to make sure the fundamental configurations are in place first. This includes a reasonable “On Time” window, GPS distance threshold, and EVV notifications.
Rosemark System allows users to determine what they consider “on time” and “on location.” If caregivers are on time and on location, their clock-ins and outs will link automatically, saving schedulers time and effort during EVV management. Make sure all caregivers are aware of both so they can do their best to meet agency expectations.
Notifications are another great way to make sure both schedulers and caregivers are aware of EVV-related issues. For example, “No Show” notifications are generated when a caregiver fails to clock in for their shift. In most cases, the caregiver is with the client but forgot to clock in, and the notification can prompt them with a reminder to do so. It’s always better to have a late clock in rather than no clock in at all.
Setting clear expectations with caregivers is essential for EVV to function properly. As we discussed above, clearly explaining the “on time” and “on location” windows should always be done as soon as a caregiver begins using EVV. However, another crucial conversation to have, especially when providing Medicaid services, is the importance of being “on location” rather than “on time.”
This is a common issue seen in EVV usage: the caregiver clocked in on time but far away from a client because they worried that they’d be in trouble for being late to the shift. Unfortunately, a clock in on time but two miles away is not a valid EVV event and can’t be used for billing.
Making sure caregivers understand the importance of being with the client when they clock in/out of a shift is vital, as this will ensure the home care agency is able to properly bill for services.
Timely management of electronic visit verification is one of the most important things agencies will want to keep in mind. If agency staff doesn’t review clock ins and outs quickly they begin to pile up and it’s incredibly difficult to dig out from under a mountain of EVV.
In general, Rosemark System recommends that all agencies, no matter the size, should be reviewing electronic visit verification at least once per day.
According to David Goldwyn, Customer Care Manager at Rosemark System, “This can be done as EVV events come in on the day of or after the fact, but making sure that someone is reviewing and linking EVV events frequently is the best advice we can give.”
Home care agencies also need to pay close attention to what they’re seeing when reviewing electronic visit verification. Some questions that should be considered include:
- Do the EVV times match the Shift?
- Why was the caregiver early or late?
- If the caregiver was late, does the agency want to deduct time from the shift, causing it to bill and pay less?
- Is the caregiver on location?
- If they’re not on location, where are they?
- Why aren’t they on location?
All these questions should be asked every time an EVV event is manually linked to a shift. Making sure each of these questions is answered will ensure shifts are being verified correctly.
Proactive EVV Engagement (internal & external)
The final, and perhaps most important, element of proper electronic visit verificatoin management is proactive engagement with the process. This applies to both internal (within the home care agency) and external (with the agency’s caregivers) engagement. The back office and caregivers should keep EVV in mind at all times.
Prioritizing EVV management and communication is the only way to ensure that electronic visit verification runs smoothly.
Below is a list of the different elements of EVV that fall under this category:
- Generating reports
- To determine EVV health. This can help home care agencies confirm that most (if not all) of their caregivers are using EVV on all their shifts.
- To identify caregivers who may be experiencing issues using EVV and provide coaching or training to improve their experience.
- To identify GPS issues. These GPS issues happen when a client’s location isn’t quite right or a caregiver isn’t clocking in/out where they should. Resolving these issues will improve internal processes and allow more EVV events to link automatically, saving time.
- Prompt communication with caregivers. This applies to all elements of EVV but can be especially important when following up with specific caregiver issues. Make sure to prioritize communication with caregivers to ensure swift resolution of problems.
- Training and continuing education – Make sure new caregivers are trained and give current caregivers a refresher on EVV best practices. Rosemark System recommends creating a test client that caregivers can practice with so agencies can ensure their caregivers understand what they’re supposed to do.
- Resolving GPS and/or time issues – Keeping an eye on EVV throughout the day will help agencies see and resolve issues before they become a problem. Make sure to speak with caregivers as soon as possible when something doesn’t make sense in order to determine what happened and deal with it quickly.
- Holding caregivers accountable – In the end, EVV is supposed to help determine if a caregiver is where they’re supposed to be when they’re supposed to be there. If EVV shows anything other than the caregiver being on time and on location, schedulers need to speak with the caregiver and client immediately.
Failing to proactively engage with the electronic visit verification process will significantly reduce its accuracy, which can negatively affect billing and make determining hours worked for payroll nearly impossible. Make sure that all agency staff is constantly aware of what their caregivers are doing and act quickly when things don’t look right.