Revision 18-0; Effective November 1, 2018

 

 

8100 Introduction

Revision 18-0; Effective November 1, 2018

 

The purpose of EVV is to verify members are receiving the services authorized for their care and for which HHSC and the MCOs are being billed.

The person has rights and responsibilities that must be followed when receiving services required to use EVV.

 

Rights

The person has the right:

  • To not allow their attendant to use their home telephone landline.
  • To confidentiality of information. Their information is confidential under state and federal statutes and regulations. This information may be released only in specific situations that follow state and federal guidelines and regulations.
  • To complain or voice grievances. You have the right to make a complaint, voice grievances or recommend changes in policy or service without restraint, interference, coercion, discrimination or retaliation.
  • To request an interdisciplinary meeting or service plan team meeting with their HHSC caseworker, MCO service coordinator or CLASS case management agency (CMA) regarding concerns using EVV.

 

Responsibilities

The person:

  • Must allow their attendant to use EVV to clock-in and clock-out with one of the acceptable methods when the attendant begins and ends performing authorized services.
  • Must not allow their attendant to use their personal cell phone to clock-in or clock-out.
  • Must notify their provider agency if their attendant asks the person to clock-in or clock-out of the EVV system for them.
  • Must inform their provider agency, HHSC case worker, MCO service coordinator or CLASS case management agency (CMA) immediately if the SAD has been damaged, and they   believe that someone has removed or tampered with the SAD.
  • Must ensure the SAD remains in the home at all times.
  • Must return the SAD to their provider agency or ask the provider agency remove the SAD from their home when they are no longer receiving services.

 

8200 Special Situations

Revision 18-0; Effective November 1, 2018

 

Services in the Community

The person is allowed to receive services outside the home in accordance with their service plan and existing program rules. EVV does not change the method and location in which services are delivered.

 

Companion Cases

When two or more people receive services from the same attendant in the same home, the attendant must use the EVV system to clock-in and clock-out for each person.

EXAMPLE:  Attendant Smith provides services to Bob Jones from 8 – 11 a.m., and to Mary Jones, from 11 am – 1 pm.

  • Attendant Smith will need to use EVV to clock-in at 8 a.m. and clock-out at 11 a.m. to document service delivery for Bob Jones.
  • Attendant Smith will also need to use EVV again to clock-in at 11 a.m. and clock-out at 1 p.m. to document service delivery for Mary Jones.

 

Suspended Eligibility or Authorization

If the provider agency voluntarily chooses to continue providing services when Medicaid eligibility or service authorization has been suspended for a person then those services must be completely and accurately documented in the EVV system, including completing visit maintenance within 60 calendar days of the date of service. The provider agency cannot bill the services until the eligibility or authorization is reinstated.

EXAMPLE:  Ms. Thompson has lost her Medicaid eligibility due to failure to submit documentation on time, but the provider agency has voluntarily chosen to continue providing services in anticipation of Ms. Thompson’s eligibility being reinstated retroactively.  

  • Ms. Thompson’s attendant should continue to use EVV to clock-in and clock-out when providing services to Ms. Thompson.
  • The provider agency should continue to complete visit maintenance on these visits within 60 calendar days of the date of service.
  • If the attendant does not use the EVV system to clock in and out, the provider agency will have to use non-preferred reason codes for these visits.
  • After Ms. Thompson’s Medicaid eligibility is reinstated retroactively, the visits documented in EVV during the period of ineligibility may be billed.

IMPORTANT: If the Medicaid eligibility or service authorization is not reinstated retroactively, the provider agency will not be reimbursed for those visits. Provider agencies are not required to provide services to members who do not have Medicaid eligibility or a current service authorization.