Electronic Visit Verification General Stakeholder Meeting June 16, - - PowerPoint PPT Presentation

Electronic Visit Verification

General Stakeholder Meeting

June 16, 2020

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Our Mission

Improving health care access and

• utcomes for the people we serve

while demonstrating sound stewardship of financial resources

2

WELCOME Stakeholders

• HCPF Introductions
• Housekeeping

3

Meeting Purpose

The purpose

• f

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 S tate Plan and Waivers. And specifically to:

• Review EVV

, the legislative mandate, and the scope of implementation

• Discuss EVV Proj ect Updates
• Provide a platform to gather stakeholder

feedback

4 4

Meeting Guidelines

We ask that you:

• Mind E-manners
• Identify yourself when speaking
• S

hare the air

• Listen for understanding
• S

tay solution and scope focused

5 5

Agenda

Introductions Brief Overview of EVV Implementation Timeline Code of Regulation Update Caregiver S upplemental Materials Telemedicine in EVV S andata Call Center Report Department Data Analytics Open Forum

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Overview

• f EVV

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What is EVV?

• Electronic Visit Verification (EVV) is a technology

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

• S

ection 12006 of the 21st Century Cures Act requires all state Medicaid agencies implement an EVV solution

• S

tates that do not implement EVV will incur a reduction of Federal funding

• The Department will implement and mandate EVV

for all Colorado required services on August 3, 2020

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What must EVV Capture?

TYPE OF SERVICE

PERFORMED

I NDI VI DUAL RECEI VI NG THE

SERVICE

DATE OF THE

SERVICE

LOCATI ON OF

SERVICE DELIVERY

I NDI VI DUAL PROVI DI NG THE

SERVICE

TI ME THE SERVICE

BEGINS AND ENDS

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• Personal Care
• Pediatric Personal Care
• Home Health: RN, LPN, CNA, PT, OT, S

LP

• Private Duty Nursing
• Hospice
• Homemaker
• Respite (provided in the home or community)
• Consumer Directed Attendant S

upport S ervices (CDAS S )

• In-Home S

upport S ervices (IHS S )

• Independent Living S

kills Training (ILS T)

• Life S

kills Training

• Physical Therapy (provided in the home)
• Occupational Therapy (provided in the home)
• S

peech Therapy (provided in the home)

• Behavioral Therapies (provided in the home or

community)

• Pediatric Behavioral Health
• Youth Day
• Durable Medical Equipment (select services)

Which Services Require EVV?*

*Subject to change

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Behavioral Therapies Consumer Directed Attendant Support Services Consumer Directed Attendant Support Services – SLS Health Maintenance Durable Medical Equipment Home Health – Certified Nurse Aide Home Health – Nursing Home Health – Occupational Therapy Home Health – Physical Therapy Home Health – Speech/Language Therapy Homemaker Hospice - In Home Hospice - Inpatient Independent Living Skills Training and Life Skills Training In-Home Support Services Occupational Therapy Pediatric Behavioral Therapies Pediatric Personal Care Personal Care Physical Therapy Private Duty Nursing Respite and Youth Day Speech Therapy

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Service Types Groupings

Service Location

• EVV services happen in the home and in

the community.

• EVV does not disrupt this flexibility of

service location.

• Facility-based services are exempt from

EVV unless otherwise noted.

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State EVV Model: Hybrid

Colorado 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 configured to Colorado EVV rules and requirements.

 Provider Choice S

ystems must connect to the Data Aggregator

 Training is required for S

tate EVV S

• lution

and Provider Choice EVV

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State EVV Solution Technologies

Mobile Application Telephony Provider Web Portal

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Questions

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EVV Implementation Timeline

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• The S

tate EVV S

• lution and Data Aggregator are now live and available for use.
• Providers may begin to collect EVV data and transmit to the Department.
• Opportunity to familiarize providers with EVV prior to claims integration. Claims will

continue to pay and EVV errors will appear on Remittance Advice (EOB 3054).

• Opportunity for caregivers to practice EVV collection and for members to become

accustomed to EVV.

• Help the Department identify and develop supplemental training materials.
• The Department strongly encourages providers to use EVV during the S
• ft-Launch

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Soft-Launch Review

• 9/ 18/ 19: Good Faith Effort Exemption request approved by CMS

.

• 10/ 1/ 2019: S

tate EVV S

• lution and Data Aggregator went live.
• 10/ 1/ 2019 – 8/ 2/ 2020: S
• ft -Launch.
• 8/ 3/ 2020: EVV mandate, providers must use EVV.
• 10/ 1/ 2020 – 12/ 31/ 2020: Post payment claims review for providers who are

not making an earnest effort to use EVV.

• 1/ 1/ 2021: Prepayment claims review, claims will deny without corresponding

EVV.

Colorado EVV Implementation Timeline

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• S

takeholder feedback incorporated in-between readings

• EVV rule passed Medical S

ervices Board on June 12, 2020

• Final rule will post to S

ecretary of S tate website in late July

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Medical Services Board Update

First Reading: 5/ 8/ 2020 S econd Reading: 6/ 12/ 2020 Mandate Effective: 8/ 3/ 2020

Project Updates

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• Caregiver Guide – Mobile Visit Verification Set -up
• Caregiver Guide – Mobile Visit Verification
• Caregiver Guide – Telephony Visit Verification
• Telephony Visit Verification – Quick Reference Guide
• Caregiver Letter – EVV Mandate Details
• Available on t he Depart ment ’ s EVV websit e under Resources

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Caregiver Supplemental Material

• For caregiver initial setup of the S

tate EVV S

• lution Mobile Application
• Provider Agencies remain the primary

resource for caregiver support

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Caregiver Guide – MVV Setup

• For caregivers who use the S

tate EVV S

• lution Mobile Application
• Provider Agencies remain the primary

resource for caregiver support

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Caregiver Guide - MVV

• For caregivers who use of the S

tate EVV S

• lution Telephony Visit Verification
• Provider Agencies remain the primary

resource for caregiver support

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Caregiver Guide - TVV

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TVV Quick Reference Guide

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Caregiver EVV Letter

• Letter for agencies to

provide caregivers explaining the EVV mandate

Telemedicine and EVV

Updated Guidance

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• UPDATES

guidance from January 2020 on website

• EVV is required for all services normally

requiring EVV, including newly expanded to allow Telemedicine (including services that use Place of S ervice 02 and modifier GT)

• Location of client must be recorded in

EVV record. Alternate location functionality may be needed.

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Telemedicine Guidance

Sandata Call Center Report

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Sandata Call Center

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Phone: 855-871-8780 Email: COCustomerCare@ S andata.com

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Total Incoming Calls

Percent of Calls Captured

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Jun-20

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Call Times: What To Expect

Wait Time for a Call Representative Time With a Call Representative 22.35 S econds 10.60 Minutes

EVV Department Analytics

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Expected and Cumulative Percent of Providers Who Utilized an EVV System

Expected Percent 72.73% Cumulative Percent 11.74%

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Utilizing Provider Types

10 Home Health 16 Clinic - Practitioner 17 Physical Therapist 25 Non-Physician Practitioner - Group 27 S peech Therapist 28 Occupational Therapist 36 Home & Community Based S ervices (HCBS ) 48 Rehabilitation Agency 50 Hospice 83 Behavioral Therapy Clinic

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Billing Provider Types

10 Home Health 11 Case Management Agency 14 S upply 16 Clinic - Practitioner 17 Physical Therapist 25 Non-Physician Practitioner - Group 27 S peech Therapist 28 Occupational Therapist 36 Home & Community Based S ervices (HCBS ) 48 Rehabilitation Agency 50 Hospice 83 Behavioral Therapy Clinic

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Most Common Visit Exceptions

Location Required 21.66% Unmatched Client ID/ Phone 20.44% Visits Without Any Calls 20.17% Visits Without Out Calls 14.25% Unknown Employees 5.72% Visits Without In Calls 5.21% Missing S ervice 12.55%

Visit exceptions are error flags thrown on a visit that is missing one or more required points of data.

Questions

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Contact I nformation

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Lana Eggers EVV@ state.co.us www.colorado.gov/ hcpf/ evv

Thank you!

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