Home Health Final Rule 2021

Wisconsin Electronic Visit Verification

Following similar requirements born of the 21st Century Cures Act legislation, Electronic Visit Verification has been mandated in the state of Wisconsin. What is the official start date?  What care organizations does it apply to, and what are the unique requirements? Is Wisconsin an open model state in terms of the EVV system agencies must use? We will delve into all of these questions and then some as we hone in on EVV in the state of Wisconsin. 

 

EVV for Wisconsin Agencies

 

TO VIEW THE WISCONSIN EVV SOFTWARE SOLUTION BY ALORA – CLICK HERE

 

 

Wisconsin Electronic Visit Verification Information

At its onset, EVV nationwide mandates were derived from the requirements of the 21st Century Cures Act. The Federal 21st Century Cures Act (2016) requires Wisconsin to implement a new electronic visit verification (EVV) system for agencies delivering certain types of care in the state. Electronic Visit Verification (EVV) software by definition is a system designed to electronically capture and verify provider visit information.

 

WISCONSIN EVV REQUIREMENTS

What are the requirements of Wisconsin agencies per the EVV provided information by the state?

In concert with the 21st Century Cures Act, Wisconsin agency requirements for EVV visits note that any approved system must electronically capture:

  • The name of the patient who receives the service
  • The name of the caregiver who provides the service
  • The exact type of care/services that were provided
  • The exact location of the services were provided
  • The exact date of services provided
  • The start and end time of the visit 

 

WHAT IS THE START DATE FOR WISCONSIN EVV?

Wisconsin Electronic visit verification had an original soft launch date of September 1, 2020, however, due to the COVID-19 pandemic, the Wisconsin Department of Health services officially delayed the start of training as well as the soft launch date requirement to use EVV for personal care services. The new soft launch implementation date was November 2, 2020, as the Wisconsin Department of Health Services (DHS) implemented the soft launch phase of electronic visit verification (EVV) for Medicaid-covered personal care and supportive home care services: procedure codes T1019, T1020, S5125 and S5126.* 

On its official website, the Wisconsin DHS states that it is committed to working with stakeholders to integrate Wisconsin EVV while maintaining services and ensuring needed care is delivered. DHS will not deny claims or disregard submitted encounters without EVV data during the soft launch period.

This soft launch phase will integrate EVV into the visit and claims process and prepare for the hard launch phase of EVV. The date for the hard launch (official launch) of the EVV program in Wisconsin has not been set as of November 2020.

*Beginning January 1, 2021, EVV will be required in the IRIS program for procedure codes S5125 and S5126

EVV in Wisconsin is still on course to be rolled out in two phases, with the hard launch to follow the already initiated soft launch. When the hard launch begins, DHS will require personal care services claims to include all required EVV information, or they risk claim denial.

 

AGENCIES CAN CHOOSE A WISCONSIN EVV SYSTEM

 

Agencies may elect to use a Wisconsin DHS EVV system (Sandata), or an alternative EVV system so long as such system meets all EVV requirements set forth by the state. Sandata’s aggregator technology allows providers who use Alora (and select other systems) to continue to use their system of choice (systems will need to meet EVV & DHS aggregator requirements). Sandata aggregator will work with any Wisconsin EVV system that meets the technical requirements. Technical specification details are forthcoming from Wisconsin’s DHS.

 

FINDING A COMPLIANT WISCONSIN EVV SYSTEM

 

Wisconsin Medicaid EVVAs agencies are free to choose any compliant EVV system for Wisconsin, Alora Home Health Software for Wisconsin offers an award-winning solution, consistently rated as the easiest to use by nurses and administrators alike. Alora is an approved EVV system for Wisconsin Medicaid EVV. Caregivers can complete visits on their smartphones or tablets…while administrators can enjoy the power of managing the entire agency from the convenience of their mobile devices or desktop computers. Alora was engineered with the expertise of real home health professionals and software technology experts, resulting in an extraordinarily easy to use software system. With free training and an easy to use interface, agency adoption is seamless and quick.

WISCONSIN HOMECARE BILLING AND PAYROLL SOFTWARE

EVV data captured by Alora’s electronic visit verification software automatically flows into Alora’s main Home Health Software for Wisconsin agencies. Once a caregiver departs from the patient’s home, visit information automatically updates within Alora, including the date of the visit with start and end time. The visit is then marked as complete, automating the process of preparation for billing and payroll. Any visits that are not executed as planned are immediately flagged within Alora Homecare software for manual review.

Visit the following link to learn more about Alora’s complete software for Wisconsin home health agencies.

 

CAN I CHOOSE ANY WISCONSIN EVV SOFTWARE SYSTEM I WANT TO USE?

Yes.

Wisconsin DHS has chosen to implement EVV as an open model allowing providers to use their own EVV systems/third-party vendors. Providers using an alternate Wisconsin EVV system are responsible for the costs of that solution and are required to ensure its compliance with the rules set forth by Wisconsin DHS. 3rd party EVV system requirements are posted to the Wisconsin Department of Health Services office page.

 

IF I SELECT AN ALTERNATE WISCONSIN EVV VENDOR, HOW DO I KNOW IT IS COMPLIANT?

In concert with the requirements set forth in the 21st Century Cures Act, Wisconsin agencies may use any compliant EVV system that meets the following verification criteria:

  • The EVV system must identify the individual administering the service during the visit
  • The EVV system must identify the provider agency that employs or contracts with the individual providing the service.
  • The EVV system must identify the patient receiving the service during the visit
  • The EVV system must record the date of the visit
  • The EVV system must independently verify the official start and end time of the visit
  • The EVV system must record the location of the visit

 

Investigate and ask questions of any potential EVV vendor to ensure the system they offer is capable of meeting these requirements prior to implementation. 

 

Alora is an Approved Vendor by the Wisconsin Department of Health Services (DHS)  For DHS Compatible EVV Software

MassHealth EVV Requirements

 

 

 

THE ALORA HOME HEALTH BLOG

Read the Alora blog and website to learn more about home health software for Wisconsin, Wisconsin DHS compatible EVV, and recent news, articles, and commentaries, as well as other issues that pertain to Wisconsin Home health care in the state and beyond. For more information on our blog, or for questions or feedback, please send us an email to HomeHealthSoftware@AloraHealth.com

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