Electronic Visit Verification General Stakeholder Meeting July 21, - - PowerPoint PPT Presentation

Electronic Visit Verification

General Stakeholder Meeting

July 21, 2020

1

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 Mandate Readiness Resources and S upport Proj ect Updates 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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State EVV Solution Technologies

Mobile Application Telephony Provider Web Portal

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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.

• Capture location where the service occurs

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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

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Questions

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EVV Implementation Timeline

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• 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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• The S

tate EVV S

• lution and Data Aggregator 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

• EVV will be required by section 8.001 of the Colorado Code of Regulation
• n August 3, 2020
• The Department will monitor compliance and outreach provider agencies

who are not fully utilizing EVV

• Providers who are experiencing unavoidable delays should contact the

Department

• Providers not making a earnest effort to utilize EVV may be subj ect to

Compliance Monitoring, Request for Written Response, or Overpayment Recovery

• On January 1, 2021, claims without corresponding EVV will deny

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What changes with the EVV Mandate?

Mandate Readiness

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Required Training

• Billing providers must complete training to

access the S tate EVV S

• lution OR the

Provider Choice Date aggregator.

• Training is online, self-paced, and available

now.

• First person to complete training for an

agency will be sent the agency’s access credentials within 48 hours.

• Providers agencies may contact the S

andata Help Desk for access credentials after completing training.

• Providers with multiple enrollments may

contact the S andata Help Desk to bypass multiple trainings.

• Training links can be found on the

Department’s EVV website.

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Top 5 Call-Center Questions

• Live-in Attestation Form
• eTRAC R

egistration*

• P

rovider P

• rtal P

assword R eset*

• Create a Client
• Unlock an Account*

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* Requires assist ance from S andata

Available on t he Depart ment ’ s EVV websit e under Resources

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Live-in Caregiver Questions

Available on t he Depart ment ’ s EVV websit e

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Create a Client

Available on t he Depart ment ’ s EVV websit e under S t at e S

• lut ion Page

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Create a Client

Time Frame

• August 3, 2020 to September 30, 2020

Compliance

• Training must be completed immediately
• Client and employee data must be entered immediately
• Providers must make an earnest effort to collect EVV data

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Implementation Expectations

Time Frame

• October 1, 2020 –

January 1, 2021

Compliance

• Improve the percentage of non-compliant claims billed
• Establish communication with the Department regarding any issues

impeding implementation

• Respond to Department guidance appropriately
• Overpayment recovery may be sought if no earnest effort is made to

collect EVV data

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Implementation Expectations

EVV Resources and Support

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• Caregiver Letter – EVV Mandate Details
• Caregiver Guide – Mobile Visit Verification Set -up
• Caregiver Guide – Mobile Visit Verification
• Caregiver Guide – Telephony Visit Verification
• Telephony Visit Verification – Quick Reference Guide

Available on t he Depart ment ’ s EVV websit e under Resources

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Caregiver Resources

• EVV Live-In Caregiver Attestation Form - Updated July 2020
• EVV Types of Service - Service Code Inclusions - February 2020

Available on t he Depart ment ’ s EVV websit e under Resources

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Provider Resources

HCPF Inbox

EVV@ state.co.us

DXC (Billing) Help Desk

Phone: 1-844-235-2387

EVV Help Desk

Phone: 1-855-871-8780 Email: COCustomerCare @ sandata.com

Provider Choice Interface

Phone: 1-844-289-4246 Email: COAltEVV @ sandata.com

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EVV Support Pathways

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EVV Support Pathways

Pathway Method Purpose Prepare Before Contacting Expected Initial Response Time EVV Help Desk 1-855-871-8780 COCustomerCare @ sandata.com Using S tate EVV S

• lution,

interfacing Provider Choice S ystems, S andata trainings, EVV accounts Nothing needed Phone: As soon as connected Email: within two business days DXC (Billing) Help Desk 1-844-235-2387 Provider billing or claims processing questions Nothing needed As soon as connected HCPF EVV Inbox EVV@ state.co.us

• Dept. approval of Live-in

Caregiver exemption, Policy and Program answers, Escalations from other support methods Live-in Caregiver Documentation for review, Help Desk documentation (Call number, who you talked to, etc.) Within a week

Project Updates

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• Live-in Caregivers may be exempt from EVV
• Provider agencies may choose to collect EVV from Live-in Caregivers
• Live-in Caregiver Attestation Forms must be submitted to the provider

agency or FMS vendor

• At this time, the Department only collects Live-in Caregiver Attestation

Forms for Part C: Extenuating Circumstances

• Do not send Part A or Part B forms to the Department
• Live-in Caregiver Attestation Forms must be updated annually or when

information becomes outdated

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Live-in Caregiver Touchbase

• Informal setting for questions about EVV implementation
• Open for all to listen to questions and responses
• No new policy or processes
• “ First and third Thursday” of each month
• First session on Thursday, July 23, 2020
• Available on t he Depart ment ’ s EVV websit e under S

t akeholder Informat ion

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EVV Listening Sessions

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

39

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Call Times: What To Expect

Wait Time for a Call Representative Time With a Call Representative 23.33 S econds 10.54 Minutes

EVV Department Analytics

41

42

Expected and Cumulative Percent of Providers Who Utilized an EVV System

Expected Percent 93.18% Cumulative Percent 21.99%

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Count and Percentage Breakdown of Billing Providers

36- HCBS 25- Practitioner 10- Home Health 14- S upply 48- Rehab 50- Hospice 27- S peech Thrpy 83- Behavr Thrpy 17- Physical Thrpy 28- Occptnl Thrpy 16- Clinic 09- Pharmacy 60- Personal Care 84- Behavr Thrpy

44

EVV System Use

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Most Common Visit Exceptions

Location Required 22.63% Unmatched Client ID/ Phone 21.49% Visits Without Any Calls 17.82% Visits Without Out Calls 14.43% Unknown Employees 5.84% Visits Without In Calls 5.31% Missing S ervice 12.47%

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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