Revision 18-0; Effective November 1, 2018

 

When an attendant provides authorized services to a person in the home or the community, the attendant must use one of three approved EVV time recording methods to clock in when services begin and clock out when services end. This section will describe each method available under the HHSC EVV program. The attendant should only use one method per person for clocking in and out. If the  person receives services in more than one location, the provider agency must work with the EVV vendor when choosing the most appropriate method the attendant can use at the different locations.  

When the attendant clocks-in and clocks-out of the system using one of these methods, the visit data is transmitted in real time to the provider agency to monitor and make adjustments as appropriate.

 

Home Landlines

How to use:

  • The attendant arrives at the home and before starting services, uses the person’s landline phone to call a toll-free number, issued by the EVV vendor, to clock in.
  • The attendant may be prompted to enter their EVV ID or other identifying data elements, depending on the EVV vendor’s system.
  • The attendant follows this same process when clocking out.

The provider agency must ensure the person’s home landline number is entered into the EVV system correctly. When the attendant uses the home landline, the EVV system will match the landline number used by the attendant to the number entered in the EVV system by the provider agency. If the numbers do not match, an exception will be flagged for this visit and cause the provider to perform visit maintenance.

Do not use cell phones to clock in and out of the EVV system unless the attendant is using the EVV mobile app.

Never use cell phones in place of a landline or when the SAD has not yet been installed in the home. The attendant should never ask or use the person’s cell phone to clock in out of the EVV system.

There are three exceptions to cell phone use:

  • The attendant may use their personal cell phone to call in SAD numeric codes only.
  • Consumer directed services (CDS) Option – CDS employers may allow their CDS employees to use the CDS employer’s personal cell phone to call in and out of the EVV system.
  • Attendant is using the EVV mobile app.

The EVV vendor conducts monthly phone sampling of home landline numbers entered into the EVV system to verify that the number is a landline number and not a mobile phone number. If a mobile phone number is entered into the EVV system as a home landline, those visits are subject to recoupment by the payer.

The provider agency should order a small alternative device (SAD) if:

  • The person refuses to allow the attendant use of their home landline phone.
  • The person’s home landline phone is not available due to service interruption or use by the person.

 

Allowable and Unallowable Landline Phone Types

Allowable phone types to clock in and out of the EVV system:

  • Wired phone connected to a phone jack in the wall
  • Non-wired phone with base connected to a phone jack in the wall (i.e., cordless phone)
  • Cable internet provider (e.g., Time Warner, Comcast, AT&T, etc.)
  • Non-Fixed Voice over Internet Protocol (VoIP) (e.g., Portable alternative phone services that use VoIP, including but not limited to MagicJack, or Vonage)
  • Fixed VoIP

Unallowable phone types that cannot be used to clock in and out of the EVV system:

  • Mobile phone
  • Cellular-enabled device or tablet

The EVV vendor will sample all landline numbers used to verify EVV visit transactions on a monthly basis, starting March 1, 2018. The EVV vendor will publish the results of their phone sampling for the previous month in the Landline Phone Sampling Report located under Standard Reports. Providers can use this report to monitor phone types being used to verify service delivery as well as multiple phone numbers used within the same month for the same person.

Please see Appendix V: EVV Policies to read the full Unallowable Phone Identification and Recoupment Policy and actions a provider agency must take when identifying an unallowable phone type.  

 

Small Alternative Device (SAD)

How to use:

  • The attendant arrives at the home and before starting services, locates the placement of the SAD in the home and writes down the numeric code displayed on the device. The attendant can then begin providing services.
  • When the visit is complete, the attendant writes down a second numeric code displayed on the device.
  • The attendant calls a toll-free number issued by the EVV vendor, enters the first numeric code for clocking in, and then enters the second numeric code for clocking out.
  • The numeric codes displayed on the SAD are like electronic time stamps, capturing the date and time of the visit.

SAD numeric codes expire after seven calendar days. Once the codes have expired, it is considered a failure to clock in and out of the EVV system.

A SAD is an HHSC approved device provided by the EVV vendor that displays a set of numbers used to document the time services begin and end. SADs are provided at no charge to the provider agency or person by the EVV vendor.

Upon determining that a person needs a SAD, the provider agency has 14 calendar days to order a SAD from the vendor. The vendor will give instructions on how to order a SAD electronically from the vendor’s EVV system. The EVV vendor has 10 business days to process and ship the device to the requesting provider agency. Depending on the shipping method, it may take additional days to deliver the order. If the person has selected the CDS option or the service responsibility option (SRO), the SAD will be mailed directly to the CDS employer.

 

Ordering a SAD Electronically

Effective May 1, 2018, provider agencies can order a SAD electronically through the EVV vendor system.

The new eSAD process will allow provider agencies to:

  • Order a new or replacement SAD
  • Track SAD order(s)
  • Manage, assign and un-assign SADs
  • Manage shipping addresses

The EVV system will auto-populate the following information from the client record on the eSAD order request:  

  • Client name
  • Medicaid ID
  • DOB
  • Client address
  • Payer
  • Program

 

Installation of the SAD

A provider agency representative or the attendant must place the SAD in the person’s home on or before the first service delivery date after receiving the device. The provider agency representative or attendant should ask the person where they would like the SAD placed in their home. The device should be in a location where it is accessible to the attendant at all times. The provider agency representative or attendant should explain to the person what the purpose of the SAD is and how the device works.  

 

Malfunctioning SADs

If the SAD is malfunctioning, the attendant must notify the provider agency immediately so a new device can be ordered.

Until the device is replaced, the provider agency must verify services were delivered and complete visit maintenance for those visits using the most appropriate reason code.

 

SAD Zip Ties

Under the HHSC EVV initiative, use of zip ties was required to install the device in the  person’s home. To streamline the SAD installation process HHSC and MCO representatives revised the zip tie policy to make the use of zip ties optional.

Effective June 1, 2018, provider agencies may choose if they want to utilize the EVV vendor zip tie when placing the device in the person’s home. If a person disagrees with the agency policy on installing a SAD with or without a zip tie, the provider agency must document the issue in the person’s case file, and use their preferred method.

The SAD must be in the home at all times. If the SAD does not remain in the home at all times, visits may be subject to recoupment and a Medicaid fraud referral may be made to the Office of Inspector General.
 

EVV Mobile Application

How to use:

  • The attendant arrives at the home or starts the visit in the community and before starting services, opens the EVV vendor’s mobile application to clock in.
  • The mobile app may prompt the attendant to select other options depending on the vendor’s technology.
  • The attendant will follow the same process when clocking out.
  • The EVV mobile app captures the geolocation coordinates (longitude and latitude) of where the attendant clocks in and out as well as the date and time of the visit.

The  EVV mobile app has been under pilot testing since May 2017 with one EVV vendor, DataLogic, and contains no protected health information (PHI) on the attendant’s phone. The estimated data usage of the EVV app is under two megabytes per month. It does not use minutes from the attendant's or assigned staff cell phone plan.

The EVV mobile app user requirements being piloted are:

  • The provider agency must verify the cell phone used for the EVV app is a smartphone and has an Apple iOS or Google Android mobile platform.
  • The provider agency must verify that the smart phone used for the EVV app is not a rooted or jailbroken mobile phone.
    • Rooting is the process of getting around Android’s security architecture and gaining access to the Android operating system code.
    • Jailbreaking is the process of removing the limitations put in place by a device’s manufacturer.
  • The EVV system will not allow the agency to register a rooted or jailbroken phone.
  • Before using the EVV app for the first time, the provider agency must verify with the EVV vendor the EVV app is installed and registered.
  • The attendant is responsible for keeping their phone charged. Attendant’s failure to keep their phone charged, resulting in being unable to clock in and out, is a failure to use the EVV system.

 

EVV Mobile App User Liability

The provider agency and the attendant understand HHSC, EVV vendor(s), and payers are not liable for:

  • Any cost incurred while using the EVV mobile app
  • Any virus(es) on the smartphone
  • Hacked, broken, damaged, lost or stolen smartphone
  • Non-working smartphone

 

Graphical User Interface (GUI)

When the attendant does not use the EVV system, for allowable or unallowable reasons, and the provider agency is going to bill the payer for the visit, the agency must manually enter the visit pay hours into the EVV system. The visit method in and out is marked as Graphical User Interface (GUI). GUI entered visits should not be the norm but the exception. Payers will question an agency when they see frequent GUI visits.