Electronic visit verification (EVV)

EVV is the state’s proof that a home visit happened. Each state Medicaid program decides which services need it, usually personal care and home health services paid by Medicaid, and how the data is collected. Some states run a single vendor every provider must use; others run an open model where agencies use their own EVV vendor and send the visit data to a state aggregator. The caregiver records the visit through a mobile app at the client’s address, a call from the client’s telephone, or a fixed device in the home. Whatever the method, the record carries the same facts: the service, the client, the caregiver, the date, the location and the time the visit began and ended.

On the claim, the state or its managed care plans match each billed line to a verified visit before paying. No visit record, no payment. A visit whose times do not cover the units billed, whose service code differs from the one authorized, or whose caregiver is not linked to the agency in the EVV system produces a denial or a pend even though the care was delivered.

The mistake is treating EVV as the caregiver’s problem. The visit record is a claim document. Reconcile verified visits to the schedule every day, clear exceptions before the billing run, and bill from the verified visits rather than from the schedule, because the schedule is what the state will not pay.