Electronic Visit Verification

Young female nurse comforting elderly lady










The 21st Century Cures Act—which was signed into law in the US in 2016—requires state agencies to implement a system of electronic visit verification (EVV) for personal care services and home health care services provided and reimbursed under Medicaid. The EVV mandate is designed to ensure that people get the care they are promised, and to cut down on fraudulent care claims. It has many repercussions on home care agencies, and whether those repercussions are good or bad varies by agency.

EVV electronically captures:

  • The service provided by a home care agency employee
  • The time that a visit began and ended
  • The individual who received the service
  • The date and location of the provided service

It provides a digital record of a home care visit.

The purpose behind the EVV mandate is to track home healthcare providers and ensure the visits they’re reporting to CMS (Centers for Medicare & Medicaid Services) are actually taking place, ensure patients are getting the care they require, and confirm that Medicaid is being accurately billed. The last point here being particularly important. In fact, in fiscal 2014, the U.S. government recovered $3.3 billion from individuals and companies that attempted to defraud federal health programs. [1]

From January 1, 2019 onward, reimbursement for Medicaid services rendered will be tied to meeting EVV requirements. Personal care agencies must be compliant by January 1st, 2020. Every agency will need a solution in place to verify all their reimbursable caregiver visits.

What are the implications on individual home care agencies?

Firstly, it’s important to know what services must be electronically verified. If a personal care or healthcare service is provided in a private home, and if Medicaid or Medicare is paying for it, EVV is required. Care services that are provided to hospital inpatients or nursing home residents do not require EVV.

EVV has many possible implications for home care agencies (HCAs), including the potential to improve the quality of care given, reduce scheduling and visit verification errors, allow agencies to comply with government regulations, get an edge over the competition, and achieve happier clients.

In terms of compliance, it’s important to consider how EVV is mandated in different states. In a “closed model,” a state implements a single EVV system and mandates that home care providers utilize it. In an “open model,” home care providers have the option to choose from a variety of EVV solutions that have been certified as meeting certain requirements. Agencies not adhering to EVV regulations may be penalized or have their Medicare contracts cancelled. Even with the prospect of regulatory concerns, EVV doesn’t have to be an example of bureaucratic red tape. It represents a valuable opportunity to future-proof organizations and provide employees with the tools they need to help them work faster and smarter, delivering the best possible patient experience. In order to accomplish this, it’s important to consider the role that a workforce management solution plays.

Most states and agencies are opting for mobile solutions because they are less expensive than bio-metric scanners and more reliable than landline phones, which many people no longer have. Celayix represents a perfect solution to the EVV problem, acting as a simple, easy to use approach to accommodate EVV requirements.

How can a workforce management solution like Celayix help HCAs capitalize on EVV?

1) Government compliance:

As previously mentioned, a powerful workforce management solution like Celayix can remove red tape and allow for smooth regulatory sailing. With our software, providing a digital record is easy. With features like geo-fencing and real-time communication, you can ensure employees and team members are visiting the relevant locations and providing adequate care. Having centralized data on a single digital platform takes away the stress and worry of governmental non-compliance.

2) Eliminate missed visits, late starts, and time theft:

Major problems within the home healthcare industry are employees missing shifts due to miscommunication, confusion leading to lateness, and even over-billing hours. Using intuitive software like Celayix Time Xpress allows for management to supervise, monitor and collect information on-the-go while communicating with staff through messaging functionality. By monitoring attendance, and communicating with employees in real time though their mobile or tablet, HCAs can eliminate missed shifts, lateness, and decrease the risk of fraud.

3) Improve business processes:

By deploying smartphones to field workers, home care agencies will be able to do more than just meet the EVV mandate and improve communication: They can also significantly enhance business processes. Metrics like efficiency and productivity are often talked about, but rarely defined and measured.

With the implementation of workforce management software comes the ability to vastly improve scheduling and time monitoring processes, all while integrating with your existing platforms (payroll, billing, electronic health records, etc). Once an organization can easily publish and modify shifts, apply rules-based scheduling, and instantly communicate with employees, a huge amount of administrative time and effort can now be focused on other more value-driven areas.

4) Improved patient care and client satisfaction:

HCAs have a lot on their plates. With bureaucratic considerations like regulatory compliance and scheduling, it’s easy to forget their main purpose: caring for patients. The mission statement of any HCA will usually read something along the lines of helping to care for others and improve their quality of life. So when using an adaptable solution like Celayix, the plethora of secondary concerns that tend to shackle HCAs can be tossed aside, opening up opportunities to provide excellent service for satisfied clients.

Celayix – The Perfect Partner

At Celayix, we specialize in best-of-breed employee scheduling software, with a whole host of  additional workforce management functionality. With the upcoming implementation of Electronic Visit Verification, home care agencies are being asked to make a big step in to the future. We can help you to take this leap, solving your business problems and supporting your business along the way.

If you’d like to find out a bit more about who we are, what we do, or how we can help, our attentive support staff are always happy to help.

Alternatively, you can take a product tour below, where you’ll see some of the problems we solve for customers, and how the software actually works.

Time Xpress

Team Xpress

Schedule Xpress