eWebSchedule EVV Updates for Ohio Waiver Provider Agencies: Impact on Claims Payment

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Across the nation, waiver provider agencies that deliver services to individuals with developmental disabilities are encouraged and required to start using an electronic visit verification (EVV) system. The transition to EVV is part of a broader federal mandate that originates from the 21st Century Cures Act (Cures Act).

For some provider agencies, the mandate to use an EVV compliant system when delivering services is a significant burden.

However, an EVV solution that goes beyond a "proof" of visit verification can help a provider agency deliver more efficient services.

Due to a combination of community feedback and the impact of COVID-19; many states have pushed back the “go live” date for EVV-compliant claims. For example, in the state of Ohio, waiver providers are supposed to have an EVV system in place by January 1, 2022. Otherwise, there is a threat that reimbursements from Ohio Medicaid will be reduced (penalized). As of the publication date of this article, all I-DD agencies in Ohio are expected to be using a functional EVV system from an approved state EVV vendor.

Electronic Visit Verification in Ohio:

In the state of Ohio, EVV systems are utilized to accurately document the time and location that support services started and ended. These vital services are delivered by caregivers, DSPs and other community-based service providers.

Non-agency providers (independent providers) are required to use the EVV devices provided by Sandata. These devices are administered at no cost to the individuals using them. However, provider agencies have the option to use Sandata's devices or one of the alternative EVV vendors that have been certified by the Ohio Department of Medicaid.

Some Ohio device users have expressed concerns about the limits of this EVV system. Due to this fact, many of the alternative EVV vendors have developed software solutions that meet the specific needs of Waiver Provider agencies.

All certified alternative EVV vendors, in the state of Ohio; must meet all business rules and technical requirements before they can offer their EVV system to agencies. It should be noted that neither the Ohio Department of Medicaid or Sandata is responsible for the cost of any alternative EVV solution.

The EVV mandate and Claims Adjudication:

Originally, all waiver providers were required to have some type of EVV system in place before the January 1, 2022 deadline. Otherwise, the Ohio Department of Medicaid was prepared to financially penalize independent and agency providers who did not have an EVV system in place by this date.

More recently, the ODM has adjusted their requirements for EVV systems. Ohio waiver provider agencies, as well as independent providers, are still expected to use an EVV solution that captures service time and location. This will allow agencies to train their staff and become compliant with state and federal mandates. However, the ODM stated that EVV visit data would not impact the payment of claims before January 2022.

The ODM announced that they would not start to use service provider EVV data in January 2022. As of the time of publication, no date for the impact on payments has been announced. ODM stated that they will share updates on the topic when information is available. As of July 2023, Ohio provider agencies with no EVV system have not been financially penalized.

The Ohio Department of Medicaid has promised to notify Ohio waiver providers well before EVV data is used to negatively impact their claims payment. Department officials did add that it is expected that all Ohio waiver providers are already using a state-approved EVV system.

Why Use eWebSchedule's EVV Solution:

As a software solution, eWebSchedule provides services and tools that optimize the back office of various healthcare agencies. The EVV interface is easy for DSPs to use. Our eWebSchedule software can be used as a stand-alone tool for EVV and scheduling (time collection) or integrated into our complete billing service.

RevUp Billing's approach to the EVV mandate is to deliver a software solution that allows all time worked by a DSP to be documented by a single solution. Waiver provider agencies need greater capability than just capturing a GPS time stamp for a visit. They need the ability to communicate with staff on any number of subjects at any time. An administrative problem that our eWebSchedule software solves.

Our EVV solution displays a DSP's schedule along with any shift notes entered by the supervisor during scheduling entry. This EVV system goes beyond federal and state requirements. The EVV system records information both in and out of data coverage areas. This means an agency will have more EVV/GPS compliant visits. Supervisors will not have to spend precious time investigating visits that were flagged by the state.

About RevUp Billing

RevUp Billing provides experienced and professional billing and software services for I-DD provider agencies.

If you have additional questions about EVV requirements and billing for Ohio provider agencies – contact us.

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Updated from original article published on December 14, 2021