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​EVV Frequently Asked Questions

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​General

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What is Electronic Visit Verificaiton (EVV)?

EVV is a technology which electronically verifies the delivery dates and times of home and community-based services to the individuals needing those services. EVV uses multiple technologies such as telephonic, mobile applications, and web portal verification inputs to help electronically validate services and prevent fraudulent claims. Federal law (21st Century Cures Act) requires that all state Medicaid agencies implement an EVV solution to manage their personal care services by January 1, 2020, and home health care services (HHCS) by January 1, 2023. As of July 1, 2020, providers will be required to use EVV to receive payment for any claim for PCS visits and Department of Human Services (DHS) will begin to deny PCS claims that do not have a corresponding visit(s) recorded in the DHS Sandata EVV system's Aggregator. The DHS Aggregator integrates EVV data for both providers using the DHS Sandata EVV system and providers using a third-party (Alternate) EVV system.

What are the benefits of an EVV system?

EVV can help improve quality of care by making caregiver activities transparent and measurable. Also, EVV reduces the likelihood for error or fraud by identifying the participant, recording the individual caregiver's location and clock-in and clock-out times, and services provided.

What does "soft launch" mean?

 The soft launch period is a time for provider agencies, caregivers, and clients to adapt to the use of EVV without impact to claims. During the soft launch period, provider agencies are expected to utilize the DHS Sandata EVV system or their Alternate EVV system that will interface with the DHS Aggregator. During this time, DHS and Sandata will be available to answer questions and concerns that may come up regarding EVV.  Additionally, DHS will analyze usage data to determine which providers are not utilizing EVV adequately and will reach out to provide direct technical assistance.  Also during this time, DHS will generate reports which indicate the percent of required claims that fail to meet EVV requirements. The soft launch period began in October 2019 and will end June 30, 2020.

How will EVV impact billing?

The 21st Century Cures Act requires electronic verification of visits for Medicaid-funded care before they can be paid by DHS. Beyond verification, there should not be any impact on billing.

Will I need additional staff to manage EVV?

No, additional staff should not be needed. It is very important to make sure that both caregiver staff and office staff are fully trained and compliant with EVV. This will help ensure a smooth and successful EVV implementation for provider agencies.

Do small businesses have to use EVV?

Yes, all providers of Medicaid-funded personal care services that require an in-home visit in Pennsylvania need to comply with the 21st Century Cures Act.

What is the DHS Aggregator?

The DHS Aggregator is a system that will integrate data from third-party systems (also referred to as Alternate EVV) and the DHS Sandata EVV system into a single uniform platform to facilitate payments of claims. The DHS Aggregator allows providers to continue to use an Alternate EVV system for visit verification. The six Centers of Medicare and Medicaid Services (CMS) data requirements are transmitted from the Alternate EVV system to the DHS Aggregator using Sandata's standard data specification. The DHS Aggregator includes a read-only web portal for the provider to view their data and a payer web portal which includes alerts, real-time data views and reporting. 

When will the RFP be released?

The department released a Notice of Forthcoming Procurement on December 5, 2019, for “Electronic Visit Verification (EVV) for MMIS 2020 Platform.” The description of the project is as follows: "RFP must be issued to procure an EVV system that will integrate with DHS’s MMIS 2020 Platform.  The Department will award several contracts to multiple vendors for modular services that meet federal regulations, the result of which will comprise Pennsylvania’s new MMIS 2020 Platform.  The new EVV will be a module which will be part of the MMIS 2020 Platform and will keep Pennsylvania complaint with the Cures Act.  RFP number: 17-19." Additional information will be posted to the DHS EVV website in the future.  

How can I ensure that I receive all the information I need about Pennsylvania's EVV program?

The DHS EVV website will continue to be updated with additional information. Individuals may also sign up to receive notices from the DHS EVV Listserv by sending a request to RA-PWEVVNotice@pa.gov.

Who do I contact if I have a question about EVV?

If you have questions about the EVV program, you can send an email to RA-PWEVVNotice@pa.gov or call 717-787-2600.

​Implementation

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When will the DHS Sandata EVV system be available to providers?

The DHS Sandata EVV system went live in October 2019 and is currently available to providers.  

Will EVV software be required for service coordination entities (SCEs)? 

No, SCEs will not be required to use EVV.

Do licensed homes need to do this?  Why do only community-based programs need use EVV?

The 21st Century Cures Act mandates EVV for all Medicaid personal care services and home health care services that require an in-home visit by a provider. CMS has further clarified that personal care services that are provided to inpatients or residents of a hospital, nursing facility, intermediate care facility for individuals with intellectual disabilities, or an institution for mental diseases, as well as personal care services that do not require an in-home visit, are not subject to the EVV requirement.

Why do people with disabilities that are directing their own service get a specific ID number?  

The Unique Registry ID was developed to use an identifier other than the caregiver's Social Security number and would be portable across IT systems. It was developed to address privacy concerns and also to address portability across IT systems. DHS is working on a process for agency model workers to obtain a Unique Registry ID, as well as participants who self-direct. DHS is rolling out the unique ID requirement in phases. Direct care workers in Office of Long-Term Living (OLTL) waivers in participant-directed programs were the first group required to obtain the unique ID. Based on that experience, DHS is making several enhancements to the system before rolling it out to agency workers. Once the enhancements are completed, DHS will provide additional instructions to agencies regarding the requirement.

Will DHS require tasks be captured?

DHS is not requiring the capture of tasks in this phase of EVV implementation; however, DHS will be assessing whether to include tasks in the future since DHS understands the long-term goal for standardization and auditing purposes. Pursuant to federal law (21st Century Cures Act), DHS needs to make the rollout of EVV as minimally burdensome as possible since EVV is already going to be change for many providers. Additionally, it will be difficult at this time to align the task lists across services and this could complicate training efforts and confuse providers and direct care workers in the limited time to implement by January 1, 2020. DHS will be considering the inclusion of tasks in the future as DHS received feedback and works through future implementation. For auditing purposes, current practices related to tasks should continue since this is a separate practice for quality and compliance that lies outside of EVV requirements.

What will providers need to do to make sure each direct care worker is assigned a unique number for reporting purposes?

If a direct care worker has a Direct Care Workers Unique Registry ID, the provider will use this ID as the assigned ID for reporting purposes. If the direct care worker does not have the Unique Registry ID, then the provider will use the last five digits of the caregiver's social security number for reporting purposes.

Will rounding rules be clarified?

The Office of Developmental Programs (ODP) has established a resource on rounding rules which can be found on the DHS EVV website.

Will OLTL and ODP units of services be aligned for EVV?

No. DHS will continue to follow existing rules and practices related to billing for units of services.

Will ODP units of services be aligned with Department of Labor rules?

ODP billing practices currently meet Department of Labor standards. ODP allows providers to bundle time for claims submissions and the rate assumptions include calculations for nonproductive time to account for the time that cannot be billed for use.

How will the DHS EVV system work with PROMISe?

The DHS EVV system will receive ongoing participant and authorization data from the EVV portal and claims may be submitted directly into the PROMISe portal.  You will continue to use the PROMISe portal to see if your claims were accepted.

Does every employee need to have an email address to use the DHS Sandata mobile application? What if they do not have a work email or personal email?

Yes. Every employee who has access to the DHS Sandata EVV mobile application will need a unique email address. The employee will be required to create a new email address if they do not have an individual email address to log-in to the EVV application. The caregiver's email address will be utilized to identify the caregiver delivering care to the participant. The email address is used as the caregiver's username to access the application and to respond to password reset requests. 

If a person is a caregiver and a supervisor, how should they enter themselves in the system?

The individual should first enter themselves as a user and receive a temporary password. They would then log into the EVV portal, change their password, and continue on with the ability to click into the client, employee or scheduling module. This automatically adds the user as an employee. For accessing the mobile application, the individual would look for themselves in the employee module, enter their email address, check the mobile user box and save. Once they get the email with the temporary password, they would complete the registration process with the mobile application. Note, while the username can be the same, passwords for Sandata Mobile Connect and EVV are different.

What kind of training will be available for providers?

Classroom and webinar trainings were offered in late 2019. Self-paced, online training is available through Sandata's Learning Management System and can be accessed through the DHS EVV website.

Do I have to go to training to use the DHS Sandata EVV system?

If opting to use the DHS Sandata EVV system, all agency providers must attend training prior to receiving login credentials for the DHS Sandata EVV system. It is recommended that each provider agency have two staff members attend training.  Agency provider training attendees will be responsible for training their agency's caregiver staff.

Is DHS covering the cost of training office and caregiver staff?

Training for the DHS Sandata EVV system is offered free of charge to all Medicaid providers affected by EVV deployment.  Providers only bill for services rendered. Administrative costs such as training are built into the service rates and therefore are not considered billable.  Each agency is responsible for training their staff.  Training materials and access to the self-paced, online training system is available on the DHS EVV website.

What is considered "location" and how should it be captured?

Providers bear the responsibility of meeting the federal requirements of EVV. One of the requirements of the federal mandate is that location of service must be captured as part of the visit detail that is captured electronically.  There are several EVV options for providers to use in order to meet this requirement:

  1. Using a mobile application on a smart device that captures GPS coordinates to record the location.
  2. Using a landline telephone as part of a telephonic verification;
  3. Using fixed voice over Internet Protocol (VOIP) devices as part of telephonic verification.  Non-fixed VOIP devices may only be used if paired with another method for verifying location, such as an in-home fixed visit verification device; or
  4. Using a cell phone as part of telephonic verification in conjunction with a method for verifying the location, such as an in-home fixed visit verification device.

Providers must use one of these options to meet the location requirement and must ensure that caregivers have the ability to do their jobs and capture EVV appropriately.  

Is a paper timesheet required if a direct care worker misses a clock-in or clock-out?

A paper time sheet is not required. Any issues or corrections due to a missed clock-in or clock-out may be addressed through the web portal by the administrator. For any manual entries, however, supporting hard copy documentation should be kept.  

Do caregivers need to use the participant's phone?

DHS does not expect the caregiver to use the participant's phone, although this can be a resource for telephony visit verification.

Will DHS provide phones to participants for EVV?

DHS is not supplying devices for EVV. If necessary, consumers may be able to apply for a device through the Lifeline program. More information on Lifeline may be found on the DHS website.

Will there be help with the cost for people who do not currently have data plans?

DHS will not cover the costs associated with data plans.

Some participants do not have a home phone. Will a home phone be required for EVV?

EVV does not require participants to have a landline home phone. Caregivers can capture their visit information using the application on their smartphone or by calling the telephone number associated with the telephony visit verification system.

​DHS Sandata

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Who is able to use the DHS Sandata EVV system?

The DHS Sandata EVV system is available for providers with fee-for-service clients. The system is only to be used for personal care services at this point in time.  

Is there a cost for using the DHS Sandata EVV system?

DHS will not charge providers for the use of the DHS Sandata EVV system.  However, agency providers who choose to use an Alternate EVV system may be charged for that system. Such providers will be responsible for working with DHS and its vendor, Sandata, to integrate with the DHS Aggregator and will be responsible for any interface costs charged by the provider's Alternate EVV vendor.

What are the different ways that visits can be captured through the DHS Sandata EVV system?

The DHS Sandata EVV system allows for visits to be captured through the mobile application and through telephony visit verification. Corrections to EVV data can be made by providers through the web portal.

How do I know if my claims were accepted or rejected?

Provider agencies will continue to use the same process you use today to see if your claims were accepted or rejected.  There should be few rejected claims since the DHS Sandata EVV system makes sure your have all the required claims data prior to submission.  For providers using the DHS Sandata EVV system, training is available to show how to resubmit claims through the DHS Sandata EVV system.

Do I have to use the DHS Sandata EVV system?

No. While the DHS Sandata EVV system will be offered to providers, Pennsylvania is using an open EVV system model and providers may use their own EVV vendor (Alternate EVV) so long as it captures the six required items and can interface with the DHS Aggregator. Technical specifications for Alternate EVV systems to interface with the DHS Aggregator are available on the DHS EVV website.

Will different modalities for check-in and check-out be allowable in the DHS Sandata EVV system?

Yes, a caregiver can check-in using the mobile application and check-out using telephony (or vice versa).

How secure is the data that is transmitted through the DHS Sandata EVV system?

Regarding data breach concerns, DHS has taken every precaution to ensure our systems are resilient and meet the Commonwealth's IT policies.  The Sandata platform is Health Insurance Portability and Accountability Act (HIPAA) compliant and is Health Information Trust Alliance (HITRUST) certified.

Will the DHS Sandata EVV mobile application track my movements?

No.  The mobile application only captures the GPS location when the service begins (at check-in) and ends (at check-out).

Will we be able to round units?

If you are currently able to round units, then you will still be able to do so with the DHS Sandata EVV system.

What measures assure provider data protection?

System access is protected by a unique user ID and password. Providers should maintain the confidentiality of that information. The DHS Sandata EVV vendor, Sandata, uses encryption and other security protocols on their servers. Sandata installs and maintains up-to-date firewalls and virus protection, conducts a periodic review of users and access rights, reviews and applies security patches and reviews and analyzes system activity logs. Additionally, when communicating via email to the agencies, Sandata Customer Care will use encryption when responding if the email contains confidential information.

What features does the DHS Sandata system provide, and will it enable provider compliance with waiver/state regulations?  

The DHS Sandata system will capture and record six required items: type of service, individual receiving the service, individual providing the service, date of the service, location of the service delivery, and the time the service begins and ends. The DHS Sandata system will comply with the requirements set forth in federal law. The DHS Sandata system may assist providers in satisfying Pennsylvania State regulations for other auditing and compliance purposes, but providers are responsible for ensuring their continued compliance with all state requirements.

Does DHS plan to charge a fee for the DHS Sandata EVV system in the future?

No.

What is an exception generated by the DHS Sandata EVV system?

For the initial phase of EVV implementation, exceptions are generated by the DHS Sandata EVV system when one or more of the six required items is missing. For providers using Alternate EVV systems, the Alternate EVV technical specifications included on the DHS EVV website detail the information that must be captured and submitted to the DHS Aggregator.

Are the different languages in the DHS Sandata system also available in telephony?

Yes.

Can schedules created in advance be edited in the DHS Sandata EVV system?

Yes. There are multiple ways to edit schedules and these are covered in the self-paced, online training.

What browsers does the DHS Sandata EVV system support?

The DHS Sandata EVV system support the following browsers: Microsoft Internet Explorer (v9 or higher), Mozilla Firefox (v44.0 or higher), or Google Chrome. Other browsers have not been certified to provide full functionality of the EVV system and are not recommended.

What languages are provided as part of the DHS Sandata EVV system?

The telephone system used by the EVV system has English and Spanish call prompts. Additionally, the EVV caregiver training materials and help reference guides are also provided in English. Telephony visit verification and the mobile application will be made available in English and the following languages: Egyptian Arabic, French, Fulani, Hindi, Mandarin Chinese, Nepali, Portuguese, Russian, Serbian, Somali, Spanish, Swahili, Vietnamese.

Will there be a drop-down list of services in the mobile application of the DHS Sandata EVV system?

Yes, there is a drop-down list of service options that can be selected. For those providers opting to use the scheduling module within the DHS Sandata EVV system, the scheduled visit information will be pre-populated and will not require the selection of services by the caregiver when entering visit information. If an unscheduled service is delivered at the point of care, the caregiver will need to select a service from the drop-down list. 

Can providers make manual corrections to EVV data?

Providers will be able to make manual corrections through the web portal. 

What happens if a visit is not authorized?

DHS wants to ensure that necessary services are provided and understand that there will be instances where the visit has not been pre-authorized. In cases where the visit has not been pre-authorized, the provider agency will need to follow up to correct the authorization in the system.

What if there is a schedule changes?

Clock-in and clock-out should capture any schedule changes. Where exceptions occur, the provider agency will have the ability to make edits, error corrections and changes through manual entry in the web portal.

What happens when clock-in times overlap?

If caregivers clock in simultaneously, this will generate an exception and will need to be fixed through the web portal by the administrator.

What happens if check-in and/or check-out times cannot be, or are not, captured?

Check-in and check-out times are required information that must be captured as part of the visit. In instances where the check-in and check-out times are unable to be captured through the mobile application or telephony, the times can be fixed through manual entry in the web portal.

What happens if GPS coordinates don't match an approved location for services? Will an exception be generated? Will there be a system error if the locations do not match?

The GPS coordinates will be captured in the DHS Sandata mobile application at check-in and check-out. The perimeter for locations is set at 1/4 mile in the DHS Sandata EVV system. However, even if the recorded location is outside the 1/4 mile perimeter, this will not cause an exception in the DHS Sandata EVV system. The provider will be able to enter multiple addresses where services are provided and these addresses can be updated as needed. If an error occurs, any system errors may be corrected through the web portal by the administrator.

Can more than one provider use the same device to record services to an individual?

Yes. Every caregiver will have unique login credentials.

Will providers be able to add multiple service locations?

Yes. Providers will be able to enter multiple addresses for locations where services are provided into the DHS Sandata EVV system, and these addresses can be updated by the provider as needed.

For group in-home and community support, can staff enter multiple consumers at the same time?

The DHS Sandata EVV system allows group visits to be captured in two ways: 1) establish Group Visit via Sandata Mobile Application, 2) create Group Visit manually in Provider Portal. This is covered in the DHS Sandata EVV system training.

How long is it between when visit information is entered and when I can see it in the DHS Sandata EVV portal?

Visit information is generally available in the DHS Sandata EVV portal in near real time. Data is typically uploaded and available within a few minutes.

Are the phone numbers used to call-in visit verification toll-free?

Yes, and access is available 24 hours a day, seven days a week. DHS Sandata EVV telephony visit verification toll-free numbers are provided after training on the system is completed.

What happens if the times on my claim don't match the times recorded in the DHS Sandata EVV system?

An exception will be generated in the DHS Sandata EVV system.

Who is responsible for installing the DHS Sandata EVV system web portal?

There is nothing to install. Your agency, including all users, will access the DHS Sandata EVV system via the web. This requires a current web browser and sufficient internet connection.

Do I have to buy smartphones for my caregivers?

A smartphone is not required for the DHS Sandata EVV system. The DHS Sandata EVV system allows for the use of either the mobile application or telephony visit verification to record the required visit information.  Both the mobile application and telephony visit verification allow for verifying caregiver visit date, time and location. A smart device is only necessary if the caregiver uses the mobile application to capture the visit data; however, the use of the mobile application is optional and DHS does not prefer the use of the mobile application over telephony. For caregivers using the mobile application as part of the DHS Sandata EVV system, DHS has a bring-your-own-device (BYOD) practice where employees may use their personal computing devices, such as smartphones and tablets, to download and access the mobile application. The mobile application called Sandata Mobile Connect is a free application that is available on IOS and Android operating systems.

What happens if the DHS Sandata EVV mobile application cannot connect to the system?

If GPS or cellular coverage is not a viable option for a specific visit, caregivers can use telephony visit verification to capture visit information.

Is there a way to export submitted claim data into QuickBooks or other external payroll or accounting applications?

The DHS Sandata EVV system provides a standard extract of information function to permit delivery to third-party accounting and payroll systems. Reports from the DHS Sandata EVV system can be exported in PDF, Excel, and .csv formats. The ability to integrate specifically with QuickBooks format will be dependent on the provider's system requirements.

​Alternate EVV

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If I am already using an EVV technology, do I have to switch to the DHS Sandata EVV system?

Providers may use an Alternate EVV system so long as the Alternate EVV system captures the six required EVV items and can integrate with the DHS Aggregator.

If I have my own EVV technology, how do I interface with the DHS EVV system?

A PCS provider may use an Alternate EVV system chosen by the provider, but the Alternate EVV system must align with the data being captured by the Sandata system. Providers using an Alternate EVV system will need to review with their vendor and follow with the technical specifications and related addendums that are available on the DHS EVV website. Providers interested in utilizing an Alternate EVV system, or have questions prepared specific to Alternate EVV, should contact the Sandata Alternate EVV support team to ensure the data interfaces will align before January 1, 2020. Please note, initial contact with the Sandata Alternate EVV support group should be made by the providers and they should have their vendor contact information readily available, as it will be requested.  The certification process for Alternate EVV systems to interface with the DHS Aggregator can take 4-6 weeks.

If my Alternate EVV system vendor already went through the Sandata Alternate EVV certification process, do I need to complete the certification process also?

Yes. Even though a different agency has an approved interface from an Alternate EVV vendor to the DHS Aggregator, each provider agency must complete the testing process to ensure the interface works with the Alternate EVV system and to gain Sandata's approval.

When must I complete my interface to the DHS Aggregator?

If a provider agency chooses to use an Alternate EVV system at the start of the program, DHS recommends completing the certification process no later than March 1, 2020.

What if my Alternate EVV system vendor cannot map its values to DHS EVV system field values?

The data in the DHS Aggregator must be consistent across the EVV program. Therefore, Alternate EVV systems must send the same values in the format and manner specified in the technical specifications.  Providers will need to use the DHS Sandata EVV system if the Alternate EVV vendor cannot accommodate the values, format, or interface requirements defined in the Alternate EVV technical specifications. The technical specifications are available on the DHS EVV website.

​Participant-Directed

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How do PPL and PALCO fit into the DHS EVV timelines?

PPL is using an Alternate EVV system. Training began on this system in July 2019 with full implementation by October 2019. PALCO is using an Alternate EVV system and will provide updates as soon as they are available.

Will PPL and PALCO be doing training for direct staff?

Yes, PPL conducted training for both direct care workers and common-law employers. PALCO will provide trainings once their EVV system is implemented.

​HHAeXchange

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Will the MCOs talk to Sandata?

Yes, EVV information collected by the MCOs will be shared through the DHS Aggregator.

Will the DHS Sandata EVV system and HHAeXchange communicate with each other?

The DHS Sandata system is not designed to send information to HHAeXchange. HHAeXchange has an interface to transmit data to Sandata.If a provider bills to MCOs, the EVV data in HHAeXchagne goes to the managed care organizations (MCO) and will also be transmitted to DHS Aggregator.

What if a provider wants additional EVV features not offered by the DHS Sandata EVV system or HHAeXchange?

DHS recognizes that some providers may already be using, or may seek to explore, systems that provide more services and information than required under the EVV structure for all of the provider's program needs.  Certain vendor system, including HHAeXchange and Sandata, may provide this additional functionality. Any such vendor system will need to be compatible with the DHS EVV solution that is provided through Sandata and/or HHAeXchange. Please be advices that DHS does not endorse the use of any particular system, upgrades, add-ons or additional services from any vendor, nor should providers be led to believe that such services are suggested or required by DHS, the Commonwealth of Pennsylvania or the federal government. DHS is responsible only for ensuring that EVV requirements are implemented pursuant to federal law.