After the 21st Century Cures Act was passed Electronic Visit Verification (EVV) software became essential for home care providers. EVV systems validate care delivery, helping agencies meet compliance requirements and increase operational efficiency. Integrating EVV with the Sandata Aggregator ensures compatibility with state Medicaid programs, streamlining data sharing and compliance tracking.
Importance of EVV Software in Home Care
EVV software provides:
- Real-time visit tracking
- Enhanced accuracy for billing
- Improved compliance with regulations
- Reduced manual entry errors
- Scheduling
- Compliance
- Reports
- Special tools to save time like visit approval assistant
Understanding Sandata Aggregator
Quick note: In October 2024 Sandata was acquired by HHA Exchange. We expect that the Sandata brand name will stay long into the future, but if you Google Sandata and it comes up with HHA Exchange, this is why.
The Sandata Aggregator is a centralized platform that consolidates EVV data for Medicaid programs. It collects visit data, such as start and end times, caregiver details, service type and most importantly Location of the service, ensuring states can verify that the visit was completed as described. The goal of EVV is to stop fraud.
Integration of EVV Software with Sandata Aggregator
The first thing that you need to know is that each state (and sometimes each "payer" within a state) that administers a Medicaid Home Care or Disability Services program needs to comply with the Electronic Visit Verification (EVV) mandate (written into law in the 21st Century Cures Act). These states and programs (such as Managed Care Organizations [MCOs]) choose an EVV aggregator to prove that they are compliant with EVV. This is mandatory for the state to get its home care funding. Based on this, THE FIRST THING YOU NEED TO KNOW IS "WHO IS YOUR AGGREGATOR." If you're on this page, it's likely that you did your research and you're in the right place. If not, it's a good bet that Sandata is the right answer because they are the most used aggregator nationwide (but go check anyway).
The reason for integration is simple: You NEED to do this for compliance, and integration makes it happen automatically
Compliance and Regulatory Requirements
The 21st Century Cures Act mandates EVV for Medicaid-funded services. Integration with your Aggregator (and Sandata in particular) helps providers:
- Ensure compliance with Medicaid requirements
- Avoid penalties for non-compliance
- Maintain accurate service records
- Work with user-friendly 3rd party software (sometimes called AltEVV)
Benefits of Using EVV Software with Sandata Aggregator
Using Sandata-compatible EVV software offers:
- Automated Compliance
- Simplified billing and reimbursement
- Real-time service verification
- Accurate, accessible care records
- Increased transparency and accountability
Features to Look for in EVV Software Compatible with Sandata Aggregator
Selecting EVV software compatible with Sandata requires focus on:
- Real-time synchronization (most programs want your data to be synchronized at least once per day)
- Automated checking that EVV was used (states generally want 100% compliance but expect at least85%)
- Confirmation of location with GPS, Caller ID matching (with Telephony) and FOB token devices
- Automatic checking of the visit duration so that you don't overbill or overpay. Also sometimes caregivers forget to clock in and the visit is too short. Your software should check this.
- Assistance with the approval process. With a well-integrated software solution, you should be able to find and approve many visits at once (as opposed to having to approve one visit at a time)
- Ability to see which visits require action on your part (such as the caregiver forgot to clock out)
- Ability so see which visits haven't been sent to the aggregator (more and more states won't pay for visits that aren't sent to Sandata)
- Another reason some visits aren't in Sandata is that they were missed when you did your billing. Your system should detect this.
- Information about your Sandata synchronization should be right there inside your software.
- Compliance-focused design to reduce regulatory risk
Common Challenges and Solutions
EVV software integration with Sandata Aggregator can present challenges. Here’s how agencies can address these:
| Challenge | Solution |
|---|---|
| Data not in aggregator | Your EVV software should tell you all visits that are not in the aggregator |
| Caregiver Errors | Look for software with an approval assistant that can allow you to approve the "simple errors" all at once |
| Support with EVV | Ensure round-the-clock vendor support |
Future Trends in EVV Software and Aggregation
As technology advances, EVV software will evolve to include:
- Reimbursement based on EVV: For now, some states and programs have you send your billing to the payer and send your EVV to the aggregator and they pay you even if these don't match. This is changing. In fact many states are having you send your visits ONLY to the aggregator and then the aggregator sends them for billing
- Caregivers working for multiple agencies: Each caregiver has a unique ID and it's typical for caregivers to work for more than one agency. This is all fine. But sometimes caregivers clock in for both agencies at the same time. The aggregator will know.
- Analytics and Insights: You've probably all been through audits in your agency where you show your time records. With EVV, the agency has your time records and they're auditing you all the time
- Using EVV to prevent hospitalizations: This is futuristic thinking in most cases, but since there are caregivers meeting with their clients, they can report information that can be used to detect whether a client might be at risk of a bigger issue, such as one that would cause a hospitalization. As an example of this, the state of Virginia requires all visits to report of 4 questions about the client's condition. This information is available in real-time (and can been seen on their DMAS-90 form)
How to Choose the Right EVV Software for Sandata Aggregator
Choosing EVV software involves evaluating factors such as:
- Compatibility with Sandata or the aggregator for your state or program
- Ease of complying with EVV. Your job should be hiring and mentoring great caregivers and keeping your clients safe at home. Look for software that keeps you EVV-compliant will doing most of the work for you.
- Choose a vendor that answers the phone, responds to email and text and HELPS YOU RIGHT AWAY
- Cost-effectiveness and scalability: Remember that a low price doesn't help you are spending hours per day and week doing work that the software can do for you.
A suitable EVV solution meets agency needs while aligning with Sandata's requirements.
Shameless Plus for Ankota's EVV Software
Ankota has a great integration with Sandata. Our providers have told us that visit verification review was taking them hours per day and now it takes minutes. This allows them to focus on growth and the quality of their service. We'd love to talk to you about Ankota's software for any state that has Sandata as its aggregator. Press here to get in touch.
Conclusion
Effective EVV software integration with Sandata Aggregator ensures compliance and improves efficiency for home care agencies. By selecting a compatible solution, providers can optimize operations and better meet the needs of clients and regulators.
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