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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 you need. If the Wisconsin Department of Health Services (DHS) doesn’t follow this law, Wisconsin will lose money for Medicaid services.

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 enter 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 step 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.
  • Discuss 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.
  • Show 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 IRIS 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.

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

After the hard launch on May 1, 2023, there will be consequences for you, as the employer, if your participant-hired worker (who does not live with you) is not using EVV as required. These consequences may include disenrollment from IRIS.

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 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 vendor.

At this time, the GPS location data is informational only.

  • GPS location data does not prevent the EVV visit data from going to a “verified” status or sending to DHS and payers.
  • GPS data does not currently prevent claims from being paid.

This functionality has not changed with hard launch.

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.

Who do I contact for support?What can they help with?What's their contact information?
Your provider agency
  • Answer questions that your worker has about EVV
  • Discuss which workers are required to use EVV
You can request this information from your IRIS consultant.
Your IRIS ombudsmanListen to your concerns and help you solve problems that come up
  • IRIS ombudsman at Disability Rights Wisconsin if you are between the ages of 18 and 59: 800-928-8778 or visit a Disability Rights Wisconsin office in Rice Lake, Madison, and Milwaukee
  • IRIS ombudsman at the Board on Aging and Long-Term Care if you are age 60 or older: 800-815-0015
MetaStarCommunicate your grievance to DHSMetastar: 888-203-8338 or dhsirisgrievances@dhs.wisconsin.gov

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

After the hard launch on May 1, 2023, provider agency claims will be denied if their workers are not using EVV as required.

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 vendor.

At this time, the GPS location data is informational only.

  • GPS location data does not prevent the EVV visit data from going to a “verified” status or sending to DHS and payers.
  • GPS data does not currently prevent claims from being paid.

This functionality has not changed with hard launch.

How do I know if my workers are using an EVV system?

  • Talk with your workers when they arrive for their visit. Ask if they are using an EVV system to capture the required visit information.
  • Remind your workers to check in and out of their visit using EVV.
  • Your IRIS consultant will share EVV information with you during each monthly contact. If your workers are not regularly using an EVV system, your IRIS consultant will let you know. They will help you follow IRIS policy.

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 alternate EVV system requires a check in and check out for each service.
Examples of Services and Corresponding EVV Systems
Personal Care ServiceSupportive Home Care Service
Payer/ServiceProvider TypeEVV System UsedPayer/ServiceProvider TypeEVV System Used 
Fee-for-Service Medicaid Personal CareAgencyProvider Agency'sIRIS Supportive Home CareAgencyProvider Agency's
Fee-for-Service Medicaid Personal CareAgencyProvider Agency'sIRIS Supportive Home CarePHWFEA's
IRIS Self-directed Personal CarePHWFEA'sIRIS Supportive Home CareAgencyProvider Agency's
IRIS Self-directed Personal CarePHWFEA'sIRIS Supportive Home CarePHWFEA

IRIS resources for provider agencies, FEAs, payers

Glossary

 
Last revised November 12, 2024