Essential EVV System for Home Care: Ensuring Compliance and Reducing Fraud
Emily Maina
Last update on:
March 24, 2025 9:21 AM
Published on:
Electronic verification visits have become key aspects for home health agencies that receive Medicaid funding. They provide a way to ensure that home care health services are being provided to patients by the right people and according to the proper standards.
EVV helps agencies verify that the amount of compensation given to caregivers actually matches actual working hours. Without EVV records, Medicaid claims risk being rejected, affecting business profitability.
For many agencies, choosing an EVV system can be a challenge, especially since there are several alternatives to choose from. In this article, we will explain in detail what an EVV system is and how it can benefit your business. We will also look at the best EVV solution to help your agency stay compliant and efficient.
Want to Ensure EVV Compliance?
Timeero is designed specifically for home health care agencies and caregivers.
EVV stands for Electronic Visit Verification. This technology is used to track and verify caregiver visits to clients who need home health services or other types of personal assistance. It allows caregivers and agencies to verify the time, location, and date of a home visit.
What are the EVV requirements?
The 21st Century Cures Act requires home healthcare providers in all states to implement Electronic Visit Verification (EVV) for Medicaid personal care services (PCS). This mandate serves to encourage the personal accountability of workers who deliver home care services and reduces fraudulent reporting by electronically tracking and verifying the details of care provided.
Key requirements for EVV:
Home healthcare agencies must electronically record and validate six essential data elements when using EVV systems:
Location of service delivery: Where the care was provided (e.g., patient's home).
Caregiver providing the service: The healthcare worker delivering the care.
Type of service performed: The specific medical or care service delivered.
Individual receiving the service: Verify the correct patient received care by indicating the name of the patient.
Date of the service: The exact date that care was provided.
Start and finish time of care delivered: The start and end times of the service.
The deadline for home health care services (HHCS) to implement EVV was January 1, 2023, when it became mandatory for all home care agencies in the United States. For states that faced unavoidable challenges, a one year extension to implement these changes was granted.
State-specific implementation:
While the federal law defines what information needs to be collected, each state decides how their EVV system will be set up. States have the flexibility to design their systems and may establish additional rules or requirements that home care agencies must follow. The methods for collecting and reporting EVV data may vary from state to state.
Home healthcare agencies must stay compliant with both federal and state-specific EVV guidelines to ensure proper billing and avoid penalties, such as a reduction in federal Medicaid funding.
How does the EVV system work?
As mentioned above, EVV guidelines may vary from one state to another. To use EVV, home care agencies will need to implement a system that is approved by their state to keep records of information such as what services were given and who received the service
Caregivers typically use a designated app to collect visit details. When a caregiver arrives at a patient's home, they use a device (like a smartphone or tablet) to clock in. By clocking in, the caregiver indicates they have arrived at the patient’s location and are ready to provide care.
GPS tracking is a new technological solution that helps home care agencies use EVV. As the caregiver works, GPS software tracks their location. With real-time location visibility, home care business owners can verify caregivers are on-site serving patients. GPS tracking allows managers and supervisors to quickly identify inconsistent location records and address the matter promptly.
Once the caregiver is finished with their visit, they clock out using the same device.
EVV helps home care agencies to:
Understand caregivers' whereabouts
Issue accurate compensation based on recorded work hours
Identify and address gaps in care services
Increase the efficiency of caregiving practices
Types of EVV models
There are 5 different EVV models available to choose from. The model your state chooses to implement will depend on how involved they want to be in vendor selection.
Find Your EVV Model and Aggregator
Last updated: September 2024
Provider choice model
Provider choice models give healthcare organizations the freedom to select the EVV system vendors they want to work with. These agencies take up the costs of implementing EVV.
Some states are considering increasing reimbursement rates to help agencies cover their expenses. The states that currently use this model include Washington, Virginia, Utah, New York, and Idaho.
State-mandated external vendor model
This model requires healthcare organizations to use a vendor that is sponsored by the state. The vendor chosen by the state is expected to provide a single electronic visit verification solution for agencies to implement.
The goal of this model is to standardize data and provide easy access to patient records. States that use the state-mandated external vendor model include: Connecticut, Illinois, Kansas, Nevada, New Mexico, Oklahoma, South Dakota, Texas, and Wyoming.
State-mandated in-house model
Under this model, states are expected to establish and oversee EVV solutions that home care agencies will use. The administrative burden falls on the state to develop and manage EVV solutions.
For instance, for a number of years now, the state of Maryland has mandated that providers utilize its "In-Home Supports Assurance System" EVV system.
Currently, Oregon and Maryland are the only states that use the state-mandated in-house model.
Managed care plan (MCP) choice
Managed care plans choose the EVV vendors and are responsible for reimbursing them in this model. Where a state has several MCPs, the cost of implementation falls on home care agencies as they might have to adopt different systems.
Open choice model
For states that use the open choice EVV model, agencies can choose to use the state-sponsored EVV vendor, free of charge, or choose their own EVV vendor at their own expense.
Healthcare organizations that opt to use their preferred EVV vendor can do so as long as the vendor can integrate with the state's data aggregator. There are many states, such as Florida, Colorado, Arizona, Alaska, and Alabama that use this model.
Benefits of implementing EVV
An EVV system offers the following benefits to home health agencies:
Improves accuracy of billing: Tracking visit details such as time and location of care minimizes billing errors and fraudulent reporting. Caregivers clock in using the EVV system, and their work hours are continuously recorded until they clock out. Agencies can use timesheet records during payroll to issue fair and accurate employee compensation. Caregivers cannot bill for hours they have not worked.
Ensures compliance with regulations: Using an EVV system guarantees adherence to federal EVV mandates and state-specific requirements. If a home health care service provider is found not using EVV, serious legal consequences may follow.
Improves operational efficiency: As visits are tracked, EVV helps make sure patient care is delivered on time and as planned. When a caregiver is running late, managers are informed quickly of the absence so staffing adjustments can be made. With real-time notifications in place, patients continue to receive care with no lag in service.
Enhances patient safety and quality of care: EVV provides a way for home care business owners to identify caregivers who provide subpar care. By detecting and addressing less than desired behavior, owners can safeguard the integrity of in-home care services.
Reduces fraud and abuse: EVV systems prevent caregivers from committing fraudulent practices, such as exaggerating service hours, by recording the beginning and end times of patient visits. Managers and home care agencies should frequently review timecards for accuracy and promptly address any inconsistencies.
Cost savings for home care businesses: Using an EVV system that automates recordkeeping and eliminates time-consuming paperwork processes will help you reduce administrative costs. Implementing an EVV system can also help you avoid incurring potential penalties for non-compliance.
Challenges of EVV implementation
Despite its benefits, implementing an EVV system can be a challenge for several reasons:
1. Technology adoption
Some caregivers might be resistant to adopting new technology, especially if they are not tech-savvy. They may express concerns about the extent to which their whereabouts are tracked after work hours, causing feelings of anxiety and unease.
Since employee pushback is expected, home care agencies should take ample time to explain how an EVV system works and why it is important. Providing adequate training can also be useful in helping caregivers understand how the system works.
2. Data privacy and security concerns
Caregivers may be concerned that their care routes and location data can be used without their consent. EVV systems also handle sensitive patient information such as health details and location data.
Healthcare agencies should choose systems that are secure to minimize the risk of a data breach that could expose sensitive data to unauthorized individuals. They should also verify that their EVV system of choice complies with data privacy regulations.
3.Integration with existing systems
EVV systems may need to be integrated with existing electronic health records (EHRs), billing systems, and other software. Ensuring accurate and timely data synchronization between different systems can be challenging.
Agencies should ensure their EVV systems have the capability to integrate with other apps to seamlessly transfer data. By integrating EVV systems with other medical software, home care agencies can save time and reduce errors.
4. Cost and resource considerations
Successfully implementing EVV systems may require significant upfront costs. Agencies will need to purchase hardware and software, as well as any training materials necessary for caregivers. In some EVV models, states foot the bill and pay for any expenses encountered if agencies use state-sponsored vendors. However, if home care agencies select their own EVV vendor, they are responsible for covering EVV implementation costs, which can be expensive.
To combat this problem, healthcare organizations must allocate sufficient resources for EVV implementation, including personnel and money. Creating a budget designated for EVV system maintenance will help agencies prepare for unforeseen events that may happen down the road.
Timeero - The best EVV system for home care compliance
Timeero is a comprehensive EVV software solution that streamlines your electronic visit verification process while helping you comply with federal and state regulations. Let’s take an in-depth look at the software’s features and explore how they can be beneficial to your home care business.
Time tracking for billing
When you use Timeero for time tracking, you can trust that the app’s records are precise and are an acceptable way to prove compliance with EVV regulations.
Timeero’s mobile time clock.
Timeero is available on both the App Store and Google Play Store, so your caregivers can easily download the app on their phone or tablet.
Starting the app’s timeclock is a straightforward process. When caregivers click the “Clock In” button, Timeero automatically begins to track and record hours worked along with the beginning and ending locations of patient visits.
GPS tracking for accountability
Besides time tracking, Timeero’s GPS tracking features provide an extra layer of transparency in home care. When a caregiver clocks in or out, the app not only records their time, but also the employee’s location.
Timeero’s Who’s Working dashboard improves visibility.
Timeero’s “Who’s Working” dashboard displays the real-time location of all working employees. If a patient emergency were to arise, this feature allows agencies to quickly locate and dispatch the nearest caregivers to patients in need.
Geofencing for improved patient care
Timeero’s geofencing feature allows you to draw virtual boundaries around job sites to encourage accountability and restrict your employees’ ability to clock in or out when located outside the geofence.
A geofenced job site on Timeero.
Since caregivers provide services in different locations, your agency can create geofences around each patient’s location where care will be rendered. Having geofences in place increases the accuracy of time reporting and decreases the potential of overbilling clients for time when care was not being rendered.
Face recognition for increased patient safety
Timeero’s facial recognition feature can be beneficial to home care businesses in different ways. Through biometric scanning, this feature prevents buddy punching by verifying an employee's identity against their profile picture before they are allowed to clock in or out.
Facial recognition provides an extra layer of patient security, as caregivers must prove they are the authorized employee working that shift.
Verify employees’ identities with Timeero’s facial recognition.
Electronic signatures to verify quality of care
Timeero's Signatures feature allows caregivers to digitally sign their timesheets, verifying they were present and completed their job assignments that day. Employees are prompted to enter their digital signature at the end of shifts.
Employees can add electronic signatures to their timesheets.
Agencies that require electronic signatures from staff are at an advantage. Managers and supervisors can cross-check signatures with time entries to verify the employee in question is the one actually recording their hours.
To further increase the accuracy of timesheet entries, clients can add their signature to timecards to verify that the assigned caregiver was present and rendered care that day.
Having a client sign a caregiver’s time card can serve as evidence that the patient is satisfied with the quality of service provided and can also be used to defend the caregiver if a dispute were to ever arise.
Timeero’s segmented tracking provides detailed insights into employees’ activities by dividing the workday into different segments.
Caregivers clock in once at the start of their shift, and Timeero creates segments for each visit throughout the day. This eliminates the need for manual time entry for each visit, streamlining the process and reducing the potential for errors.
This segmented approach breaks down the caregiver’s day into specific visits, allowing agencies to track each part of the shift more accurately. It helps identify irregular travel patterns, making it easier to spot inconsistencies or suspicious gaps in time between visits.
By breaking the workday into distinct segments, agencies can easily monitor for potential fraud and ensure caregivers are accurately reporting their work activities.
Timeero’s segmented tracking feature.
Use Timeero, a simple and reliable EVV solution
Instead of juggling multiple systems to remain compliant with EVV requirements, consider using Timeero, a comprehensive solution that is hassle-free. Timeero works seamlessly with existing smartphones and tablets, making it easily accessible by your whole workforce.
Forget having to obtain expensive hardware or other costly devices to verify visits. Timeero has everything you need to remain EVV compliant within a single, user-friendly app. Try using Timeero as your electronic visit verification software today.
Grow Your Home Care Business With Timeero.
Ensure compliance, track and manage caregivers efficiently.
Emily Maina is a tech-savvy writer with a passion for creating content. With years of experience in the industry, she is well-versed in the latest trends and developments in the tech industry. When she’s not working, Emily enjoys exploring the great outdoors or watching her favorite shows.
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