August 16, 2019

Update to EVV Claims Matching Policy for Fee-for-Service EVV Claims

The new EVV Claims Matching Policy, effective Sept. 1, 2019, was published on July 24. An update to this policy is as follows:

EVV claims for Acute Care and Long-Term Care Fee-for-Service:

  • With dates of service between Sept. 1, 2019 through Oct. 31, 2019
    • receive an informational explanation of benefit and are not denied when a data element does not match during the EVV claims matching process.
  • With dates of service on or after Nov. 1, 2019
    • EVV claims for Acute Care and LTC FFS are denied by the payer when a data element does not match during the EVV claims matching process.

EVV Visit Maintenance Unlock Request Policy

The EVV Visit Maintenance Unlock Request Policy was revised with an effective date of July 1, 2019. However, on July 12 the policy was placed on hold. New updated EVV Visit Maintenance Unlock Request Policy is effective Sept. 1, 2019. Program providers and MCOs should follow the existing policy in the EVV Provider Policy Handbook, Section 4200 – Visit Maintenance until the new policy goes into effect on Sept. 1, 2019.

EVV Training is Available

Multiple training methods and topics about electronic visit verification are available to program providers and financial management services agencies, including:

EVV Roadshow – Instructor-Led Training (Aug. 1 – Nov. 1)

Computer-Based Training

Courses will be available in mid-August:

Webinar with Live Q&A Session Hosted by TMHP

  • Register for the Aug. 15 webinar about selecting an HHSC-approved EVV vendor, the EVV provider onboarding process, the EVV Aggregator, EVV Portal, and submitting EVV claims.
  • After registering, a confirmation email will be sent with information about joining the webinar.

EVV Tool Kit

New EVV Claims Matching Process and EVV Portal Access Begins Sept. 1, 2019

Effective Sept. 1, 2019, program providers currently required to use EVV must submit claims for EVV-relevant services, with dates of service on or after Sept. 1, 2019, to TMHP through TexMedConnect or Electronic Data Interchange. This applies to both Fee-for-Service and Medicaid managed care claims.

Click here for more information about the EVV claims matching process and EVV Portal access.

EVV Visit Transaction Validation Enhancements for All MCOs

Effective Aug. 1, 2019, EVV visit transaction validation enhancements will be enabled in the DataLogic Vesta EVV system for program providers who submit EVV-relevant claims to MCOs. These EVV visit transaction validation enhancements will be enabled to help improve data quality and to help program providers prepare for the new claims matching process beginning Sept. 1, 2019.

Click here for more information.

EVV Service Bill Codes Table Available

Detailed bill code information for EVV services is now available in the EVV Service Bill Codes table on the HHSC EVV website. The EVV Service Bill Codes table identifies the EVV program and service bill codes required for EVV-relevant services that are currently in use, and those with changes effective Sept. 1, 2019.

Click here for more information.

For questions about these alerts contact HHSC EVV Operations.