electronic visit verification visit verification...solution which verifies information through...
TRANSCRIPT
Electronic Visit Verification
General Stakeholder Meeting
July 21, 2020
1
Our Mission
Improving health care access and outcomes for the people we serve
while demonstrating sound stewardship of financial resources
2
WELCOME Stakeholders
• HCPF Introductions
• Housekeeping
3
Meeting Purpose
The purpose of this meeting is to engageproviders, members, and other stakeholders asthe Department works to implement EVV forcommunity based services offered through boththe State Plan and Waivers.
And specifically to:
• Review EVV, the legislative mandate, and the scope of implementation
• Discuss EVV Project Updates
• Provide a platform to gather stakeholder feedback
44
Meeting Guidelines
We ask that you:
• Mind E-manners
• Identify yourself when speaking
• Share the air
• Listen for understanding
• Stay solution and scope focused
55
Agenda
Introductions
Brief Overview of EVV
Implementation Timeline
Mandate Readiness
Resources and Support
Project Updates
Sandata Call Center Report
Department Data Analytics
Open Forum
6
Overview of EVV
7
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
• Section 12006 of the 21st Century Cures Act requires all state Medicaid agencies implement an EVV solution
• States 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
88
State EVV Solution Technologies
Mobile Application Telephony
Provider Web Portal
9
What must EVV Capture?
TYPE OF SERVICE PERFORMED
INDIVIDUAL RECEIVING THE
SERVICE
DATE OF THE SERVICE
LOCATION OF SERVICE DELIVERY
INDIVIDUAL PROVIDING THE
SERVICE
TIME THE SERVICE BEGINS AND ENDS
10
• Personal Care
• Pediatric Personal Care
• Home Health: RN, LPN, CNA, PT, OT, SLP
• Private Duty Nursing
• Hospice
• Homemaker
• Respite (provided in the home or community)
• Consumer Directed Attendant Support Services (CDASS)
• In-Home Support Services (IHSS)
• Independent Living Skills Training (ILST)
• Life Skills Training
• Physical Therapy (provided in the home)
• Occupational Therapy (provided in the home)
• Speech 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
11
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
TherapyHomemaker 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
12
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
1313
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 Systems must connect to the Data Aggregator
14
Questions
15
EVV Implementation Timeline
1616
• 9/18/19: Good Faith Effort Exemption request approved by CMS
• 10/1/2019: State EVV Solution and Data Aggregator went live
• 10/1/2019 – 8/2/2020: Soft-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
17
• The State EVV Solution 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 Soft-Launch
18
Soft-Launch Review
• EVV will be required by section 8.001 of the Colorado Code of Regulation on 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 subject to Compliance Monitoring, Request for Written Response, or Overpayment Recovery
• On January 1, 2021, claims without corresponding EVV will deny
19
What changes with the EVV Mandate?
Mandate Readiness
20
Required Training
• Billing providers must complete training to access the State EVV Solution 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 Sandata Help Desk for access credentials after completing training.
• Providers with multiple enrollments may contact the Sandata Help Desk to bypass multiple trainings.
• Training links can be found on the Department’s EVV website.
21
Top 5 Call-CenterQuestions
• Live-in Attestation Form
• eTRAC Registration*
• Provider Portal Password Reset*
• Create a Client
• Unlock an Account*
2222
* Requires assistance from Sandata
Available on the Department’s EVV website under Resources
23
Live-in Caregiver Questions
Available on the Department’s EVV website
24
Create a Client
Available on the Department’s EVV website under State Solution Page
25
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
26
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
27
Implementation Expectations
EVV Resources and Support
28
• 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 the Department’s EVV website under Resources29
Caregiver Resources
• EVV Live-In Caregiver Attestation Form - Updated July 2020
• EVV Types of Service - Service Code Inclusions - February 2020
Available on the Department’s EVV website under Resources
30
Provider Resources
HCPF Inbox
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
31
EVV Support Pathways
32
EVV Support PathwaysPathway Method Purpose Prepare Before
ContactingExpected Initial Response Time
EVV Help Desk
1-855-871-8780
Using State EVV Solution, interfacing Provider Choice Systems, Sandata 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 [email protected]
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
3333
• 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
34
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 the Department’s EVV website under Stakeholder Information
35
EVV Listening Sessions
Sandata Call Center Report
36
38
Total Incoming Calls
Percent of Calls Captured
39
40
Call Times: What To Expect
Wait Time for a Call Representative Time With a Call Representative
23.33 Seconds 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%
43
Count and Percentage Breakdown of Billing Providers
36- HCBS
25- Practitioner
10- Home Health
14- Supply
48- Rehab
50- Hospice
27- Speech Thrpy
83- Behavr Thrpy 17- Physical Thrpy
28- Occptnl Thrpy 16- Clinic
09- Pharmacy
60- Personal Care
84- Behavr Thrpy
44
EVV System Use
45
Most Common Visit Exceptions
Location Required22.63%
Unmatched Client ID/Phone21.49%
Visits Without Any Calls
17.82%
Visits Without Out Calls
14.43%
Unknown Employees
5.84%
Visits Without In Calls5.31%
Missing Service12.47%
Visit exceptions are error flags thrown on a visit that is
missing one or more required points of data.
Questions
46
Thank you!
48