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TexMedConnect and EVV Portal Access

Date: 08/25/23

Superior HealthPlan would like to ensure providers have the latest information on TexMedConnect and Electronic Visit Verification (EVV) portal requirements. Please review these important updates below.

Electronic Visit Verification (EVV) Requirement for Home Health Care Services (HHCS)

As a reminder, Electronic Visit Verification (EVV) will be required for Home Health Care Services (HHCS) effective January 1, 2024. The HHCS required to use EVV are found in the Texas Health and Human Service Commission (HHSC) Programs, Services and Service Delivery Options Required to Use EVV PDF. Providers can access PDF and Excel versions of the EVV HHCS Service Bill Codes Table on the Resources section of the HHSC 21st Century Cures Act webpage.

Claims Submission

Program providers and Financial Management Services Agencies (FMSAs) must submit all HHCS EVV claims to Texas Medicaid and Healthcare Partnership (TMHP) starting with dates of service on or after December 1, 2023.

Superior will reject any HHCS claims with EVV services for dates of service on or after December 1, 2023. Claims will be sent back to the program provider and FMSA, directing them to submit the claims to TMHP for EVV claims matching.

All HHCS program providers and FMSAs that are new to EVV must register for a TexMedConnect account with TMHP. More information about TexMedConnect, please reference the TexMedConnect User Guide.

Claims Matching

For dates of service on or after January 1, 2024, the EVV Aggregator will begin sending the actual match result for HHCS EVV claims to Superior, and Superior will process the claims accordingly (i.e., deny claims that receive EVV02 – EVV06 match codes). The actual claims match results will be viewable in the EVV Portal.

Provider Actions Required

1. Register for TexMedConnect

  • Claims for MCO EVV services will be submitted to TMHP through TexMedConnect or through Electronic Data Interchange (EDI) using a Compass 21 (C21) Submitter ID.
  • Access TexMedConnect through the TMHP website. To use TexMedConnect, you must already have an account on the TMHP website. If you do not have an account, set one up using the information provided in the TMHP Portal Security Provider Training Manual Website.
  • Program providers and FMSAs that need help setting up C21 or CMS Submitter IDs should contact the TMHP EDI Helpdesk at 1-888-863-3638, Option 4.

2. Request EVV Portal Access

  • To access the EVV Portal, program providers and FMSAs must have a TMHP User Account.
  • Program providers and FMSA staff must contact their TMHP Provider Administrator to request EVV Portal access.
  • For full instructions, please review the EVV Portal Job Aids found on the Resources section of the TMHP Learning EVV Training webpage.

For general EVV questions or information, please email Superior’s EVV team at SHP_.EVV@SuperiorHealthPlan.com.