Medicaid Requires GPS /EVV Tools to Track Your Services

Karen Lee

Ponderosa is ready, are you?

For those who offer ABA or medical services for any mandated home, community-based, and state plan services, Medicaid will require proof of the location and duration of these visits to each client. The 21st Century CURES Act passed in December of 2016 calls for an Electronic Visit Verification (EVV) system to be put in place by January 1, 2020, to avoid a reduction in federal Medicaid funding.
 
At Ponderosa, we have already begun a system upgrade in preparation to help you meet compliance with the EVV system. We will keep you informed of progress by making periodic announcements over the next few months on our application status. You will need to select us from the federal and state provider lists, or we can modify your systems to help you report these details for verification:

  • Date of the service
  • Individual providing the service
  • Individual receiving the service
  • Location of service delivery
  • Time the service begins and ends
  • Type of service performed

The Department of Health Care Policy and Financing (the Department) will require all Medicaid providers to use the EVV system. The state of Colorado will implement a similar application for federally funded services as well as some additional support areas. Participation is mandatory and currently includes:

  • Consumer-Directed Attendant
  • Homemaker
  • Hospice
  • In-Home ABA Services
  • In-home RN, PT, LPN, OT, CNA, or SLP Care
  • In-home Setup of Durable Medical Equipment
  • Training for Independent Living Skills or Life Skills
  • In-home Occupational and
  • Behavioral Therapies
  • In-home Physical Therapy
  • In-home Speech Therapy
  • In-home/Community Respite
  • Pediatric Personal and
  • Behavioral Health Care
  • Personal Care
  • Private Duty Nursing
  • Youth Day

*Facility-based Per Diem Services, Managed Care, PACE, and other Capitated Services are exempt from
EVV

The Colorado EVV program is a hybrid model allowing a provider agency to choose to use the state EVV solution or an alternate EVV vendor, such as Ponderosa. The Department has subcontracted with Sandata Technologies to provide mobile applications, telephony, and a provider web portal. If you use Ponderosa, we will ensure that your system conforms to Colorado EVV rules and requirements and is able to interface with the Sandata system to offer:

  • Enhanced care coordination and quality outcomes. 
  • Reduced billing errors and improved payment accuracy.
  • Improved Health and Welfare to individuals receiving services.

A list is of vendors who have interfaced with Sandata in other states is available on the Electronic Visit Verification web page. The Department recommends providers make their alternate vendor choices by the end of July 2019 to allow time for interface testing and to have a functional EVV solution by January 1, 2020. Providers participating in the Colorado EVV program and using Ponderosa as their EVV vendor will receive two documents with instructions from federal and state programs.

  • A document with basic specifications for receiving information from a third-party EVV vendor containing the details of clients, employees, visits, and their communications, as well as the ability to send changes regarding the appointment.
  • An addendum describing any additional requirements specific to the state of Colorado.

To review technical requirements, go to Electronic Visit Verification web page under the Resources drop-down section. Questions can be directed to the Department of Health Care Policy and Financing at evv@state.co.us or by contacting Ponderosa.

We value our relationship with you and want you to be well-informed about our participation and how it will affect your billing and claims processes. We are here to answer any questions or concerns. Contact us.

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