The 21st Century Cures Act mandates the use of electronic visit verification systems (EVV) by January 1, 2020 for Medicaid payers and providers delivering in-home personal and/or home health care services. On November 21, 2019 North Carolina was granted an extension setting a new deadline of January 1, 2021.
Billing claims will be denied if no verification is found.
WHAT IS EVV – ELECTRONIC VISIT VERIFICATION?
Federal mandate requires states to implement EVV and must verify:
- Type of service provided
- Member receiving the service
- Caregiver providing the service
- Date of the service
- Location of the service delivery
- Time the service begins and ends
WHAT DOES THIS MEAN FOR NORTH CAROLINA?
- NC DHHS has contracted with Sandata to be their aggregator. The 7 MCOs have contracted with HHAeXchange.
- In North Carolina there are two EVV aggregators: HHAeXchange and Sandata. Depending on the services you provide you may have to connect with one or both aggregators and submit EVV data to receive payment for those services.
- NC Medicaid’s EVV system (Sandata) will launch on Jan. 1, 2021. For 90 days, claims will not pend based on failed validation. Providers have until March 31, 2021, to implement and make corrections to any validation issues. If a validation issue is not resolved in 90 days, the payment may be subject to recoupment.
- EVV implementation of services administered by LME/MCOs (HHAeXchange) is planned for April 2, 2021.
WHY CHOOSE ONTARGET EHR – EVV SOLUTION?
- OnTarget was built and developed by Health and Human Service Providers from North Carolina with the knowledge of the unique niche in the IDD and MH industry. We have been in business for over 20 years and expanded into 13 other states.
- OnTarget will be approved by the LME/MCO for HHAeXchange and ready to go for the new deadline.
- We can ensure compliance and avoid invalid claims by capturing the correct, required data.
- With OnTarget you will only have to use ONE system – for EVV clock-ins, documentation, full clinical records, timesheets and billing electronically to your payers.
Where can I find more information on the State of NC EVV?
NCDHHS- EVV