Electronic Visit Verification FAQs
What is EVV?
- EVV, Electronic Visit Verification, uses a technology-based system to electronically record information regarding service, individual receiving services, staff providing services, geolocation of service delivery, begin time and end time of service.
- EVV is a Federal mandate for Medicaid personal care services. This data is required in order to receive payment for services provided
Why do we need to use EVV?
In 2016, Congress passed the 21st Century Cures Act, designed to improve the quality of care provided to people. One part of the 21st Century Cures Act requires the use of EVV for all Medicaid-funded personal care services. Implementation was required by January 2019, and a late start date for home health services by January 2023.
DIDD waiver services receive approximately 2 dollars in Medicaid funding for every one dollar the state invests. If the state does not comply with the Cures Act, the federal government will reduce that funding, which could significantly impact waiver services.
DIDD maintains minimal compliance with the Cures Act. The following services have been identified as personal care services (PCS) requiring EVV verification:
What DIDD services will use EVV?
DIDD has identified the following services as personal care services (PCS) requiring EVV verification:
- RESPITE LEVEL 1 - DAILY 8 to less than 16 hrs. per day (In-home)
- RESPITE LEVEL 2 - DAILY 16 to 24 hrs. per day (In-home)
- RESPITE LEVEL 3 - DAILY 24 Hour Awake (In-home)
- RESPITE LEVEL 4 - QUARTER HOUR less than 8 hrs. per day (In-home)
- PERSONAL ASSISTANCE QTR HR- Limited to a maximum of 860 units/month
- KATIE BECKETT-Supported Home Care and Respite Services (provided by traditional 1915c Waiver providers)
Who will be impacted in the DIDD waiver?
In total, this impacts people receiving waiver services through DIDD in the Statewide, CAC and SD Waiver who receive agency-based PA and In-Home Respite. Those who are self-directing services will continue to use the EVV application provided through PPL.
What type of information will be collected through EVV?
The 21st Century Cures Act requires that states use EVV to collect six data points:
- Type of Service
- Person Served
- Dates of Service
- Location of Service
- Name of Caregiver
- Times of Service
What vendor will DIDD be working with to implement EVV?
For those who receive PA or In-Home Respite through a community-based agency, DIDD is working with a new contractor Therap to implement EVV with a go-live date of January 1, 2022. This currently involves over 100 providers in the DIDD provider network.
People who self-direct services in the Self-Determination Waiver must use Time4Care, the mobile application provided by PPL, the contracted financial supports broker. To find more information about the Time4Care application and the EVV implementation for self-direction, go to the "EVV for Self-Direction" page.
What is the projected timeline leading up to implementation?
As mentioned above, DIDD will implement EVV with Therap effective January 1, 2022. Until that time, providers will continue to use the current EVV contractor.
How will EVV work for provider agencies?
EVV is managed at provider agencies through a web-based application that will allow for scheduling and managing agency staff, persons supported, and services provided.
Will DIDD be using EVV for billing?
DIDD is looking to maintain compliance with the 21st Century Cures Act; therefore, EVV will be moving into the billing in mid-2022 when the Therap system goes live with billing.
How will DIDD reconcile EVV information and services billed?
DIDD will be receiving data through the current EVV system and then move into Therap in 2022. Providers will be monitored for EVV usage and will additionally be reviewed along with claims entered into the Provider Claims Processing (PCP) portal. As currently required, billing should be based on documentation provided by the staff on hours worked and activities performed (PA notes/log).
Will providers continue to bill in PCP for EVV services provided?
Until billing goes live within Therap, claims will remain being billed into the Provider Claims Processing portal.
How will I use the EVV Management System to manage day-to-day functions?
DIDD will enter authorizations for services into the EVV System. Provider office staff will be required to schedule visits in advance of delivery of service. Direct support staff will electronically check in/out for services rendered. Provider office staff will then perform system maintenance in the EVV system to validate and confirm services rendered.
Respite service approvals sometimes develop with very short notice. Due to this, Respite services will be allowed to use staff check-in and out without a schedule in place. However, an approved authorization for service is required.
How will failure to use EVV usage affect my staff and my agency?
Failure to use the EVV system creates a situation where the PCS visits must be entered manually and approved by the provider agency administrative staff. Manually confirmed visits can affect the provider's overall compliance score and create additional corrective actions, which can include potential non-payment of service.
How will I manage EVV for my direct support professionals?
In addition to the management system, there are two ways for employees in the field to check in using EVV. The first and preferred method is using a mobile application or Bring Your Own Device (BYOD). Employees who opt to bring their cell phones may download the application, triangulating a person's location using Geo-Location. This application is available for download on both Android and i0S.
The next is using IVR/telephony, where employees can call to check-in and out. The system will match the caller's phone number to the numbers listed in the EVV user database.
FROM THERAP FAQ: There are several ways to submit EVV data
- Therap mobile application - requires a smartphone or other smart device with location services
- Interactive Voice Response (IVR) - accessed via telephone
What kind of technology do I need to manage EVV?
- Minimum Requirements for Therap
- 800x600 Screen Resolution
- 32-bit color quality
- Compatible with the following Internet Browsers:
- Mozilla Firefox, Google Chrome, Microsoft Internet Explorer 11 onwards
- Adobe Reader 5.0 or above
- Microsoft Office Excel
- Microsoft Office Excel 97-2003 Worksheet (*.xls) for file imports
- Microsoft Office Excel Worksheet (*.xlsx) for file exports
- Please ensure cookies are enabled and pop-ups are allowed
- Mobile Application
- For all Apple devices, the minimum operating system requirement is iOS 11.0+
- For all Android devices, the minimum requirement is Android 5.0 or higher
More information can be found here:
How much data does EVV use?
For direct support staff utilizing their own devices for Mobile Visit Verification is minimal – up to 100 MBs per month. The mobile app does not need to run continuously. Data will only be needed for check in and check out. It can be compared to using Facebook for one minute or one minute of streaming video.
How much does it cost to download the mobile app?
The mobile app is free to download and available on Android or iOS devices.
What happens if a direct support staff forgets to clock in or their phone dies?
If this is for a pre-scheduled slot, direct support staff can check in/out within 18 hours of his or her scheduled time. Checking in/out more than 15 minutes outside of the scheduled time will require a comment. In the comment direct support staff can explain the reason for late check in/out or list the correct check in/out time for the Schedule Admin to view. If this is for a pre-scheduled slot more than 18 hours from the scheduled time, direct support staff won’t be able to check in/out but can use the general comment box to note any details for the Schedule Admin to view.
The expectation is that staff check-in and out timely for their assigned schedule. Repeated issues of staff failing to report timely to their assigned shift could result in corrective actions needed by the agency on how this issue is being addressed and corrected.
What if a direct support staff can’t get a signal?
If direct support staff cannot connect to the Therap mobile application via WIFI or cellular data, staff can document on the service/daily note and submit to the agency to have the agency admin staff to manually enter the staff’s scheduled visit.
Do direct support staff have to turn on their location to use the mobile app?
Yes, location settings must be turned on and set to “High Accuracy” (for Android devices).
My direct support staff are concerned about privacy. Why do you need their location?
Privacy is very important to us. Geolocation is required as part of the 21st Century CURES Act which requires the use of location services. The mobile app only captures location at two times: when a direct support staff checks in on shift and when the staff checks out on a shift. The mobile app does not track location during a shift.
What if staff cannot locate the person supported or the service provided in the drop down?
Contact your provider’s EVV administrator. If the person supported isn’t showing up in the drop down, it’s possible that they are not on your caseload or were not marked as schedulable. If a service isn’t showing up, it’s possible that it wasn’t marked as self-check-in-able, the service wasn’t assigned to you in the staff setup, or the individual doesn’t have a service authorization in Therap for that service.
What if the direct support staff does not have internet to check in upon arrival?
Continue to provide the services and document on the service/daily note as required. The manager may want the direct support staff to check in when he or she does get internet access so that they can edit the time or tell them when you arrived so they can enter the shift manually. You’ll want to communicate with your agency in this situation.
Will employers still be responsible for approving an employee's time?
Yes. Employers will still be required to approve employees' time as recorded via EVV. Employers, or their designated representatives, will be trained on how to verify time via EVV.
Who will train me on EVV?
Therap will provide online individualized provider training for agency management on its EVV system. Two people at a minimum per agency usually attend that training. Completion of this training is required to enter the EVV Management System.
Therap will also provide support in a weekly EVV webinar - Tuesdays at 1pm CT
Register for the webinar here!
What kind of training will be available for my employees?
Agency management will be responsible for training additional office staff on the use of the system as well as field staff on EVV. Access step by step user guides, training videos and e-learning courses on the Therap TN EVV Support page.
Who should I contact for support using Therap?
All support inquiries should be addressed to firstname.lastname@example.org. The Therap team will assess the issue and the appropriate team member will follow up. Many questions may be addressed in a variety of support materials for EVV on the TN EVV Support Page including: user guides with step by step instructions and screenshots, training videos, and e-learning courses for DSPs to learn how to check in/out in Therap.
My agency's electronic management system has an EVV component; can I use that instead of Therap?
All providers must use the Therap system provided by DIDD.
How much will this cost us?
The Department of Intellectual and Developmental Disabilities is paying for the system, and there is no charge to providers for basic functionality.
Will EVV be used for supported living services?
No. The 21st Century Cures Act does not require the use of EVV for Supported Living services or other residential services.