Electronic Visit Verification (EVV) Implementation Tips
Nov 16, 2022
The federal deadline to implement the EVV requirements for Home Health providers delivering services under Section 40 and Hospice providers delivering services under Section 43 is January 1, 2023.
The following tips are designed to help providers’ EVV claims process in a timely manner.
Three-Day Recycle Period
Home Health and Hospice service claims with dates of service beginning on July 1, 2022, are subject to an EVV claim pend edit, unless a verified EVV record is found. The pend time is a three-day recycle period (which can be longer than three calendar days).
For examples of claim pend timelines, see the Claim Pend Process Timeline Examples (PDF).
Please enter EVV visit records in a timely manner as claims are evaluated against EVV records daily. The sooner a visit record is found for a claim within the three-day recycle period, the sooner the claim will process. To avoid the three-day recycle period, please make sure your verified EVV record is in the Sandata or alternate EVV system prior to submitting the accompanying claim.
Please note that claims may also pend for reasons other than EVV.
Providers who “span” bill should only do so when the services are on consecutive days. You should submit a separate claim line for each date of service when the dates of service are not consecutive. For example, you should only bill from December 1, 2022 – December 7, 2022, when services are provided on each day of that week. If you are providing services to a member on non-consecutive dates, such as Monday, Wednesday, and Friday, you should not span bill; otherwise, your claims will warn, then deny starting January 1, 2023, for no verified EVV record found on Saturday, Sunday, Tuesday, or Thursday. Please see the Weekly Billers of Personal Care Services Reminder (PDF) to review the e-message sent on December 8, 20202, about span billing, which is also applicable to providers of home health and hospice services.
Providers using the Sandata solution can take advantage of Sandata reporting to monitor trends for EVV exceptions.
Remember that claims can be reviewed in the MIHMS Health PAS Online Portal at any time if you wish to view the editing and processing status of claims in the system.
Third Party Vendor/Alternate EVV System
Communication between providers and their vendor is critical to the success of the integration process. Providers must resubmit any record with an exception or rejection. The provider and the vendor must have a process to resolve exceptions and rejected records prior to the implementation of the alternate EVV system. MaineCare, Gainwell, and Sandata are not able to determine this process.
To minimize GPS exceptions, providers should add any address to a member’s file where the provider will deliver EVV services. All addresses in the member’s file will be evaluated for GPS verification.
Providers are strongly encouraged to utilize all assistance and tools available to them:
See the State of Maine EVV webpage for more information, including Frequently Asked Questions (FAQs).
Go to the Health PAS Online Portal contains informational documents for assistance.
If you have questions, please email MaineCare's EVV email box or call Provider Services at 1-866-690-5585, option 3.
See the EVV webpage for more information, including Frequently Asked Questions (FAQ).
Please contact Provider Services with questions:
Email MaineCare's EVV email box
Call Provider Services at 1-866-690-5585, option 3