If you deliver home care services that are reimbursed by Medicaid then you need to comply with EVV. Officially, the law that instated EVV (The 21st Century Cures Act), is broader and can (should) apply to Medicare and Veterans services, but in practice it's being managed and enforced by Medicaid. To make matters more complex, Medicaid as a program is administered at the state level, so being able to do EVV in Missouri doesn't mean that you can do EVV in Virginia.
But let's focus... if you provide in-home services paid for by Medicaid you need to comply with EVV.
There are two ways to go about it: 1) You can usually get a solution from your payer (which might be state Medicaid or might be one or more Managed Care Organizations [MCOs]) appointed by your state to administer their home care or disability services program. 2) Alternatively you can choose a 3rd party EVV software system.
What's the difference between a 3rd Party EVV Software System and one provided by a payer?
Great question!
- Payer Provided EVV software's purpose is to keep Payers Compliant with EVV
- 3rd-Party EVV software's purpose is to help you manage your agency well, while complying with EVV
Tell me more: what do I NOT get with Payer Provided EVV Software?
The payer software will allow you to clock-in and clock-out for visits that require EVV. It most likely does not do the following:
- It does NOT help you schedule (although you can likely tell it what schedule you came up with)
- It does NOT help you to ensure that caregivers are getting the hours that they want (note that not getting desired hours is the biggest reason that caregiver's leave)
- I will likely share an "hours report" with you that you can use to help you with payroll, but it does NOT know what your pay rates are, your rules for OT and shift differentials, travel pay, etc.
- It does NOT give you dashboards to gage your efficiency, financial performance, or compliance on an individual caregiver basis.
- The list goes on and on... it just helps the payer stay compliant with EVV...
What additional benefits can I get from a 3rd-Party EVV software?
In contrast to payer provided systems, 3rd-Party EVV Software need to compete for your business. Their primary mission is to help your agency to succeed, while complying with EVV.
This is what you can get with fully integrated 3rd-Party EVV Software:
| Payer Recommended EVV System | 3rd Party EVV System |
|---|---|
| Client Demographics (Client ID, Name, Address, and Phone) |
|
| Includes basic client demographic data |
Everything you get in a Payer provided EVV system, plus:
|
| Caregiver Information | |
| Basic caregiver details (Name and Unique ID) |
Everything you get in a Payer provided EVV system, plus:
|
| Visit Tracking & Scheduling | |
| Standard visit clock-in and clock-out |
Everything you get in a Payer provided EVV system, plus:
|
| Payroll & Approval | |
| Basic data capture for payroll |
Everything you get in a Payer provided EVV system, plus:
|
| Advanced Features & Support | |
| Generally no advanced features or dedicated support |
Many advanced features, including:
|
Other things to look for from 3rd-Party EVV Software
Integration Capabilities
Another strength of third-party EVV software allows it to connect effortlessly with existing home healthcare systems. The majority of healthcare agencies operate several digital platforms that manage scheduling tasks and serve as payment systems, payroll systems, and compliance tracking systems. A high-end third-party EVV system acts as a data connector between various platforms so that healthcare providers eliminate manual entry tasks and decrease errors.
Top-tier EVV software vendors facilitate time-based data exchange between EVV systems and EHR and billing technologies through API links. Through smooth integration processes, agencies prevent visit verification mismatches while reducing both payment denial situations and processing delays. The compatibility of third-party EVV solutions with several Medicaid programs operating across different states makes them suitable for agencies that provide services in multiple domains.
Customization Options
The main advantage of third-party EVV software becomes clear through its customization features that agencies can use to design features according to their specific operational requirements. Home care providers face implementation restrictions using built-in state-provided EVV solutions because they enforce a standardized approach to all users. Third-party EVV vendors enable agencies to modify their workflows and shape reporting outputs as well as user interface designs for increasing operational effectiveness.
The verification approaches supported by many third-party systems cover GPS tracking alongside biometric authentication and visit verification through voice recognition and telephony verification. The system offers versatility that allows agencies to make verification methods fit different caregiver and patient accessibility restrictions and personal choices. Agencies use their ability to modify reporting instruments which helps them create instant analytics and monitor operational effectiveness for making better agency-wide decisions.
Vendor Selection Process
Agencies must thoroughly examine reliability and scalability together with customer support when selecting their appropriate third-party EVV vendor. Compliance-related EVV functions and billing management require agencies to check for vendor platforms that guarantee high security and system stability combined with reduced operational interruptions. Look for a vetted third-party vendor to provide their robust systems built from implementations that demonstrate adherence to industry standards.
Vendor selection heavily depends on the ability to handle increasing demand because scalability stands as a key criterion. Agencies that scale their offerings should choose an EVV solution that manages growing patient and caregiver information without causing system performance degradation. The mobile applications from vendors provide offline document abilities that allow caregivers to maintain visit documentation in areas with restricted Internet access.
Agencies heavily depend on vendor support because both technical problem-solving and compliance-related assistance need immediate responses. EVV providers delivering the best service include round-the-clock support in addition to complete training materials and specific account representatives to help users with implementation and diagnostics. An informed EVV vendor selection becomes achievable by reading customer reviews along with gathering peer recommendation details from medical agencies.
Compliance and Regulatory Considerations
The main hurdle in home healthcare consists of following both federal and state regulatory requirements for Electronic Visit Verification (EVV). According to the 21st Century Cures Act, every Medicaid-reimbursed personal care and home healthcare service needs to implement EVV systems for visit verification. Each state implements EVV in different ways which creates complicated challenges to compliance since agencies work across various locations.
Third-party EVV solutions make it possible for agencies to tackle regulatory challenges through continuous updates of their systems with current compliance requirements. Third-party EVV platforms stand higher than state-managed solutions in terms of real-time compliance updates since they operate under continuous vendor monitoring of regulatory adjustments. Agencies utilize prevention strategies to stay away from non-compliance fines while maintaining smooth audit processes.
Third-party EVV solutions provide automated documentation as a vital compliance feature for users. The systems produce complete documentation about each visit that contains timestamp information and both caregiver identity and service description specifics. Agencies can efficiently retrieve and submit correct visit records to Medicaid or managed care organizations for audits or dispute purposes, which helps to eliminate claim rejections.
Cost-Effectiveness of 3rd-Party EVV Software
Many healthcare agencies hold back from third-party EVV software investments because of expenses at first but find these tools generate savings throughout their life cycle. The basic capabilities of state-supplied EVV platforms force agencies to buy extra software or to launch manual systems when they need to complete operational tasks. The all-in-one platform of third-party EVV solutions removes operational inefficiencies because it combines systems for visit verification with billing and payroll processing alongside compliance monitoring capabilities.
The implementation of third-party EVV software minimizes financial losses that occur because of denied claims and non-compliance. The combination of precise visit verifications with automated billing functions prevents agencies from submitting unclean claims, which leads to minimal revenue interruptions. The enhanced responsibility of caregivers through improved systems allows agencies to prevent fraud cases with unauthorized overtime activities, thus reducing overall expenses.
Third-party EVV vendors provide subscription plans that allow service agencies to select payment options fitting their financial capability and operational requirements. Cloud-based solutions decrease home care agencies' expenses for on-site infrastructure, thereby making them more affordable to both small and medium-sized businesses.
Conclusion
Home care agencies gain more freedom and integration advantages alongside better compliance support when they implement independent EVV systems instead of using state-mandated EVV systems. These solutions enable real-time data exchange as well as adaptable workflow designs and built-in compliance tracking mechanisms which help agencies deliver better operational results through increased efficiency and quality of services.
A strategic financial choice involves reliable third-party EVV system acquisitions because they enable regulatory compliance and improve visit verification accuracy, which boosts operational efficiency and company stability. The selection of a vendor whose requirements match the needs of a home care provider leads to process optimization, ensures compliance, and delivers high-quality patient care with confidence.
Ankota's mission is to enable the Heroes who keep older and disabled people living at home to focus on care because we take care of the tech. If you need software for home care, EVV, I/DD Services, Adult Day Care centers, or Caregiver Recruiting, please Contact Ankota.
Your Comments :