Electronic Visit Verification (EVV): FAQs

Section 12006(a) of the 21st Century Cures Act mandates that states implement EVV for all Medicaid personal care services and home health services that require an in-home visit by a provider. This applies to personal care services provided under sections 1905(a)(24), 1915(c), 1915(i), 1915(j), 1915(k), and Section 1115 and home health services provided under Section 1905(a)(7) of the Social Security Act or a waiver. States that do not implement EVV will experience financial penalties from the federal Centers for Medicare & Medicaid Services.

Providers’, workers’, and members’ information is protected under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). When a worker checks in and out of a visit using the Sandata system, the information captured is encrypted. The provider can see the information in the Sandata EVV portal in near-real time. Sandata also sends the encrypted data to DHS and payers. Payers match it with a claim or encounter in near-real time. Sandata also sends the encrypted data to DHS and payers. Payers match it with a claim or encounter.

EVV systems are required to capture location information at the beginning and end of visits. DHS will not deny a claim because of GPS information.

Providers using alternate EVV systems should contact their vendors for information about HIPAA and other data processes.

It depends on the situation.

DHS does require live-in workers to use an EVV system for home health care services and for the RN supervisory visit using code 99509.

DHS does not require use of an EVV system for live-in workers for personal care and supportive home care services, but HMOs, managed care organizations (MCOs), and providers can require live-in workers to use an EVV system. 

IRIS fiscal employer agents (FEAs) cannot require participant-hired live-in workers to use an EVV system.

See the “Live-in Worker Required by DHS to Capture EVV Information” column on the DHS EVV: Service Codes that Require Use of an EVV System in Wisconsin webpage for more information on which service codes always require live-in workers to use an EVV system.

If a live-in worker isn’t required to use an EVV system by DHS or their employer, their employer must submit a form that identifies them to their program. Identifying the live-in worker lets claims be paid without EVV information.

For more details, see EVV and Live-In Workers, P-03593 (PDF).

No, a worker's live-in status only applies to the member or participant they live with.

Yes. Workers must check in and out of visits using an EVV system when providing services for all required service codes, no matter where they are providing the service. Find all service codes that require EVV on the DHS EVV: Service Codes that Require Use of an EVV System in Wisconsin webpage.

Yes. If out-of-state care is approved, workers are required to check in and out of visits using an EVV system as usual.

EVV does not change existing policy about prior authorization for out-of-state travel, as described in Wisconsin Admin Code § DHS 104.01(6)(d) and ForwardHealth Online Handbook topic #279.

The SMC app only identifies the worker's location at the start and end of the visit. It does not track location before, after, or during the visit. Alternate EVV systems may work differently. Please check with your vendor.

At this time:

• GPS location information shown in the Sandata EVV portal is informational only. It does not prevent the EVV visit information from going to a “verified” status or being sent to DHS and payers.
• GPS data does not prevent claims from being paid.
• The Office of the Inspector General may look at GPS information when reviewing claims.

Employees are responsible for training their workers. For training workers on the Sandata EVV system, see the EVV: Training Workers webpage. Alternate EVV users should check with their vendor.

Providers can see the Service Codes that Require Use of an EVV System in Wisconsin webpage for a list of services and programs that require use of an EVV system.

DHS does not require members or participants to verify a visit or provide a signature for personal care services, unless the worker is using the EVV system to document record of care. See the Personal Care Worker Guidelines for Completing a Record of Care topic (#2500).

Home health care workers, including independent nurses, do not need to document individual tasks or collect a member's signature in the Sandata EVV system.

Alternate EVV systems, providers, and IRIS FEAs can choose to require signatures, even when DHS does not.

Sandata upholds rigorous standards for HIPAA privacy and data protection. The system encrypts information to make sure it is secure. Sandata is certified by the Health Information Trust Alliance (HITRUST) conducts regular mandatory training, and sends frequent communications to all Sandata employees about best data security practices.

The process for changing a member’s address and phone number has not changed with EVV. The member is responsible for keeping this information up to date.

The member can report changes to their local income maintenance agency or tribe, online on ACCESS (ACCESS in Spanish), or by using the Information Change Report, F-10183.

Members who also need to update their address with the Social Security Administration should request an address change specifically in the "SSI record." This will ensure the address change transfers correctly. Social Security Administration address changes may take a few weeks to process completely.

The process for changing a member’s address and phone number has not changed with EVV. The member is responsible for keeping this information up to date.

The member can report changes to their local income maintenance agency or tribe, online on ACCESS (ACCESS in Spanish), or by using the Information Change Report, F-10183.

Members who also need to update their address with the Social Security Administration should request an address change specifically in the "SSI record." This will ensure the address change transfers correctly. Social Security Administration address changes may take a few weeks to process completely.

The process for changing a member’s address and phone number has not changed with EVV. The member is responsible for keeping this information up to date.

The member can report changes themselves by contacting their local income maintenance agency or tribe, online on ACCESS (ACCESS in Spanish), or by submitting the Medicaid Change Report, F-10137.

Members who also need to update their address with the Social Security Administration should request an address change specifically in the "SSI record." This will ensure the address change transfers correctly. Social Security Administration address changes may take a few weeks to process completely.

The process for changing a participant’s address and phone number has not changed with EVV. The participant is responsible for keeping this information up to date.

The participant can:

• Contact their IRIS consultant, who can update that information in the DHS IRIS Care Management system. The IRIS consultant should also support the participant in reporting the address change to the income maintenance agency or the Social Security Administration, whichever is appropriate.
• Call the IRIS Call Center for help at 888-515-4747.

IRIS participants who also need to update their address with the Social Security Administration should request an address change specifically in the "SSI record." This will ensure the address change transfers correctly. Social Security Administration address changes may take a few weeks to process completely.

Members and participants may receive help with cell phone and internet services through programs like the Lifeline Program or Affordable Connectivity Program.

Providers can make sure claims are paid on time by making sure that EVV visits are in a verified status (no exceptions) in the Sandata EVV portal or aggregator before submitting a claim.

Fee-for-service providers will receive a claim denial on their remittance advice with an explanation of benefits (EOB) message. The two fee-for-service EVV EOB messages are:

• #1047 "EVV system visit not found"
• #1048 "EVV system units do not meet requirements of visit"

If there is a different EOB message, then the claim was not denied because of EVV.

Providers can see EOB codes and descriptions for any claim submitted to ForwardHealth on the ForwardHealth Portal.

As a reminder, EVV visits must be in verified status to be matched to a claim.

The message “Detail EOBs 1047” is an explanation of benefits (EOB) code. EOBs help providers determine find out why a claim was denied so they can fix the mistake and resubmit the claim.

EOB 1047, “EVV System Visit not found” means that ForwardHealth did not find EVV information for the date of service billed. For Sandata users, the EVV administrator will need to log in to the Sandata EVV portal and use the Visit Maintenance tab to search for the visit.

• If there isn’t a visit in the EVV system, they can manually create one.
• If there is a visit, they will need to fix any exceptions.
• Once the exceptions have been fixed or a manual visit has been created, the administrator should make sure the visit is now in a verified status. If it is, the claim can be resubmitted.

Alternate EVV system users should check with their EVV vendor about how to correct EVV visit information in their EVV system.

The message “Detail EOBs 1048” is an explanation of benefits (EOB) code. EOBs help providers determine why a claim was denied so they can fix the mistake and resubmit the claim.

EOB 1048, “EVV system units do not meet requirements of visit” means that ForwardHealth found EVV information for the date of service billed, but the EVV units are less than the billed units. In other words, the visit the EVV system recorded was too short.

For Sandata users:

• The EVV administrator should compare the claim's billed units to the EVV units.
• If the claim's billed units are wrong, the administrator can fix the claim and resubmit.
• If the EVV units are wrong, the administrator can fix them in the Sandata EVV portal and confirm the visit is in a verified status.
• If this visit was billed as a span of dates and one or more of the dates don't have enough EVV units, the administrator can bill each date separately.
• Once the billed detail units are the same as or less than the EVV units and the visit is verified in Sandata, the claim can be resubmitted.

Alternate EVV system users should check with their EVV vendor about how to correct EVV visit information in their EVV system.

Before resubmitting a denied claim, providers using the Sandata system should make sure the EVV visit information is accurate and verified in the Sandata EVV portal.

Alternate EVV system users should check with their EVV vendor about how to correct EVV visit information in their EVV system.

Additional Fee-for-Service Claims Resources

• The ForwardHealth Portal Claim Status Information (P-00969a) (PDF) fact sheet explains how to search for a claim and the statuses a claim can have, including pay, deny, suspend, and adjust.
• The ForwardHealth Portal Resubmitting a Denied Claim (P00969b) (PDF) fact sheet walks through how to search for a denied claim, make changes, and resubmit a claim.
• For EVV claim denials, the EVV Customer Care team is the best resource for questions. Providers can contact them at vdxc.contactevv@wisconsin.gov or 833-931-2035 Monday–Friday, 7 a.m.–6 p.m. Central time (CT).
• For general claim submission or resubmission help, providers may contact ForwardHealth Provider Services at 800-947-9627, Monday–Friday, 7 a.m.–6 p.m. CT to speak with a call center representative or any time to speak with a virtual agent.
• For complex questions specific to fee-for-service claims and billing, providers should contact the assigned field rep from this map (PDF).

Providers can find more information about EVV and claims in:

• The EVV Lifecycle flyer, P-03124 (PDF) – A snapshot of how EVV visit records fit into the general claims process.
• Fee-for-Service EVV Administrator Training: Claims Edits written presentation, P-03570 (PDF) or video – A detailed presentation explaining how EVV fits in the claim process, explanation of benefit (EOB) codes for EVV, how to resolve edits to resubmit a claim, span billing, and best practices.

Rounding rules have not changed with EVV. DHS continues to follow these three steps for fee-for-service claims:

1. Combine the duration of all EVV visits to the date of service for the member by provider (splitting visits that happen overnight).
2. Convert visit time into units.
3. Compare the units in the EVV system against the billed units submitted through the usual billing process.

Refer to Rounding Policies topics (#21817) in the ForwardHealth Online Handbook.

HMO and MCO providers should refer to their HMO or MCO for rounding policies.

IRIS providers should refer to their FEA for rounding policies.

For claims for visits that happened during a power or system outage that lasted more than 24 hours, providers may do one of the following:

• Manually enter EVV visit information.
• Use the UC modifier on detail lines for visits without EVV information. The UC modifier will allow the claim to bypass the EVV claim edits and be paid even though there is no EVV information that matches the claim detail.

Providers must be able to show proof of an outage upon request. DHS keeps a list of Sandata outages lasting longer than 24 hours on the DHS EVV homepage, under the Sandata Outage Information and Provider Documentation section.

Providers can refer to the Power Outage and Electronic Visit Verification System Outage Policy topic (#22860) in the ForwardHealth Online Handbook for more information.

No, Wis. Admin. Code § DHS 107.12(1)(f) states that only time spent in direct care is billable. Administrative tasks, like entering visit information in the EVV system or training, may not be billed separately.

If you are an independent nurse who is getting started with EVV, we recommend reaching out to Wisconsin EVV Customer Care. An EVV Customer Care specialist can work with you individually to set up your system and answer any questions you may have.

Wisconsin EVV Customer Care is available at vdxc.contactevv@wisconsin.gov or 833-931-2035 Monday–Friday, 7 a.m.–6 p.m. Central Time.

Managed care providers should ask their MCO questions about billing and claims. Providers who still have questions can contact EVV Customer Care at vdxc.contactevv@wisconsin.gov or 833-931-2035, Monday–Friday, 7 a.m.–6 p.m. Central time.

HMO providers should ask their HMO questions about billing and claims. Providers who still have questions can contact EVV Customer Care at vdxc.contactevv@wisconsin.gov or 833-931-2035, Monday–Friday, 7 a.m.–6 p.m. Central time.

IRIS providers should ask their FEA questions about billing and claims. Providers who still have questions can contact EVV Customer Care at vdxc.contactevv@wisconsin.gov or 833-931-2035, Monday–Friday, 7 a.m.–6 p.m. Central time.

Fee-for-service providers should contact Wisconsin EVV Customer Care at vdxc.contactevv@wisconsin.gov or 833-931-2035, Monday–Friday from 7 a.m. to 6 p.m. Central time.

All other providers should contact their payer.

For Sandata EVV system users:
When more than one independent nurse provides private duty nursing (PDN) services to a member, one of the nurses sharing the case must be the PAL. Only the PAL’s national provider identifier (NPI) or Medicaid ID (MA ID) is listed in the billing provider field on the PA form.

The Sandata EVV portal automatically receives PA information based on the billing provider field on a member’s PA. This means Sandata only pulls authorization information into the PAL’s Sandata EVV portal.

PAL Pathway

The independent nurses who aren't the PAL need to manually enter authorization information in their Sandata EVV portals. This will allow them to check in and out of their EVV system during a visit without errors. They only need to complete this process one time for each client they support in a non-PAL role.

The manually entered authorization information does not create an actual PA. Therefore, the manually created authorization ID will not match the actual PA number (issued by the payer) that the PAL will see in their Sandata EVV portal.

Non-PAL Pathway

Non-PAL independent nurses should follow the steps in the Adding Required Authorization Information in the Sandata EVV portal training, P-03550 (PDF), to add this client information.

For alternate EVV system users:
Providers using an alternate EVV system should check with their vendor.

No, as long as both are true:

• The service code the non-PAL is authorized to provide remains the same.
• The end date for the manually entered authorization information in the Sandata EVV portal has not expired.

If the service code or end date needs to be changed, the non-PAL nurse can make those changes in the Sandata EVV portal.

Administrators can follow the steps in Sandata EVV Portal Security, P-02748, to reset their own passwords or to reset passwords for other administrators locked out of their Sandata EVV portal.

Yes. If a worker is providing one of the services that requires checking in and out of visits using an EVV system, they are required to have a worker ID. This is true even for live-in workers who don’t have to use an EVV system, as long as they’re providing these services.

Workers are assigned one worker ID from the secure ForwardHealth Portal. This one ID identifies the worker across any provider they work with. This ID is also used within the Sandata EVV system.

The provider or FEA will enter the following worker information on the ForwardHealth Portal:

• Legal first and last name
• Date of birth
• Social Security number
• Email address
• Worker start date (optional)
• Gender (optional)

Providers can watch the How to Create and Maintain Electronic Visit Verification Worker ID video for more information.

Note: Because independent nurses are both the EVV administrator and the worker who provides services, they must add themselves as a worker using this process.

The process for changing a member's or participant's address and phone number has not changed with EVV. Members and participants are responsible for keeping this information up to date. They can find instructions for updating their information in the “Members and participants” section of these FAQs.

If a change to member or participant information is delayed, the provider can add a valid and verifiable address or phone number in the Sandata EVV Portal client profile. This will only update the Sandata system and will not update the Medicaid file in any other system.

The “Modify Clients” section in Electronic Visit Verification (EVV) Portal: Clients Module, P-02749, shows the steps for the administrator to update member or participant information.

EVV does not change or replace current requirements about the completion and retention of time sheets, record of care, or other documentation. Providers can choose to use EVV to capture some records, including record of care for personal care services.

Providers should check documentation requirements with their payers. Employers should let their workers know what their documentation requirements are.

Provider administrators using the DHS-provided Sandata EVV system can view worker check-in and check-out times through the Sandata EVV Portal in near-real time. Information from alternate EVV vendors through the Sandata aggregator will be updated frequently, but the frequency depends on the vendor.

The DHS-provided Sandata system does not include a scheduling component to identify late shifts.

If the provider needs to correct check-in or check-out times, they can see Visit Maintenance, P-02754 for instructions.

Providers using an alternate EVV system should check with their vendor.

No. Once a visit has been verified, its status can be changed, but visits can't be deleted from the Sandata EVV system.

Visit status options are: In Process, Incomplete, Omit, and Verified. Providers can see Visit Maintenance: Omit Status, P-02754K (PDF), for instructions on how to omit a visit.

Claim submission requirements haven’t changed with EVV. Providers should contact their payer for details.

The federal Centers for Medicare & Medicaid Services has not provided guidance on paper documentation requirements for EVV.  Payers have their own requirements for documentation.

For fee-for-service care, the ForwardHealth Online Handbook covers information about record retention. Documentation that supports the need for changing the visit is required for all changes in the Sandata EVV portal.

Yes. Providers can see a description of changes for each visit on the Sandata EVV portal when they click on a visit’s history section or look at the Visit Verification Activity Report.

The DHS Office of the Inspector General monitors manual corrections to EVV data.

No. In the DHS-provided Sandata EVV system, workers can use:

• TVV, which uses a landline phone to check in and out of visits
• FVV, which uses a small device to generate codes that need to be called in later from any phone
• The SMC app in Offline mode, which doesn’t require internet during the visit, but does require internet or cell service afterwards

If the app seems stuck and won’t progress to the next screen, but there is no spinning circle or band at the top of the screen with the word “Offline,” the worker should make sure that their device’s location services setting is turned on. The SMC app requires location services to be on to record visits.

If a spinning wheel appears on the SMC app, it means that the internet signal is too weak to load the app. Some troubleshooting steps to follow are:

1. Connect to a Wi-Fi network if possible.
2. Restart the device.
3. Uninstall and reinstall the app.

The SMC app will automatically shift into offline mode when it can’t find a signal. The worker should then record the visit for an Unknown Client. “Offline” will show in a band across most screens for the visit.

Later, to transfer the app's visit information to the Sandata EVV portal, the worker will need to log into the app once they have cellular, internet, or Wi-Fi connection.

When using the SMC app without Wi-Fi or cellular data, the worker will see an Offline banner at the top of the screen. Offline Mode allows the SMC app to be used without cellular service or a connection to the internet, as long as location is enabled on the device. The app will direct workers to start the visit for an Unknown Visit. Workers should enter in the client’s name and Sandata ID or Medicaid ID. Entering this information will make sure the visit matches up with the client’s file later.

Later, the worker will need to log into the app once they have a cell, internet, or Wi-Fi connection, so the visit information can upload to the Sandata EVV portal.

Workers can use the reset password link on the login screen of the app. See EVV Sandata Mobile Connect, P-02751, for more detailed instructions.

The DHS-provided Sandata EVV system only identifies the worker's location at the start and end of the visit. It does not track location before, after, or during the visit. Alternate EVV systems may work differently. Please check with your vendor.

At this time:

• GPS location data shown in the Sandata EVV portal is informational only. It does not prevent the EVV visit information from going to a “verified” status or being sent to DHS and payers.
• GPS data does not prevent claims from being paid.
• The Office of the Inspector General also has access to GPS location.

Workers can refer to Electronic Visit Verification (EVV) Sandata Mobile Connect, P-02751 (PDF), for instructions on resetting passwords.

Administrators can refer to the Sandata EVV Portal Security, P-02748, for password reset instructions.

Some of the common reasons why a worker can’t start a new visit in the SMC app are:

1. A previous visit is still in progress.
2. Location Services is not turned on in the device's settings.
3. The app needs to be refreshed.

Either the EVV administrator or the worker can take action.

An EVV administrator can look in the Sandata EVV portal to make sure no previous visits are still in progress. If a visit is in progress, the administrator can end the visit from the Sandata EVV portal. The worker can then start a new visit in the SMC app.

A worker using the SMC app should double-check the client ID and make sure it is entered correctly. If the client still is not in the system, the worker should click “Start Unknown Visit” and enter the information. EVV Sandata Mobile Connect Essentials, P-02751 covers these steps.

A worker can complete a TVV call as usual. The provider agency administrator may need to clear an Unknown Client exception.

The worker should let their administrator know this occurred. The administrator can check the EVV system and make sure the worker has the correct client ID. If the client is missing, the administrator can follow up with EVV Customer Care.

Providers can add clients to the Sandata system by using the instructions in Adding Required Authorization Information in the Sandata EVV Portal, P-03550 (PDF).

Workers can use the switch service button as long as:

• They’re using the DHS-provided Sandata system.
• The member and provider are the same.

The switch service button works whether the two services have the same payer or different payers.

Workers can refer to EVV Sandata Mobile Connect Essentials video and EVV Sandata Mobile Connect Essentials, P-02751, for step-by-step instructions on how to switch services during a visit using the SMC app.

The worker can use the SMC app to check whether a previous visit is still in progress. If it is still in progress, they can end the visit from the app by following these steps:

• Tap the three horizontal lines in the upper left corner of the screen to open the navigation menu. Tap Visits on the menu, then the Upcoming tab.
• If a visit is in progress, they’ll see the client’s name and clock-in time. They can tap on the visit to open it. From there, they can either:
  • Complete the visit by tapping the Complete button at the bottom of the screen.
  • Abandon the visit by tapping the trash can in the top right and pressing Yes to confirm. This will allow them to start a new visit.

If no visits are in progress and the worker still can’t start a new visit, the worker should try each of the following steps:

• Download the latest version app from their app store.
• Make sure the Location Services setting is on in their phone or tablet’s settings.
• Clear their device’s cache and cookies.
• Remove the app and reinstall it.

Workers can see their visits from the last seven calendar days by opening the SMC app's menu, tapping Visits, then tapping Past.

The SMC app and TVV offer 15 language options, including those most frequently used in Wisconsin. Workers, members, and participants can set their language preferences separately. Choices include English, Spanish, Hmong, Arabic (Egyptian), Burmese, Chinese (Simplified), French, Hindi, Laotian, Nepali, Russian, Serbian, Somali, Swahili, and Vietnamese.

Written training materials are available in multiple languages. Providers can request additional languages by emailing EVV Customer Care at vdxc.contactevv@wisconsin.gov. Please allow 30 business days for translation and delivery.

A fixed Voice over Internet Protocol (VoIP) phone sends voice communications over the internet. Fixed VoIP phones are like a traditional landline, with a base plugged in to the wall or modem. An example is phone service through a cable company.

A fixed VoIP line can be used for TVV because it is associated with an address, like a landline. A non-fixed VoIP line, however, is not associated with an address and cannot be used for TVV.

A worker using the SMC app should double-check the client ID and make sure it is entered correctly. If the client still is not in the system, the worker should click “Start Unknown Visit” and enter the information. EVV Sandata Mobile Connect Essentials, P-02751 covers these steps.

A worker can complete a TVV call as usual. The provider agency administrator may need to clear an Unknown Client exception.

The worker should let their administrator know this occurred. The administrator can check the EVV system and make sure the worker has the correct client ID. If the client is missing, the administrator can follow up with EVV Customer Care.

Providers can add clients to the Sandata system by using the instructions in Adding Required Authorization Information in the Sandata EVV Portal, P-03550 (PDF).

The SMC app and TVV offer 15 language options, including those most frequently used in Wisconsin. Workers,  members, and participants can set their language preferences separately. Choices include English, Spanish, Hmong, Arabic (Egyptian), Burmese, Chinese (Simplified), French, Hindi, Laotian, Nepali, Russian, Serbian, Somali, Swahili, and Vietnamese.

Written training materials are available in multiple languages. Providers can request additional languages by emailing EVV Customer Care at vdxc.contactevv@wisconsin.gov. Please allow 30 business days for translation and delivery.

For services that are provided fee for service and are using the DHS-provided Sandata EVV system, workers do not need to check out and check in again after midnight. They should check in when they arrive and check out just prior to leaving.

Providers using alternate EVV systems should check with their vendor for worker instructions. HMO and MCO providers should check with their HMO or MCO for policy details.

For providers using the Sandata EVV system, workers can start a group visit when all of these conditions are met:

• The worker is providing services to multiple members or participants in a single visit.
• The members or participants are at the same location.
• The members or participants have the same program payer (for example, DHS, HMO, MCO or IRIS FEA).

Refer to Electronic Visit Verification: Group Visits, P-02755 (PDF) for more information about group visits.

Providers using an alternate EVV system should check with their vendor.

Yes. Workers may need to check in and check out more than once during a single visit or use two EVV systems in one visit if:

• The worker provides services that are paid by two different programs (fee-for-service Medicaid personal care [MAPC] and IRIS).
• The worker works for two different providers that use two different EVV systems.
• The provider’s EVV system requires a separate check in and check out for different services.

Yes. Workers might need to use more than one EVV system when:

• The worker provides services that are paid by two different programs (for example, fee-for-service Medicaid personal care [MAPC] and IRIS).
• The worker works for two different agencies that use two different EVV systems.

Workers choose a broad service code that covers many tasks, including helping someone bathe, get dressed, and brush their teeth. They don't need to check in and out for individual tasks.

As a reminder, DHS doesn’t require workers to capture tasks in an EVV system, unless they’re using it to document record of care. HMOs, MCOS, FEAs, and providers can require workers to capture tasks in an EVV system.

All workers are required to capture the six key data points for EVV:

1. Who receives the service
2. Who provides the service
3. What service is provided
4. Where service is provided
5. The date of service
6. The time the service begins and ends

Personal care workers using an EVV system for record of care are also required to capture additional information:

7. Tasks performed during the visit
8. Notes that would have been put on a timesheet
9. Verification (electronic signature or voice recording) from the client of the services provided

For additional information, providers should refer to Record of Care and Timekeeping topic (#22859) of the Online Handbook, or check with their HMO, MCO, or IRIS FEA.

Home health care service providers, including independent nurses, should continue their regular documentation practices outside EVV.

Yes, every worker who is required to capture EVV information has to have an email address unique to them. If they work for multiple providers, they can use the same email address for all providers, but they can’t share an email with any other workers.

Workers may be able to use the combo code when providing self-directed personal care (service code T1019) and supportive home care services (service code S5125) to IRIS participants and all of the following are true:

• The services are provided to an IRIS participant.
• Personal care and supportive home care services are both being provided in a single visit.
• The worker is being paid for both services by the same place: either the provider or the FEA.
• The worker is using the DHS-provided Sandata EVV system.

The combo code is used to log EVV visits with the DHS-provided Sandata system. It is not used for billing.

Workers using an alternate EVV system should follow the guidelines given by the provider that pays them.

Workers should check in at the beginning of each visit and check out at the end of each visit, no matter which services they’re providing or when they’re providing them.

The exception is for visits lasting more than 24 hours. The SMC app will automatically end a visit after 25 hours. Workers must check out and back in for visits lasting longer than 24 hours.

Providers using alternate EVV systems should check with their vendors about whether their systems will automatically log workers out.

For service codes that are billed on a per-visit basis, like 92507 (Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual; per visit) or 99509 (Home visit for assistance with activities of daily living and personal care; per visit), workers must check in and check out for each instance of the code that the provider bills.

For EVV, DHS does not require a minimum or maximum amount of time for each visit, but some EVV systems won’t register a visit unless it lasts for a certain amount of time. For example, the Sandata EVV system won’t recognize a visit less than 7 minutes long. No matter which system they’re using, workers should check in when they arrive and check out when they leave as usual.

The SMC app and TVV offer 15 language options, including those most frequently used in Wisconsin. Workers, members, and participants can set their language preferences separately. Choices include English, Spanish, Hmong, Arabic (Egyptian), Burmese, Chinese (Simplified), French, Hindi, Laotian, Nepali, Russian, Serbian, Somali, Swahili, and Vietnamese.

Written training materials are available in multiple languages. Providers can request additional languages by emailing EVV Customer Care at vdxc.contactevv@wisconsin.gov. Please allow 30 business days for translation and delivery.

Administrative code requires the nurse to directly observe the personal care worker. The nurse and worker should independently check in and out for their visits. An EVV system will not automatically confirm that their times overlap. Auditors will be able to review the EVV record to be sure the overlap occurred.

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. Alternate EVV systems may work differently. Please check with your vendor.

At this time:

• GPS location data shown in the Sandata EVV portal is informational only. It does not prevent the EVV visit information from going to a “verified” status or being sent to DHS and payers.
• GPS data does not prevent claims from being paid.
• The Office of the Inspector General also has access to GPS location.

No, workers can check out of the visit wherever they stop providing the service for that visit. EVV does not change where services are allowed to be provided per DHS policy. The worker should choose home or community based on where they are at the moment they are checking in or checking out of the Sandata EVV system, even if the visit takes place in multiple settings.

DHS will not deny a claim because of GPS information.

There are several reasons why a GPS exception might happen in the Sandata EVV system, like:

• The services were provided in the community.
• The client’s address has not yet been updated yet.
• The worker was more than 0.25 miles away from a known service location.
• There is an error with the device recording the visit.

Unlike other exceptions in the Sandata system, a GPS exception does not prevent the visit from getting to a verified status or being sent to DHS and payers. Providers can use the GPS information as part of their own quality assurance or internal audit practice.

There are two places to review GPS data.

1. Providers can use the GPS Distance Exception Report to view visits with GPS exceptions.
2. Providers can see GPS location information for a specific visit in Visit Maintenance in the Sandata EVV Portal by clicking on the specific visit. On the Visit Detail screen, click the GPS button to view the location map.

Unlike other exceptions in the Sandata system, a GPS exception does not prevent the visit from getting to a verified status or being sent to DHS and payers. Providers can use the GPS information as part of their own quality assurance or internal audit practice.

If a visit suggests a location that would be unusual for the member or participant (for example, a waterpark for a client who is afraid of water), the provider can follow up with the employee and get more details or provide client-specific information to ensure the best support.

Providers can use the GPS Distance Exception Report as part of their own quality assurance or internal audit practice. Providers could use this report to watch for irregularities.

DHS will not deny a claim because of GPS information.

DHS does not offer additional funding for EVV expenses.

Members and participants may be eligible to receive assistance with mobile phone and internet services through programs like the Lifeline Program or Affordable Connectivity Program.

No, there is no charge for use of the DHS-provided Sandata EVV system.

Providers should refer to the Department of Labor fact sheet on Deductions From Wages for Uniforms and Other Facilities Under the Fair Labor Standards Act (FLSA) for guidance that would be applicable to this scenario. For labor law questions, providers may wish to consult with an attorney.

The FVV device itself will be paid for by DHS and does not require data or complex installation. (It is “fixed” to a surface in the member's or participant’s home using an adhesive tape.)

FVV devices give codes that must be called in. This means that the provider, worker, member, or participant must have a phone. Any type of phone, from any location, can be used to call in FVV codes.

Review the New to EVV? flyer, P-03078, for additional information or contact Wisconsin EVV Customer Care:

vdxc.contactevv@wisconsin.gov

833-931-2035
Hours: Monday–Friday
7 a.m.–6 p.m. Central time

Independent nurses are required to use an EVV system if they provide services that require EVV. Find a list of all service codes that require EVV on the DHS EVV: Service Codes that Require Use of an EVV System in Wisconsin webpage. For EVV, independent nurses are considered both a provider and worker. They will have both administrative duties and worker duties in EVV.

• Sandata Mobile Connect (SMC) app – the preferred method
  • Works on a smart phone or tablet
  • Can be used on Android or Apple devices
  • Works even if cell service or Wi-Fi is unavailable during the visit
  • Americans With Disabilities Act (ADA) 508 and WIPAA compliant
  • GPS captured only at check in and check out
  • Most efficient and accurate method
• Telephonic visit verification (TVV) – second best method
  • Uses the member's or participant's home phone
  • Uses the same technology as 911 to determine location
  • Requires use of a landline or a fixed Voice over Internet Protocol (VoIP) phone, like a phone service provided by a cable company
  • May not use a cell phone
• Fixed visit verification (FVV) – the method of last resort
  • Uses a small device that is “fixed” or attached in the member or participant’s home
  • Generates codes at check in and check out that have to be recorded for entry later
  • Captures the visit information but doesn’t report it—the information will still need to be called in when the worker has access to a phone
  • Provider must attest that SMC and TVV use are not possible
  • Most cumbersome method and most prone to errors
• Sandata Aggregator: Allows providers to use an alternate EVV system as long as it meets technical requirements. Providers using alternate EVV can log in to the aggregator to ensure EVV visits are in a verified state. Providers can refer to the Alternate EVV webpage to learn more about alternate EVV requirements.

No. Only services billed under the required service codes are included in EVV. Find a list of all service codes that require EVV on the DHS EVV: Service Codes that Require Use of an EVV System in Wisconsin webpage. Providers interested in including other service codes may want to use an alternate EVV system.

In most cases, information should be received the next day. Contact Wisconsin EVV Customer Care if the following take longer than three days:

• Employees appearing in the Sandata EVV Portal
• Employees receiving initial Sandata/e-TRAC email and temporary passwords
• Member or participant authorizations showing in the Sandata EVV Portal
• Alternate EVV visits showing in the Sandata aggregator

Fee-for-service authorizations can take up to 20 days for approval. This has not changed with EVV. Members can be manually added to the Sandata EVV portal, if needed.

EVV does not change or replace current requirements about the completion and retention of time sheets, record of care, or other documentation. Providers can choose to use EVV to capture some records, including record of care for personal care services. Workers should check with their provider, HMO, MCO, or FEA regarding documentation requirements.

Change of ownership steps to take for:

• Medicaid-enrolled providers
  • Complete the change of ownership process (see below for resources). A new provider ID will be assigned.
  • After the new ID is received, follow the remaining steps on the New to EVV? flyer, P-03078.
  • Notify payers of the new ownership (see below).
• Non-Medicaid-enrolled providers
  • Enroll as a new EVV provider.
  • Sign up for a provider ID by following steps on the New to EVV? flyer, P-03078.
  • Notify payers of the new ownership (see below).
• Payers will need to create service authorizations with the new provider ID. This way the authorization can flow to Sandata properly and connect with claims for authorized services.

Resources:

• Fee-for-service providers can refer to the Providers Have 35 Days to Report a Change in Ownership topic (#22257) of the ForwardHealth Online Handbook or reach out to Provider Services if they have any questions about obtaining a provider ID.
• IRIS providers can reach out to their FEA for details about the change of ownership process.
• Providers working with HMOs and managed care organizations (MCOs) should check with their HMO or MCO for details on change of ownership requirements.