Home Health Final Rule 2021

Pennsylvania EVV Update

In this edition of the Alora Home Health blog, we turn attention to the state of Pennsylvania, and its EVV implementation. If care providers have not already started implementing electronic visit verification (EVV), providers are at risk of being out of compliance on January 1, 2021.

The Latest on Pennsylvania EVV Implementation

 

All claims and encounters for personal care services subjected to EVV requirements for dates of service on or after January 1, 2021 must have a corresponding electronic visit or claims payment will be impacted. Manual editing compliance rates will also go into effect on January 1, 2021. Please reference the recently released bulletins Electronic Visit Verification (EVV) for Personal Care Services (PCS) Bulletin, number 07-20-04, 54-20-04, 59-20-04, 00-20-03 and Electronic Visit Verification for Personal Care Services Provided in Fee-for-Service Delivery System, number 05-20-03 for additional details.

Support volume is expected to increase now through the end of January. Please be aware that response time may be longer than normal during this time. 

If you do not have a working EVV system at this time or are experiencing difficulties integrating your Alternate EVV system with the DHS Aggregator, DHS strongly encourages you to consider using the DHS Sandata EVV system as an interim solution to mitigate payment impacts.  Providers electing to use the DHS Sandata EVV system must complete Sandata’s “Pennsylvania DHS – Electronic Visit Verification (EVV) Self-Paced Training for Agency Providers” training in order to receive credentials to use the system for OBRA, Act 150, and Offices of Developmental Programs and Medical Assistance Programs fee-for-service participants. Please begin this process as soon as possible by completing the sign-up form here: https://sandatalearn.com/?KeyName=PAEVVAgency.

Upon completing the self-paced training required for using the DHS Sandata EVV system, providers will be issued a Welcome Kit, including their agency’s production credentials.  Providers must setup their agency and direct care workers and activate members in the EVV Provider Portal as well as train the rest of their staff on how to use the system, including the Sandata Mobile Connect™ application and Telephonic Visit Verification (TVV™) visit capture modalities to their direct care workers.  Providers should be aware of the time involved with completely setting up the DHS Sandata EVV system.  The time for complete setup will vary by agency.

Click here to view Alora’s Pennsylvania DHS EVV System

Common Questions

 

Q:  I am using the DHS Sandata EVV system and my password has expired.  How do I reset my password?

 

A:  Please note Sandata passwords must be renewed every 60 days.  You should be resetting your password prior to expiration.  If your password has expired, the Provider Assistance Center (PAC) can assist you in resetting your password.  PAC may be contacted via email at papac1@dxc.com

 

Q: I am using the DHS Sandata EVV system and I do not see all of my visits in “Visit Maintenance.”  How do I view all of my visits? 

 

A:   The default setting in the Visit Maintenance module is for providers to identify all visits with exceptions that require acknowledgment or fixes from the current day.  In order to see all visits, navigate to the Visit Maintenance module >> update your Date Range parameters >> above the search button select the drop-down feature in the “FILTER VISITS BY” field and click “ALL VISITS,” >> click [Search]. 

 

Q: I am using an Alternate EVV system.  How do I view my visits in the DHS Aggregator?

 

A:  Log into the DHS Aggregator and navigate to “Visit Review” on the menu. Update your search parameters, ensuring the “FILTER VISIT BY” drop-down has “All Visits” selected and your Date Range covers all of the dates where visits occurred that are in question, then click [Search].  For additional guidance, please refer to the “Online Manual” accessible from the DHS Aggregator Portal menu

 

Alternate EVV agencies should review the exceptions and will need to log into their own EVV system to make the needed updates/corrections and resubmit those visits in an AltEVV file to the DHS Aggregator.

 

Your Agency System Administrator/Trainer can also refer to the ” PA-DHS Alt EVV – AGGREGATOR Self-Paced” training on the Sandata Learning Management System (LMS): https://www.sandatalearn.com/?KeyName=PAAltevv.

 

Q: My visits are showing exceptions, how do I fix this?

 

A:  If your agency uses the DHS Sandata EVV system, log into the EVV Provider Portal and click on Visit Maintenance. Then, update your search parameters, “FILTER VISIT BY” drop-down has “All Exceptions” selected and your Date Range covers all of the dates where visits occurred that are in question, then click [Search]. 

 

To resolve exceptions, please refer to Chapter 8 Visit Maintenance, Sections 8-17 “Identifying Exceptions” and 8-19 “Correcting Exceptions” from the EVV Sandata Training Guide available on the PA-DHS EVV Webpage at: https://www.dhs.pa.gov/providers/Billing-Info/Documents/PA-DHS%20Standard%20Sandata%20EVV%20Agency%20Provider_Participant%20Training%20Guide_w%20Scheduling%20and%20Billing%20Master_10.04.2019.pdf

 

If you are an Alternate EVV agency, log into the DHS Aggregator and navigate to “Visit Review” on the menu.  Then, update your search parameters, ensuring the “FILTER VISIT BY” drop-down has “All Exceptions” selected and your Date Range covers all of the dates where visits occurred that are in question, then click [Search].  Alternate EVV agencies should review the exception results and will need to log into their own EVV system to make the needed updates/corrections and resubmit those visits in an AltEVV file to the DHS Aggregator.  For additional guidance, please refer to the “Online Manual” accessible from the DHS Aggregator Portal menu.

 

Q: Why do I get a duplicate e-mail error in the Employee Module?

 

A:  Verify you do not have a double entry in the Employee module for the same staff member.  If so, please make one inactive and delete the e-mail to avoid the duplicate error.

 

Q:  My client was just approved for services but isn’t showing up in DHS Sandata EVV system. When can I expect the client to show in my system?

 

A:  Please allow 1 week for the client to show in your Sandata EVV system from the date of the authorization. If services need to be rendered prior to this time, log visits as an unknown client until the recipient shows in DHS Sandata EVV.   

 

Q:  How do I train my staff to use DHS Sandata EVV system? 

 

A:   Providers are responsible for training staff to use the DHS Sandata EVV system. The agency administrators who completed the training should be training others. While the Sandata LMS system is limited to 2 accounts per provider agency, the agency administrator/trainer can choose to use their account to share the Sandata LMS content. The administrator/trainer can display their screen and walk staff through the designated areas to which they need to train (e.g., Sandata Mobile Connect application). 

 

Q: I am using an Alternate EVV system for Pennsylvania and I received my production credentials. What do I do now?

 

A: If you have been provided Production Credentials, you should be accessing those credentials within 24 hours of receipt. Providers must then confirm their EVV data is viewable in the DHS Aggregator to complete the certification process.  Once the provider views the data, providers must contact the PA Alternate EVV Support Team to confirm by email at PAAltEVV@sandata.com or by phone at 1-855-705-2407.

 

Q: I am using an Alternate EVV system and I am experiencing rejections.  Who should I contact?

 

A: If your agency is receiving claims that set either ESC 927 or ESC 928, first log into the DHS EVV Aggregator Portal to confirm that your EVV visit data has been received and is correct.  If your EVV data for the matching visit(s) are found and all data elements are accurate, please contact your Alternate EVV vendor to determine whether they received a Sandata Technologies error file for your agency. If so, the vendor should review the Sandata error file and determine whether the provider or vendor need to make the required changes.  If further support is needed to resolve a technical error, you should reach out to the PA Alternate EVV Support Team by phone at 1-855-705-2407 or by email at PAAltEVV@sandata.com.

 

Q: Do I need to use EVV if I am providing services remotely?

 

A: EVV is required for personal care services, including those approved by ODP to be offered as remote services due to COVID-19.  Caregivers can clock in and out using EVV in the community regardless of whether the address is in the system. The location of the service delivery is a requirement but there will be no validation against the “location of service delivery” found in the DHS Aggregator record at this time. 

 

Q: Who should I contact with billing questions?

 

A: Billing questions should be directed to the appropriate DHS program office: 

 

ODP Claims Resolution Section

1-866-386-8880,RA-odpclaimsres@pa.gov

Hours of operation: Monday-Friday, 8:30 a.m.-noon and 1-3:30 p.m.

OLTL Provider Call Center

1-800-932-0939

Hours of operation: Monday-Thursday, 9 a.m.-noon and 1-4 p.m.

Do not forget you have available resources on the PA DHS EVV website link provided here: https://www.dhs.pa.gov/providers/Billing-Info/Pages/EVV.aspx

Including a FAQ’s page: https://www.dhs.pa.gov/providers/Billing-Info/Pages/EVV-FAQ.aspx,  which may answer a majority of your questions as well.

 

DHS APPROVED ALTERNATE EVV SYSTEM

 

Pennsylvania EVV Alternate VendorAlora is a certified alternate EVV vendor for Pennsylvania. Alora is a strong alternative to the state offered free solution with minimum functionality. Why just get by when you can THRIVE with a powerful EVV solution that is part of a complete agency management system, Alora.

 

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Read the Alora blog for industry news, including recent news, articles, and commentaries, as well as other issues that pertain to Homecare in the U.S and beyond. For more information on this topic, or others in the homecare spectrum, please send us an email to HomeHealthSoftware@Alorahealth.com

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