Virginia Medicaid EVV Electronic Visit Verification

What’s Happening with Virginia Medicaid and EVV?

Virginia has chosen an open model for it’s EVV-compliant solution. Providers will need to have an EVV system that meets the basic system capabilities as defined in the EVV draft regulations and ensure the vendor or clearinghouse they choose can submit complete Electronic Data Interchange (EDI) 837P transactions according to the companion guides.

The State of Virginia has implemented an Open Model.Provider Choice. The Virginia Appropriations Act expanded the use of EVV to include consumer directed personal care, respite and companion services. Virginia’s Department of Medical Assistance Services (DMAS) extends the deadline to begin EVV for agency and consumer directed personal care, respite care, and companion services that originate or conclude in the member’s home, to April 1, 2020. EVV in Virginia will require providers to report the six 21st Century Cures Act data elements, listed below, as part of the claim submission.

1. The type of service(s) performed (service type)
2. The individual receiving the service(s) (patient/client)
3. The date of the service (date of shift)
4. The location of the service delivery.  This can either be in an individual’s home or community setting and is recorded at both the beginning
   and end of the service (location is not tracked during the shift).
5. The individual providing the service (caregiver)
6. The time the service begins and ends

Medicaid Commonwealth Coordinated Care (CCC) Plus Waiver and Developmental Disability waiver programs as well as the Early and Periodic Screening Diagnosis and Treatment (EPSDT) deadline is also extended and will be required to use EVV by April 1, 2020.

In Managed Long Term Care Service and Support  (MLTSS) programs, providers will submit information with an 837P to the MLTSS plan (see list below). Private duty agencies will find it to their advantage to partner with these MCO’s. MCO’s as well as the home health providers will be needing agency partners to care for these types of care for their client/members. On the Aetna website for instance a private duty or medicaid agency could do a home health provider search, contact that provider and establish a relationship for future referrals. Make sure your reviews and testimonials are good so you appear to be a suitable partner and referrer to them.

• Aetna Better Health of Virginia
• Anthem HealthKeepers Plus
• Magellan Complete Care of Virginia
• Optima Health
• United Healthcare
• Virginia Premier Health Plan

Virginia Medicaid and Rosemark’s EVV System

Providers will need to have an EVV system that meets the basic system capabilities as defined in the EVV draft regulations and ensure the vendor or clearinghouse they choose can submit complete Electronic Data Interchange (EDI) 837P transactions. Rosemark’s 837P allows providers to capture the six data elements that you need to bill the MCO’s for the care that your agency has provided. It is automatically gathered through the Caregiver Mobile App and/or telephony. Save your agency time, get paid faster and be compliant!

For a discovery conversation with a Rosemark representative and demo call 734-662-3537