HHS: Topics About Using an EVV System
Date: 05/06/22
This notice is for Superior HealthPlan providers, Financial Management Services Agencies (FMSAs) and Consumer Directed Services (CDS) employers required to use Electronic Visit Verification (EVV). The topics are about using an EVV system.
Manually Entered Visits
If the service provider or CDS employee fails to clock in and clock out of the EVV system for any reason, the program provider, FMSA and CDS employer must manually enter the visit into the system within the visit maintenance time frame.
If the visit maintenance time frame has expired, the program provider, FMSA or CDS employer must obtain an approved Visit Maintenance Unlock Request from the payer to manually enter the visit. The payer will deny requests to create manual visits after the visit maintenance time frame unless the reason for creating a manual visit is due to a payer or system error. Manually entered visits are measured as part of the EVV Usage Score.
For more information, refer to Sections 7010 Manually Entered EVV Visits and 11000 Usage in the Texas Health and Human Services (HHS) EVV Policy Handbook.
Missing Clock in and Clock out Times
If a service provider or CDS employee fails to clock in or clock out of the EVV system for any reason, the program provider, FMSA or CDS employer must:
- Complete visit maintenance.
- Enter an appropriate reason code.
- Ensure the missing clock in or clock out time is entered into the free text.
This includes entering missing clock in and clock out times when creating a manual visit.
The EVV vendor systems assist with entering missing times into the free text through different methods. Contact your EVV vendor for information about how their system supports this requirement.
For more information, refer to Section 9000 Reason Codes in the HHS EVV Policy Handbook.
Waiting to Receive an Alternative Device
When a program provider, FMSA or CDS employer has determined a member needs an alternative device, they have 10 Business Days to order an alternative device from the EVV vendor. The EVV vendor has 10 Business Days to process an order and ship the alternative device to the requestor upon receipt of a complete order. Depending on the shipping method, it may take more days to deliver the order.
HHS requires service providers or CDS employees to clock in and clock out of the EVV system using one of the HHS-approved clock in and clock out methods (mobile method or home phone landline) while waiting to receive an alternative device.
If one of these methods is not available, the program provider, FMSA or CDS employer must manually enter the visit into the EVV system within the visit maintenance time frame.
For more information, refer to Section 7040 Alternative Device in the HHS EVV Policy Handbook.
EVV System Outages
If a service provider or CDS employee is unable to use the EVV system due to a system outage, the program provider, FMSA or CDS employer must manually enter the visits within the visit maintenance time frame.
The EVV vendors will communicate in the following matter when there is a system outage:
- First Data AuthentiCare will send out an email blast.
- DataLogic Vesta will post a notification to their Vesta dashboard.
Program providers, FMSAs and CDS employers should report unexpected system outages to their EVV vendor (contact information listed below) or to the TMHP EVV mailbox at evv@tmhp.com.
For more information, refer to Sections 1400 Failure to Use an EVV System and 8000 Visit Maintenance in the HHS EVV Policy Handbook.
No Service Authorization on File
HHS is aware that there could be instances when a service authorization for member services is delayed.
Program providers and FMSAs who choose to continue services while waiting for a service authorization must still require service providers and CDS employees to use the EVV system.
Service providers and CDS employees should capture their time worked through the mobile method, home phone landline or alternative device. If the service provider or CDS employee does not clock in or clock out electronically, then the program provider, FMSA or CDS employer must manually enter the visit in the EVV system.
For information about how to use the EVV system while waiting for a service authorization, contact your EVV vendor.
If you have not received an authorization from your payer, you may use the contact information in the table below.
Member’s Program | Contact Information |
|---|---|
Acute Care Fee-for-Service (FFS) | 1-800-925-9126 or www.tmhp.com/contact |
CLASS and DBMD | Utilization Review at 512-438-4896 |
HCS and TxHmL | The service coordinator listed on your Individual Personal Planning (IPP). |
Managed Care (STAR+Plus, STAR Kids & STAR Health) | Provider should contact Superior HealthPlan for assistance. |
PCS for a FFS PCS/CFC client | The provider should contact the DSHS case manager. |
PHC, FC and CAS | HHS regional case manager listed on your authorization. |
YES and HCBS-AMH | CMBHS Help Desk at 1-866-806-7806 |
Contact Superior for more assistance in determining factors for late authorizations.
If Superior is non-responsive and you would like to file a formal complaint for a severely delayed authorization, you can email MCCO at HPM_Complaints@hhsc.state.tx.us.
EVV Vendor Contact Information
DataLogic Vesta | First Data AuthentiCare |
|---|---|
For program providers:
For FMSAs and CDS employers:
Website: https://vestaevv.com/ |
|