EVV System: What Home Care Agencies Need to Know?

Natasa Djalovic
Last update on:
April 18, 2024 2:48 AM
Published on:

If you run a home health agency that receives Medicaid funding, you need to know about EVV. 

EVV stands for Electronic Visit Verification - a system that helps you document and verify the services you provide to your clients. Without it, your Medicaid claims for payments could be rejected, and you could put your business at risk.

But don’t worry. EVV system for home care is not just an administrative burden. It’s also a smart solution to improve your home healthcare business’s quality, efficiency, and profitability. 

The system can help you track your caregivers’ performance, minimize errors and fraud, improve the satisfaction of your clients, and save time and money.

In this article, we will explain the EVV system for home care, why it’s important, how it works, and some of its benefits. 

Let’s get started!

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The 21st Century Cures Act - Bringing Advances to Patients

The U.S. healthcare sector has undergone major changes recently, thanks to the 21st Century Cures Act. This federal law was established in 2016 to improve the quality and accessibility of health care for both patients and service providers.

One of its key features is the requirement for Electronic Visit Verification for home health and personal care services funded by Medicaid.

Under this law, states must require EVV use for agencies that conduct in-home visits as part of home healthcare services. The Act sets key EVV data the system has to record and verify electronically. 

In 2020, the Department of Health and Human Services issued two new rules for the next phase. These rules give patients more control over their health data and, at the same time, encourage innovation in the healthcare industry.

Although the federal law outlines essential data that should be collected and verified electronically, it’s up to individual states to design their systems. 

This means your state government determines how the data is collected and reported to EVV providers. They might have additional compliance rules you need to follow.

What Is EVV System for Home Care?

To put it simply, EVV is a system that uses technology to confirm when, where, and how long a caregiver visits a client at home. It records and verifies crucial information about each in-home visit, such as the service type, the date, the location, and the identity of the service provider and the patient. 

However, the EVV system for home care is not only a legal obligation. It is also a smart way to ensure that patients receive the best support possible and that providers get paid correctly and fairly. 

Sometimes, caregivers may inflate their service hours or provide substandard care. The EVV system detects and deters such practices, helping providers identify and prevent fraud and potential neglect or abuse in-home care services. 

EVV can also help monitor the quality and safety of care for patients with disabilities, who may need more support from their caregivers.

What Are the EVV Requirements?

So, we’ve established that under the 21st Century Cures Act, states must require EVV use for Medicaid-funded home healthcare services that rely on in-home visits by a provider. 

This applies to Medicaid services that conduct in-home visits and support individuals in their daily living activities (like dressing and bathing) or instrumental activities (preparing meals, taking medication, managing finances, etc....) 

The home health care agencies that use EVV must be able to record and verify six key data elements electronically:

  • The type of service performed;
  • The individual receiving the service;
  • The date of the service;
  • The location of service delivery;
  • The individual providing the service;
  • The start and finish time of care delivered.

States may also have additional information and criteria that they require for EVV compliance since they are designing their own solutions.

The deadline for implementation of EVV for home health care services (HHCS) was January 1st, 2023. 

However, the government has granted an extra year of delay for states that faced unavoidable challenges and showed a good faith effort to meet the EVV requirements.

How Do EVV Systems Work?

To be EVV compliant, service providers need to implement a state-approved EVV solution. Generally speaking, this type of software relies on a system that electronically verifies things like the service provided, who received the service, and more. 

Usually, this is accomplished via a web-based device or a smartphone. Employee GPS tracking apps and computer software are state-of-the-art technology and the foundation for EVV for home health. 

The technology behind EVV for home healthcare agencies allows them to track the location of their mobile teams, determine their compensation, enhance service quality, and even increase efficiency. 

Most EVV solutions use Global Positioning Services (GPS) to verify the location where the service is provided. For example, one of the methods tracks a provider’s location at the start and end of each visit. It also sends this data to the state Medicaid agency. 

In most cases, care providers will be expected to use a mobile phone or a special-purpose device in the client’s home to record their visit via an app. 

Alternatively, caregivers can use a client’s landline to call a toll-free phone number and verify their visit through interactive voice response (IVR). 

State Specific Variations

It is important to note that states can decide how to implement EVV software for service provider agencies and build their own systems based on the federal mandate key points. 

CMS has described examples of systems but doesn’t endorse any approach over another one. As states are not required to use a particular or uniform system, EVV compliance differs from country to country

Nevertheless, states are required to consider existing best practices and EVV systems in use within their borders. They also need to ensure that this tracking system is minimally burdensome for both the people receiving the service and those providing it. 

In addition, electronic visit verification in the home health industry must comply with the privacy and security requirements of the Health Insurance Portability and Accountability Act (HIPAA). 

When researching state rules, home health care agencies need to pay attention to three key pieces of information: 

  • State-approved EVV model;
  • Allowed data collection models (GPS mobile apps, telephony, or fixed verification device);
  • EVV implementation deadline.

Some countries have already implemented a federal EVV mandate for home healthcare visits billed to the state. Others have submitted Good Faith Effort Exemption Requests to delay the implementation of EVV for a year.

EVV Models 

Medicaid has addressed five major models implemented by states in their Informational Bulletin. Although they all provide similar solutions, they differ in aspects like state involvement in EVV management and vendor selection.

The states have been given flexibility regarding the type of EVV model they want to implement. 

Still, the approach they opt for has to meet statutory requirements such as HIPAA privacy and security standards. 

These are five major EVV models states can choose from:

1. Provider Choice Model

This model gives complete freedom to healthcare organizations to choose their vendors. Still, they also have to cover the costs of the EVV implementation. Some states are considering raising reimbursement rates to compensate agencies’ expenses.

The model is, for example, used in Idaho, New York, Utah, Virginia, and Washington. 

2. Managed Care Plan (MCP) Choice

Managed Care Plans (MCPs) select and reimburse EVV vendors in this approach. Regarding states with multiple MCPs, home healthcare agencies may face higher administrative costs. They may have to adopt multiple forms of technology and integrate multiple EVV systems with scheduling or payroll software. 

3. State Mandated In-House System

Within the state-mandated in-house system, states must develop and manage EVV solutions that all home care agencies must use. Compared to other models, this one places a greater administrative burden on the state.

For example, the state of Maryland has required providers to use its “In-Home Supports Assurance System” EVV system for some years now. 

4. State Mandated External Vendor Model

The state-mandated external vendor model requires service providers to use a state-sponsored vendor. State contracts with a single EVV vendor, and that vendor is to implement a single electronic visit verification solution. 

This approach ensures standardization and access to all data by the state. Again, the state is responsible for providing education on EVV operations. 

The model is, for example, implemented in Nevada, New Mexico, Connecticut, and Illinois.

5. Open Choice Model

Under this model, the state selects an EVV vendor that agencies can use free of charge. Service providers can also work with another vendor instead of a state-sponsored one. Still, they have to cover the expenses in that case. 

Healthcare organizations that opt for alternative solutions must be aware that they must use the ones that integrate with the state’s data aggregator, such as Sandata, HHAeXchange, or other solutions sponsored in the state. 

Many states, such as Alabama, Alaska, Arizona, Colorado, and Florida, have opted for the Open Choice Model.

How Can Right EVV Solutions Benefit Home Care Agencies?

So, as we established above, the EVV system verifies the time, location, and type of service your caregivers provide during each visit.

Still, EVV for home health is more than just a time and attendance verification tool. It also helps your agency stay in regulation and ensure your clients receive the care they need. 

And, if you opt for the best EVV system for home care, you can reap many additional benefits. 

Let’s dive deeper into the advantages of using electronic visit verification. 

Improved Client Care 

One of the most important advantages of this software is that EVV-compliant home healthcare agencies can easily monitor patient visits, eliminate fraud, and protect them from inadequate care. 

For example, if you opt for Timeero as your technology partner for ensuring EVV compliance, you can easily identify any red flags on the field. 

timeero segmened tracking
Timeero's Segmented Tracking Feature

From a single dashboard, you can see a very detailed timeline of your caregivers’ shifts, including the patients they visited and the exact times and duration. With such a system in place, the possibilities of fraud are basically eliminated. 

Agencies can also use EVV systems to instantly review the latest patient health data, reports, and other important notes. Ultimately, this can improve efficiency in providing home healthcare services and better care for clients. 

Accurate Recording of Billable Hours 

Advanced tech solutions provide businesses with numerous advantages. In this particular case, many EVV solutions for home health can easily log visits and record billable hours in real time, and they can do it more accurately.

timeero mobile app
Timeero lets you easily track and view caregivers’ time, locations, and mileage

Ensuring your field employees are paid properly is vital for their motivation and productivity, and this smart system can help compensate your workforce fairly. 

It will optimize the payroll process and help eliminate overbilling and falsely filed invoices. 

Enhancing Employee Safety 

EVV-compliant apps with GPS tracking can do more than help health organizations manage their remote staff. 

Mobile teams providing community-based services face unique challenges. Sometimes, they must provide care in remote or potentially dangerous locations. EVV systems can help agencies improve their staff’s safety by providing an additional layer of security. Tracking employee location is critical for managing their safety. 

Always know where your available caregivers are.

With real-time location visibility, agencies and mobile teams can rest assured knowing that field workers’ location is being accurately monitored. 

Integration With Scheduling, Mileage Tracking Tools, and Other Apps

There are even more perks if you implement an EVV system for home care. Modern EVV software solutions can be easily integrated with scheduling or mileage-tracking tools. These integrations can help with daily workflow automation beyond attendance recording and verifying an in-home visit. 

However, some of the best EVV tools for home health are tailored to fit the agencies’ needs and include features essential for the home health providers, such as scheduling or mileage tracking. For example, Timeero Scheduling lets managers easily create and assign jobs and schedule them to their staff. It also has numerous safeguards in place to prevent any scheduling conflicts.

timeero scheduling
You can easily schedule your nurses and caregivers, and ensure EVV compliance using the same tool.

As soon as the shift is created, the caregiver will receive a notification. Managers can even let their crew accept or deny a shift, minimizing the odds of any problems.

Another great feature offered in this EVV-compliant solution is mileage tracking, helping healthcare agencies streamline mileage reimbursement and cut down their mileage costs.

timeero route replay
Timeero offers an easy way to track caregiver mileage and routes.

An integrated approach offers numerous possibilities for providing in-home care, from scheduling and calculating mileage reports to sending tasks and notes to caregivers. 

Verifying Payroll  

EVV for home health care solutions can be integrated with payroll systems to streamline the payroll process and easily verify staff’s compensations. As mentioned, EVV technology can record billable hours in real time, verify them with GPS, and then export this information into a payroll system. 

timeero integrations
Timeero integrates with the most common payroll and accounting tools.

Such integrations eliminate the manual work and save vast amounts of time. And in addition to verifying work hours and payroll, they make the entire process more accurate.

Retaining Top Talent

Smart digital tools are unparalleled in optimizing business operations using a data-driven approach. In addition to streamlining the financial aspects of business and managing employees, another significant benefit of this tracking system is often neglected. 

Collecting and storing important patient data, like their habits and preferences, can help caregivers personalize their approach and deliver quality service. It can also improve matching the care provider with a client. 

EVV system for home care has the potential to provide mobile workers with more information on their patients, enabling them to get to know the persons they work with better and perform an even better job. 

Also, less time spent on paperwork with this smart system means more time on patient care.

Ultimately, these benefits lead to increased work satisfaction and improved employee retention. Therefore, adopting smart tech solutions can be a great way for agencies to reduce home health turnover rates and retain their top talent.

Reduced Costs 

Optimized business operations mean cuts in costs. For starters, EVV for home health providers allows them to reduce payroll expenses. Costly, time-consuming paperwork can finally be eliminated.

Also, agencies that still use paper-based timesheets are more prone to facing potentially expensive errors. 

timeero time and mileage
Ditch manual tracking and data entry and streamline your processes

With the right system in place, it is possible to eliminate these issues and avoid additional expenses that come with paper consumption and administrative errors.

Selecting Your Technology Partner 

If you want to stay ahead of the curve, you must be ready to comply with the EVV model rolled out in their state. To do so, it is necessary to understand the new EVV system for home care, adopt an intuitive, easy-to-use software, and train your staff. 

However, meeting the mandatory EVV requirements is also an excellent opportunity for your agency to embark on the digital transformation journey and streamline other necessary but time-consuming processes, such as time and mileage tracking, field staff management, scheduling and PTO tracking, payroll, and mileage reimbursement. 

Timeero is the trustworthy partner you’re looking for on such a journey. 

To learn more about its capabilities, read our Timeero review. Or, just download the app and check it out yourself.

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Natasa Djalovic

Natasa is a writer specializing in the IT and software industry with 6+ years of experience in content writing and online marketing. During that period, she wrote more than 1,000 articles and several ebooks. She majored in English language and literature and loves cats, sneakers, and candy. When she's not working, she's probably binge-watching Netflix.

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