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Electronic Visit Verification (EVV): Information for IRIS Participants, IRIS Consultants, IRIS Providers, FEAs, and Payers

Silhouette of an adult in a wheelchair at sunset

The 21st Century Cures Act is a federal law that was passed in 2016. It requires each state, including Wisconsin, to collect visit information using an electronic visit verification (EVV) system. The law helps make sure that participants receive the services needed. If the Wisconsin Department of Health Services (DHS) doesn’t follow this law, Wisconsin will lose money for Medicaid services.

In IRIS, EVV is required for self-directed personal care services and routine supportive home care services (services provided under service codes S5125, S5126, T1019).

Here's how it works

When a worker arrives to care for you, they will do a quick check-in to record visit details. They may use a smart phone or tablet to capture the date, time, location, and service. In some cases, they may use a small digital device or your landline telephone. They will check out at the end of the visit too.

If you need help right away before your worker checks in, that’s okay. The check-in step can be done after your worker makes sure you are all set. The check-in time can be fixed in the system later.

EVV is secure and compliant with the Health Insurance Portability and Accountability Act (HIPAA).

What you are responsible for with EVV depends on how you hire workers

Option 1: I hire my own workers and work with a fiscal employer agency

This means you do not work with a provider agency to coordinate workers. You are your workers' employer in the IRIS Program. You are responsible for making sure your workers follow IRIS policy. EVV is part of that policy.

 If you hire your own workers and work with a fiscal employer agency, then you are responsible for making sure your workers use EVV.

Who do I contact for support?What can they help with?What's their contact information?
Your fiscal employer agency (FEA)
  • Explain your role in EVV and why it’s required.
  • Answer EVV system questions (for example, trouble with using an EVV system, logging a visit, password resets or EVV ID information, making corrections, fixing incorrect punches, errors).
  • Let you know where to find EVV training and resources.
  • Let you know which workers are required to use EVV.
  • Provide EVV set-up information for non-live-in participant-hired workers.
  • Answer worker questions about EVV.
  • Answer payroll and timesheet questions.

Acumen/Outreach: www.acumenfiscalagent.com/state/wisconsin/

GT Independence: www.gtindependence.com/state/wisconsin/wi-evv/

iLIFE: www.ilife.org/evv/evv-information-and-training/

Premier: premier-fms.com/evv-resources/

Your IRIS consultant
  • Explain your role in EVV and why it’s required.
  • Discuss EVV’s impact on your enrollment in the IRIS program.
  • Let you know which workers are required to use EVV.
  • Share how your workers are doing with EVV.
  • Let you know where to find EVV training and resources.
  • Practice how to talk with workers about the seriousness of EVV, what is required, and your options if your worker doesn’t capture visit information using EVV.
  • Discuss the EVV grace period for new IRIS participants.

Advocates4U:

First Person Care Consultants:

Lutheran Social Services Connections:

Midstate Independent Living Choices, Inc.:

Progressive Community Services, Inc.:

TMG:

Wisconsin EVV Customer Care
  • Answer general questions about EVV and why it’s required.
  • Let you know which workers are required to use EVV.
  • Share how your workers are doing with EVV.
Wisconsin EVV Customer Care:
833-931-2035
Email: vdxc.contactevv@wisconsin.gov
Monday–Friday 7 a.m.–6 p.m. CT
Your IRIS ombudsmanListen to your concerns and help you solve problems that come up.

Disability Rights Wisconsin (for participants ages 18-59):

Board on Aging and Long-Term Care (for participants ages 60 and above):

IRIS Complaints and Grievances HotlineCommunicate unresolved issues to the Wisconsin Department of Health Services.

IRIS Complaints and Grievances Hotline

If a printed version is preferred, print the IRIS Participant Contact Sheet, P-03485, available in English, Hmong and Spanish.

  • Participant-hired workers who do not live with you will need to use EVV.
  • If your worker lives with you, that worker will not have to use EVV. Your IRIS consultant can help you submit the proper paperwork for your live-in worker.

As the employer, you are responsible for making sure your workers use EVV. If your participant-hired worker (who does not live with you) is not using EVV as required, you may be disenrolled from the IRIS program.

You, as the employer, will need to make sure your workers know how to use EVV.

Your fiscal employer agency (FEA) chooses which EVV system participant-hired workers will use. If you need information about your worker’s EVV system or help finding training resources, contact your FEA first.

Your IRIS consultant can also help you find the resources to train your participant-hired workers.

  • Ask if your worker checked in and out for every visit.
  • Provide EVV training materials and resources from your FEA. Your IRIS consultant can help you find these resources, too.
  • If your worker made a mistake when entering information in the EVV system, or forgets to check in or out, follow your FEA’s EVV correction process.
  • Talk with your IRIS consultant about how your workers are doing during your monthly contact. Your IRIS consultant will have this information ready to share at each meeting.
  • Ask your IRIS consultant for help if you aren’t sure how to talk to your workers about the importance of EVV.

FEAs will pay participant-hired workers’ claims in a timely manner and work with participants and participant-hired workers to resolve missing or inaccurate EVV data.

The DHS-provided Sandata EVV system identifies the worker's location at the start and end of the visit. It does not track location before, after, or during the visit. Other EVV systems may work differently. Please check with your FEA regarding their system. At this time, the GPS location data is informational only.

Option 2: I work with a provider agency to coordinate workers

This means you do not hire your own workers. Your provider agency is the employer, and they are responsible for making sure their workers use an EVV system.

 If you work with a provider agency to coordinate workers, then your provider agency is responsible for making sure their workers use EVV.

Your provider agency will determine which workers need to use EVV.

The provider agency will need to manually create the EVV visit or their claims for payment will be denied.

No, you do not need to train the provider agency’s workers. The provider agency will manage EVV requirements, including training.

The DHS-provided Sandata EVV system identifies the location at the start and end of the visit. It does not track location before, after, or during the visit. Other EVV systems may work differently. Please check with your provider agency about the EVV system they are using.

IRIS consultant resources

Yes, a worker might need to check in and check out more than once during a single visit with one participant because:

  • A worker provides personal care services and supportive home care services that are paid by two different programs (fee-for-service Medicaid personal care [MAPC] and IRIS).
  • A worker is paid by a fiscal employer agency to provide self-directed personal care services and is paid by a different agency to provide supportive home care services.
  • A participant-hired worker provides self-directed personal care services (T1019) and supportive home care services (S5125) and their FEA’s EVV system requires a check in and check out for each service.

Examples of Services and Corresponding EVV Systems

Personal Care Service
Payer/ServiceProvider TypeEVV System Used
Fee-for-Service Medicaid Personal CareAgencyProvider Agency's
Fee-for-Service Medicaid Personal CareAgencyProvider Agency's
IRIS Self-directed Personal CarePHWFEA's
IRIS Self-directed Personal CarePHWFEA's
Supportive Home Care Service
Payer/ServiceProvider TypeEVV System Used
IRIS Supportive Home CareAgencyProvider Agency's
IRIS Supportive Home CarePHWFEA's
IRIS Supportive Home CareAgencyProvider Agency's
IRIS Supportive Home CarePHWFEA

IRIS resources for provider agencies, FEAs, payers

Glossary

 
Last revised December 4, 2024