As agencies move to Electronic Visit Verification (EVV) they will achieve numerous benefits including regulatory compliance and increased speed for processing billing and payroll. To learn more about EVV, please see our earlier articles explaining EVV and the 21st Century Cures Act.
Challenges to Overcome When Implementing EVV
There are several issues that will arise as you implement EVV, as follows:
Reported Times will no longer be "perfect:" When your not using EVV, your time sheets will generally be "perfect." Your caregiver will show up right when they're supposed to and leave right on time. A visit scheduled from 8:00 AM to 10:00 AM will be recorded as arrived at 8:00 AM and departed exactly at 10:00. When EVV is added, these times will no longer be perfect. For example they might arrive at 7:56 AM and leave at 9:53 AM.
You'll need to "round" or "truncate" visits in accordance with the rules of your funding source: Most Medicaid programs have you bill personal care visits in 15 minute units. Some programs only pay for completed 15 minute units, while others employ rounding rules. A typical rounding rule is called the "rule of seven eigths," which means that 7 minutes rounds down and 8 minutes round up. Other rules apply too. For example labor laws often require you to pay for every minute worked even if you're not able to bill for those minutes.
Resistance to Change: In a typical organization, 20% of your workers will love and embrace EVV right away and 60% will be fine with it but the last 20% will be unhappy about it and come along "kicking and screaming." The best thing you can do to prevent this is to make sure that the EVV system is easy to use and that you provide training and hand-holding in the early days.
Caregivers will make mistakes: In the early days of your implementation, caregivers will forget to clock in or clock out or make other mistakes. When mistakes are made, it is likely that a time sheet, signed by the client will be required.
A Best Practice: The One Day Time Sheet
One best practice that we share is the idea of a one day time sheet. Most agencies who are "on paper" use a one week time sheet. Continuing with a one-week time sheet makes it "too easy" for your caregivers who are resistant to the new approach. They'll just keep doing it the "old way."
The idea of a one-day time sheet changes this. If the caregiver makes an error, you ask for them to fill out a time sheet for that one day and have the client sign it. Some agencies even mandate.that the time sheet be brought to the office that same day This is a bit difficult, but that's by design. If the caregiver has to fill out a paper time sheet and get it signed each time that they forget to clock in our out, they will quickly learn.
More Best Practices
If you have additional questions or are seeking further best practices for implementing EVV in your organization, we'd be happy to help. The easiest way is to click here to contact Ankota or call us on 844-4-ANKOTA.
Ankota provides software to improve the delivery of care outside the hospital, focusing on efficiency and care coordination. Ankota's primary focus is on Care Transitions for Readmission avoidance and on management of Private Duty non-medical home care. To learn more, please visit www.ankota.com or contact us.