Electronic Visit Verification - General Stakeholder Meeting November 19, 2019 - Colorado.gov
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Electronic Visit Verification
General Stakeholder Meeting
November 19, 2019
1
Our Mission
Improving health care access and
outcomes for the people we serve
while demonstrating sound
stewardship of financial resources
2
Welcome Stakeholders
• Restroom locations
• HCPF IntroductionsThe purpose of this meeting is to engage providers,
members, and other stakeholders as the Department
works to implement EVV for community based services
offered through both the State Plan and Waivers.
And specifically to:
Meeting • Review EVV, the legislative mandate, and the scope
Purpose of implementation
• Discuss EVV project updates
• Provide a platform to gather stakeholder feedback
4We ask that you:
• Mind E-manners
Meeting • Identify yourself when speaking
Guidelines • Share the air
• Listen for understanding
• Stay solution and scope focused
5Introductions
Brief Overview of EVV
Live-in Caregiver Definition
Agenda Scope of EVV Program
Claim Edit Follow-up
Sandata Call Center Report
Stakeholder Engagement Discussion• Electronic Visit Verification (EVV) is a technology
7
solution which verifies information through
mobile application, telephony, or web-based
portal
• EVV is used to ensure that home or community-
based services are delivered to people needing
those services by documenting the precise time
service begins and ends
What is • Section 12006 of the 21st Century Cures Act
EVV? requires all state Medicaid agencies implement
an EVV solution
• States that do not implement EVV will incur a
reduction of Federal funding
• The Department intends to implement EVV for all
Colorado required services in late summer 2020.TYPE OF SERVICE INDIVIDUAL DATE OF THE
What must PERFORMED RECEIVING THE
SERVICE
SERVICE
EVV
Capture?
LOCATION OF INDIVIDUAL TIME THE SERVICE
SERVICE DELIVERY PROVIDING THE BEGINS AND ENDS
SERVICEWhich Types of Services Require EVV?
EVV Required
• Select Fee for Services (FFS) State Plan and HCBS Waiver
Services
EVV Excepted
• Per Diem Services, Managed Care, Program for All-Inclusive
Care for the Elderly (PACE), and other Capitated Services
9Which Services Require EVV?*
• Personal Care • Independent Living Skills Training (ILST)
• Pediatric Personal Care • Life Skills Training
• Home Health: RN, LPN, CNA, PT, OT, SLP • Physical Therapy (provided in the home)
• Private Duty Nursing • Occupational Therapy (provided in the home)
• Hospice • Speech Therapy (provided in the home)
• Homemaker • Behavioral Therapies (provided in the home or
community)
• Respite (provided in the home or community)
• Pediatric Behavioral Health
• Consumer Directed Attendant Support Services
(CDASS) • Youth Day
• In-Home Support Services (IHSS) • Durable Medical Equipment (select services)
*Subject to changeService Types Groupings
Consumer Directed
Consumer Directed
Behavioral Attendant Support Durable Medical Home Health – Home Health –
Attendant Support
Therapies Services – SLS Equipment Certified Nurse Aide Nursing
Services
Health Maintenance
Home Health – Home Health –
Home Health –
Occupational Speech/Language Homemaker Hospice - In Home Hospice - Inpatient
Physical Therapy
Therapy Therapy
Independent Living
Skills Training In-Home Support Occupational Pediatric Behavioral Pediatric Personal
Personal Care
and Services Therapy Therapies Care
Life Skills Training
Private Duty Respite and Youth
Physical Therapy Speech Therapy
Nursing Day
1112
• The Department recognizes that EVV services
can happen in the home or in the community.
Service • It is essential that EVV does not disrupt this
flexibility of service location.
Location • Services that happen in a facility or professional
building are exempt from EVV. Unless noted
otherwise.Questions or Comments
Key Terminologies
Term Meaning
State EVV Solution State EVV system available to providers at
no cost
Provider Choice System EVV system procured, purchased, and used
by a provider
Alternate Vendor Vendor who manages a provider choice
system
Data Aggregator Where provider choice systems will submit
EVV data to the State SolutionColorado selected a vendor that will provide EVV
solutions, while also allowing providers to use
alternative/existing EVV systems, if they meet
state specifications:
✓ Providers choosing to use an alternate
vendor must ensure that their system is
State EVV configured to Colorado EVV rules and
requirements.
Model:
Hybrid ✓ Provider Choice Systems must connect to
the Data Aggregator
✓ Self-paced aggregator training must be
completed prior to connecting to the Data
AggregatorState EVV Solution
OverviewColorado EVV Technologies
Mobile Application Telephony
Provider Web Portal
(Santrax)Mobile Application: MVV
• Mobile Visit Verification (MVV): A GPS enabled mobile application
downloaded on a smartphone or tablet
• “Bring your own device” method that works on iPhone and Android
• GPS Enabled
• Captures location when a caregiver clocks-in/clocks-out
• No continual location reporting
• Direct care workers log-in with unique Sandata ID or email address
• Available in English, Spanish, Somali, Russian, Chinese Mandarin, and
Arabic EgyptianRural Area Considerations
• State EVV Solution application will work in rural areas or
telephony can be used
• MVV will automatically switch to “Disconnected Mode” when
smartphone or tablet is not connected to a network
• EVV data will be saved for a later transmission when the
caregiver logs-in and network connectivity (cellular or wi-fi)
is establishedTelephony Visit Verification (TVV)
• Each provider ID has two toll-free, multi-language
numbers
• Both numbers are accessible 24 hours a day, 7 days a
week
• Non-GPS option
• Client phone is preferred for TVV
• Location captured through ANI technology
• Member identified by Sandata Client ID
• Direct care workers identified by Sandata IDProvider Portal
• Used for visit maintenance and administrative tasks
• Limited capacity for manual entry of EVV data
• Used by providers who utilize State EVV Solution
• View and verify visits
• Address exceptions or errors
• State enforced manual entry thresholdProject Updates
Colorado EVV Implementation Timeline
• Good Faith Effort Exemption request was approved 9/18/19
• Additional time will be used to explore solutions to exempt live-in caregivers
• The State EVV Solution and Data Aggregator are now live and available for use
• The Department strongly encourages providers to use EVV during the Soft-Launch
• DME providers may begin using EVV in early 2020
• Colorado anticipated EVV mandate will be late summer 2020
DMEGood Faith Effort Request Approved
Early Colorado
Adoption - CMS
Anticipated
Voluntary Mandate
Mandate
Soft Launch • January 1, 2021
• Summer 2020
• Pre-payment
• Began October • CCR Rule in claims review
1st, 2019 Effect
State exploring live-in caregiver solutions
24Proposed Live-in Caregiver Definition
A live-in caregiver is a caregiver who permanently or for an extended period of time resides in
the same residence as the Medicaid member receiving services. Live-in caregiver status is
determined by meeting requirements established by either the U.S. Department of Labor or
Internal Revenue service. Verification of live-in caregiver status must be validated by the
provider though an official Department form. The Department permits live-in caregiver
establishment beyond the above definitions in limited circumstances, at Department discretion.
Examples may include:
• Joint custody arrangements
• Children in Foster Care
• Members transitioning out of residential service
Note: Live-in caregiver status is established by the member/caregiver relationship. If a caregiver
provides services to more than one member, the establishment of live-in status only pertains to
relationships where documentation has been provided and approved.
25EVV Project Scope
SERVICE
TYPE CLIENTS VISITS PROVIDERS
BHSVC 10 15 1
HHBAS 2 8 2
HHNUR 4 4 2
Program HMKR
IHSS
145
3
876
3
5
2
Size Since OT
PEDBT
2
5
2
9
2
3
Go-Live PRSNL 77 582 9
PT 12 13 2
RSPT 4 12 1
SLT 3 8 1
No Service 39 118 7
*Data pulled on 11/13/2019
TOTAL 306 1650 37SERVICE TYPE VERIFIED VISITS UNVERIFIED VISITS PERCENT VERIFIED
Verified vs.
BHSVC 15 0.0%
HHBAS 8 0.0%
Unverified HHNUR
HMKR 50 826
4 0.0%
5.7%
Visits IHSS 3 0.0%
OT 2 0.0%
Verified:
• Complete visit PEDBT 3 6 33.3%
• All data points collected
PRSNL 206 376 35.4%
• Cures-compliant visit
• Can match to a claim line PT 13 0.0%
RSPT 3 9 25.0%
Unverified:
• Incomplete visit SLT 1 7 12.5%
• One or more data points missing No Service 118 0.0%
• Not a Cures-compliant visit
TOTAL 263 1387
• Cannot match to a claim lineClaim Edit Follow-up
From Provider Newsletter:
29Claim Edit Follow-up
30Questions or Comments
Sandata Call Center Update
Contact:
Phone: 855-871-8780 or email
Email: CO-HCPF-EVVProviderHelpdesk@etraconline.net
32Calls Presented
Presented - calls that come into the call center (Dark Green)
Answered - calls that were answered by a call center representative (Light Green)
Abandoned - calls that were not answered by the call center (Gray)
33% of Calls Answered in 60 Seconds
Percentage is the amount of calls that were answered in 60 seconds over all calls received.
34% of Calls Captured
Percentage is the amount of calls that were answered from all calls presented.
35Average Answer and Talk
Call Minutes: 9.8 9.9 9.4 7.8 11.4 9.1 10.8 9.9 7.2 7.1
Average time of call, in seconds.
Average time to answer call, in seconds.
36Electronic Visit Verification
Roadmap 2019Project
Develop
Kickoff and Develop
Colorado Collect User
Finalize Stakeholder
2018 Training
Rules and
Regulation Feedback Acceptance
Plan Draft on EVV CCR Testing
Electronic Visit State
System
Verification and
Aggregator
Implementation Register
Release
Technical Provider
Collect
Stakeholder
Live
Specifications
Roadmap for
Training
for Provider
Choice
Welcome
Letter
Feedback
on
Systems Scheduler
2018-2020
Interface
Provider
Testing Training Begin Go Live
Mandatory
Call Center Soft Use
Available
Launch Summer*
2020
*Subject to changeSoft-Launch
• Began October 1, 2019 when the State EVV Solution and Data Aggregator went live.
• Providers may begin to collect EVV data and transmit to the Department.
• Optional participation until EVV is mandated, estimated late summer 2020.
• Opportunity to familiarize providers with EVV prior to claims integration. Claims will
continue to pay and EVV errors will appear on remittance advice.
• Opportunity for caregivers to practice EVV collection and for members to become
accustomed to EVV.
• Help the Department identify and develop supplemental training materials.
39Stakeholder Engagement
DiscussionStakeholder Meeting Updates
Subcommittees
• Consumer Direction and Family Caregiver
• Training and Communications (Sunset November 2019)
• Systems (Sunset November 2019)
• Privacy (Sunset February 2019)
General EVV Stakeholder Meeting
• How would you like to use this time?
41Questions
42Contact Information
Lana Eggers
EVV@state.co.us
43Thank you!
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