Electronic Visit Verification (EVV): FAQs

The following are FAQs the Wisconsin Department of Health Services (DHS) has received from stakeholders through public forums, the EVV email box, and the Wisconsin EVV Advisory Workgroup.

The answers provided in the FAQs are specific to the Wisconsin DHS EVV system and may not be representative of alternate EVV systems.

This page will be revised with new information as it becomes available.

Overview

What is EVV?

Electronic Visit Verification (EVV) is a system that uses technology to verify that authorized services were provided. Workers will be required to send information to an EVV system at the beginning and end of each visit, including:

  • Who receives the service.
  • Who provides the service.
  • What service is provided
  • Where service is provided.
  • Date of service.
  • Time in/time out.

NEW! What happens to the information collected by the EVV system?

The confidentiality of the information is protected under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). When a worker submits EVV data using any of the Sandata solutions, the six required data points are encrypted. The data can be viewed by the provider agency in the Sandata portal in near-real time. Sandata also transmits the encrypted data points for each visit to DHS to match it with a future claim/encounter and for validation. 

Why implement EVV?

DHS is implementing EVV to be in compliance with the federal 21st Century Cures Act. This is mandatory for Medicaid programs in all states. The Centers for Medicare & Medicaid Services (CMS) will fine state programs if they do not implement EVV.

What is the federal 21st Century Cures Act?

Section 12006(a) of the 21st Century Cures Act mandates that states implement EVV for all Medicaid personal care services and home health services that require an in-home visit by a provider. This applies to personal care services provided under sections 1905(a)(24), 1915(c), 1915(i), 1915(j), 1915(k), and Section 1115 and home health services provided under Section 1905(a)(7) of the Social Security Act or a waiver.

On August 19, 2019, CMS granted DHS approval of its EVV good faith effort exemption request.

With this approval, CMS will not apply federal fines against Wisconsin Medicaid funding during calendar year 2020. This approval allows Wisconsin Medicaid to implement the EVV system during calendar year 2020 without the risk of being fined for noncompliance.

How will DHS engage with stakeholders?

DHS has created an EVV stakeholder engagement plan that will be reviewed and updated based on the needs of the project and input from stakeholders. The plan consists of the following:

Provider agency workgroup: Began meeting in 2017
Provider agency survey: Completed in August 2018
Member, participant, worker, and association forums in various statewide locations and online
HMO, MCO, and IRIS administrator meetings: Held as needed throughout planning and implementation
Wisconsin EVV Advisory Workgroup: Kickoff held on November 15, 2018, and monthly meetings will be held throughout the life of the project
Email box: Established for all feedback
Email list: Created so stakeholders can receive EVV updates

Has DHS researched how other states implemented EVV?

Yes. DHS has contacted numerous states to discuss how they have implemented EVV. DHS is also participating in meetings where states discuss their EVV implementation designs and lessons learned.

What programs and services does EVV affect?

EVV affects all personal care and home health services, including services provided through Wisconsin Medicaid and BadgerCare Plus fee-for-service (ForwardHealth card), BadgerCare Plus and SSI HMOs, Family Care, Family Care Partnership, and IRIS (Include, Respect, I Self-Direct).

DHS has determined the procedure codes that will be impacted by EVV.

BadgerCare Plus Fee-For-Service and BadgerCare Plus and SSI HMOs

The impacted procedure code for ForwardHealth (BadgerCare Plus fee-for service and BadgerCare Plus and SSI HMOs) is T1019 (personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, ICF/IID or IMD, part of the individualized plan of treatment [code may not be used to identify services provided by home health aide or certified nurse assistant]).

Family Care and Family Care Partnership

The impacted procedure codes for Family Care and Family Care Partnership are:

  • T1019 (personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, ICF/IID or IMD, part of the individualized plan of treatment [code may not be used to identify services provided by home health aide or certified nurse assistant]).
  • T1020 (personal care services, per day)
  • S5125 (attendant care services, per 15 minutes)
  • S5126 (attendant care services, per day)
IRIS

IRIS will be updating procedure codes with the waiver renewal on January 1, 2021. Therefore, beginning with EVV's soft launch, the impacted procedure code for IRIS is T1019 (personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, ICF/IID or IMD, part of the individualized plan of treatment [code may not be used to identify services provided by home health aide or certified nurse assistant]).

After the IRIS waiver is renewed effective January 1, 2021, the impacted procedure codes for IRIS will also include:

  • S5125 (attendant care services, per 15 minutes)
  • S5126 (attendant care services, per day)

NEW! Will respite care need to use EVV?

No, respite is not subject to EVV. Only services billed under procedure codes T1019, T1020, S5125, and S5126 are included in EVV.

NEW! Can EVV be used for services outside the home?

Yes, EVV can be used for community visits and services provided outside the home.

NEW! When will EVV be implemented?

In response to the COVID-19 pandemic, the Wisconsin Department of Health Services is delaying the start of training and the soft launch date (formerly September 1, 2020) requirement to use EVV for personal care services. 

What is a soft launch?

DHS will be rolling EVV in two phases, a "soft launch" and "hard launch." When the soft launch begins for personal care services and supportive home care, it will be a period in which all provider agencies and workers will be required to use EVV, but it will not be integrated into claims processing.

The soft launch will be a time to cooperatively overcome any initial hurdles and help establish processes.

What is the hard launch?

DHS will be rolling out EVV in two phases, a "soft launch" and "hard launch." The hard launch is when DHS will require personal care service claims to include required EVV information, or they may be denied. The hard launch date has not been established.​

NEW! Who is responsible for training agency workers to use EVV?

For the DHS-provided EVV system, DHS will train administrators from fiscal employer agents (FEAs), IRIS consultant agencies (ICAs), HMOs, managed care organizations (MCOs), and provider agencies. Additionally, workers will receive training on how to check in and out through a training video DHS will provide. 

NEW! What languages will the trainings be in?

All trainings are available in English. Recorded trainings will also be available in Hmong and Spanish. Translations to additional languages will be provided upon request. 

Will workers be assigned a unique ID number for EVV?

Yes. EVV requires a way to identify the individual providing services. Assigning a unique ID protects the workers' personally-identifiable information within the EVV system. This will be addressed in training.​​​

How can I provide my feedback?

You can contact DHS by emailing the EVV box.

Member and participant questions

Can Wisconsin choose not to implement EVV?

No. Section 12006(a) of the 21st Century Cures Act mandates that states implement EVV for all Medicaid personal care services and home health services that require an in-home visit by a provider. States that do not implement EVV will experience financial penalties from CMS.

NEW! Will the member or participant need to use EVV to verify that services were received?

No, Wisconsin is not currently requiring members or participants to use the EVV portal to verify that services were received.

NEW! Will parents or other family supports need to work through an agency to provide care?

No, families will not be required to change how they provide care or join a provider agency in order to do so.

How does Sandata protect information?

Sandata upholds rigorous standards for Health Insurance Portability and Accountability Act of 1996 (HIPAA) privacy and data protections and uses strategies such as encryption to ensure protected health information is secure. Sandata is certified by the Health Information Trust Alliance (HITRUST), conducts regular mandatory training and sends frequent communications to all Sandata employees regarding best data security practices.

Will providers be financially impacted by the implementation of EVV?

The 21st Century Cures Act requires the implementation of EVV to be "minimally burdensome." Minimally burdensome does not mean it will have no impact, but DHS will work to minimize impact when possible.

Agencies should expect to incur some costs for the training and setup of the state-provided system. DHS will collaborate with stakeholders to ensure these changes have the least amount of financial impact on members, participants, workers, and providers while still meeting federal requirements.

What technologies will be available to submit visit verification information through Sandata?

  • Sandata Mobile Connect (SMC) or Mobile Visit Verification (MVV): A mobile application to collect visit information
  • Sandata Telephonic Visit Verification (TVV): Uses automatic number identification (ANI) technology to validate phone calls from the member's or participant's identified phone number(s) to collect visit information.
  • Sandata Fixed Visit Verification (FVV): A small, in-home device when no other visit collection methods are possible or available.
  • Sandata EVV Aggregator: Allows provider agencies to continue to use a third-party EVV system as long as it meets technical requirements

Will EVV require internet access?

An onsite internet connection is not needed to check in and out on the mobile app. The encrypted visit information can be uploaded at a later time when an internet connection is available.

No internet connection is required for TVV or FVV.

Where can I see a Sandata system demonstration?

The April 2019 EVV forum provides a general Sandata system demonstration (beginning at the 30-minute mark). The demonstration is not specific to Wisconsin's EVV solution.

NEW! Who is responsible for training agency workers to use EVV?

For the DHS-provided EVV system, DHS will train administrators from fiscal employer agents (FEAs), IRIS consultant agencies (ICAs), HMOs, managed care organizations (MCOs), and provider agencies. Additionally, workers will receive training on how to check in and out through a training video DHS will provide. 

Does the EVV GPS monitor a worker at all times, including before and after work?

The technology used to verify the worker's location only records locations at the start and end of the service. It does not record their location at any other time.

Will scheduling be used to know if there are any missed visits?

No. The DHS-provided Sandata EVV system does not include a scheduling module. Provider agencies may elect to purchase additional features, such as scheduling, from Sandata or other alternate EVV vendors.

Will natural or unpaid supports (unpaid help and care that someone received from their friends, family, or community) be required to use EVV?

No. EVV is for services paid for with state Medicaid dollars. EVV is not applicable to unpaid support.

How can I submit EVV questions?

You can contact DHS by emailing dhsevv@dhs.wisconsin.gov.

Provider agency, worker and association questions

Who is the EVV vendor in Wisconsin?

On November 19, 2018, DHS announced that our current Medicaid Management Information System (MMIS) fiscal agent, DXC Technology, contracted with Sandata Technologies as the EVV vendor. DHS made this decision to optimize integration with the current MMIS.

How does Sandata protect information?

Sandata upholds rigorous standards for Health Insurance Portability and Accountability Act of 1996 (HIPAA) privacy and data protections and uses strategies such as encryption to ensure protected health information is secure. Sandata is certified by the Health Information Trust Alliance (HITRUST), conducts regular mandatory training, and sends frequent communications to all Sandata employees regarding best data security practices.

Will providers be required to use Sandata's EVV technology?

No. DHS will use Sandata's aggregator technology to implement EVV, which allows providers who already have an EVV system to continue to use it if it meets EVV and DHS aggregator use requirements. The aggregator merges the data from the existing system into the Sandata system.

What third party systems does the Sandata aggregator work with?

The Sandata aggregator will work with any system that meets the technical requirements. Technical specifications are forthcoming.

Will Sandata Technologies be allowed to charge impacted providers, HMOs, MCOs, or IRIS program administrators for use of the EVV system?

No.

Will impacted providers need to purchase an EVV system?

No.

Do agencies need to pay the state to use the EVV system being provided?

No. Agencies will not pay for use of the state-provided EVV system.

Will providers be financially impacted by the implementation of EVV?

The 21st Century Cures Act requires the implementation of EVV to be “minimally burdensome.” Minimally burdensome does not mean it will have no impact, but DHS will work to minimize impact when possible.

Agencies should expect to incur some costs for the training and setup of the state-provided system. DHS will collaborate with stakeholders to ensure these changes have the least amount of financial impact on members, participants, workers, and providers while still meeting federal requirements.

What technologies will be available to submit visit verification information through Sandata?

  • Sandata Mobile Connect (SMC) or Mobile Visit Verification (MVV)— A mobile application to collect visit information.
  • Sandata Telephonic Visit Verification (TVV)— Uses automatic number identification (ANI) technology to validate phone calls from the member’s or participant's identified phone number(s) to collect visit information.
  • Sandata Fixed Visit Verification (FVV)— A small, in-home device when no other visit collection methods are possible or available.
  • Sandata EVV Aggregator—allows providers to continue to use a third-party EVV system as long as it meets technical requirements.

Who will provide the technology?

DHS will provide access to the Sandata EVV system free of charge. The hardware for submitting data to this system must be provided by the agency, worker, or member/participant. This may include a cell phone, tablet, or landline. More specific information will be provided in the training phase of the project.

Will there be any charges for FVV devices (for example, installation, data, or service)?

While the FVV devices will be paid for by DHS, the phone to call in the visit must be provided by the agency, worker, or member/participant. The FVV device is considered the option of last resort. More specific information related to FVV will be provided in the training phase of the project.

Does Sandata have a mobile app for EVV?

Yes. DHS will work with Sandata to configure its existing mobile application for Wisconsin’s needs. The app will be available for Android and iOS (Apple) devices.

How much data and battery life is used on a cell phone for each visit?

The app takes relatively little memory on a cell phone (comparable to a calendar app, about 12 MB) and uses minimal data for each check in/out pairing (comparable to one minute of Facebook time, about 0.1-0.3 MB).

Will EVV require internet access?

An on-site internet connection is not needed to check in and out on the mobile app. The encrypted visit information can be uploaded at a later time when an internet connection is available.

No internet connection is required for the TVV or FVV solutions.

Can a worker use a cell phone that is not a smart phone to call in using telephone (TVV)?

For TVV, a landline must be used; it confirms location the same way the 911 system does. If TVV is used from a cell phone, the call/visit will be recorded but the end report will note the location was not confirmed in the usual way.

Where can I see a Sandata system demonstration?

The April 2019 EVV forum provides a general Sandata system demonstration (beginning at the 30-minute mark). The demonstration is not specific to Wisconsin's EVV solution.

NEW! When will training begin?

In response to the COVID-19 pandemic, DHS is delaying the start of training. We will announce a new timeline when it is available.

NEW! Who is responsible for training agency workers to use EVV?

For the DHS-provided EVV system, DHS will train administrators from fiscal employer agents (FEAs), IRIS consultant agencies (ICAs), HMOs, managed care organizations (MCOs), and provider agencies. Additionally, workers will receive training on how to check in and out through a training video DHS will provide. 

NEW! What languages will the trainings be in?

All trainings are available in English. Recorded trainings will also be available in Hmong and Spanish. Translations to additional languages will be provided upon request. 

NEW! What language options are available through the Sandata portal and applications?

The Sandata app and Telephonic Visit Verification (TVV) will offer 15 language options including those most frequently utilized in Wisconsin. Workers and those receiving care can set their language preferences separately. Choices include English, Hmong, Laotian, Burmese, Spanish, French, Russian, Serbian, Somali, Swahili, Arabic (Egyptian), Hindi, Chinese (Mandarin), Nepali, Vietnamese. 

Sandata's portal for administrative processing is available in English.

NEW! What kind of technical support will be offered for workers and provider agencies?

The DHS EVV call center will be equipped to assist with questions and technical issues encountered while using the DHS-provided EVV system. DHS will offer other resources as needed to clarify common concerns after the launch.

Does the EVV GPS monitor a worker at all times, including before and after work?

The technology used to verify the worker’s location only records locations at the start and end of the service. It does not record their location at any other time.

Will scheduling be used to know if there are any missed visits?

No, the DHS-provided Sandata EVV system does not include a scheduling module. Provider agencies may elect to purchase additional features such as this from Sandata or other alternate EVV vendors.

Will EVV affect long-term care facilities who are working with individuals enrolled in Family Care and whose care is funded by an MCO?

No, per CMS, personal care services received in a hospital, nursing facility, ICF/IID or IMD, do not require use of EVV.

Will RNs be using the verification during supervisory visits?

No, the nurse will not need to use EVV during their supervisory visit.

Will natural or unpaid supports (unpaid help and care that someone receives from their friends, family, or community) be required to use EVV?

No. EVV is for services paid for with state Medicaid dollars. EVV is not applicable to unpaid support.

NEW! Do workers who split shifts, such as a morning and an evening visit, have to clock in and out twice? 

Workers will check in and check out at the beginning and end of each shift.

NEW! Will EVV add extra steps to the services I provide?

EVV is an additional step workers need to take for checking in and out. It typically takes less than a minute. EVV will not otherwise change the services provided. Any emergency need should be tended to immediately. EVV should not impact the quality of care.

NEW! Does travel time need to be recorded as part of the visit with EVV?

No, travel time is not one of the service codes impacted by EVV. Coverage and billing for this and other services that are not included in EVV remain unchanged.

NEW! Will claims without required EVV data be denied?

DHS will begin EVV with a soft launch. During the soft launch period, claims will not be denied for missing or incomplete EVV data. It is a time to cooperatively overcome any initial hurdles and help establish processes.

A later hard launch date will require claims to include EVV information. Claims that do not have the required EVV information at the time of hard launch may be denied. DHS may exclude such personal care costs from managed care capitation rate development.

NEW! Are agencies able to require their workers to use their personal cell phone for work?

Please see the Department of Labor fact sheet on Deductions From Wages for Uniforms and Other Facilities Under the Fair Labor Standards Act (FLSA) for additional guidance that would be applicable to this scenario. For labor law questions, provider agencies may wish to consult with an attorney.

NEW! Are agencies responsible for cell phone or data charges if the worker is using a mobile device to record their visit?

Please see the Department of Labor fact sheet on Deductions From Wages for Uniforms and Other Facilities Under the Fair Labor Standards Act (FLSA) for additional guidance that would be applicable to this scenario. For labor law questions, provider agencies may wish to consult with an attorney.

NEW! If a worker's visit is four hours in duration, but the worker was only approved to spend three hours, is the agency required to pay the worker for the entire recorded visit?

Please see the Department of Labor fact sheet on Deductions From Wages for Uniforms and Other Facilities Under the Fair Labor Standards Act (FLSA) for additional guidance that would be applicable to this scenario. For labor law questions, provider agencies may wish to consult with an attorney.

NEW! Will EVV replace paper timesheets?

No, not at this point for the DHS-provided EVV system.

NEW! How quickly will visit information be available in the Sandata portal?

Information from visits will be updated in the Sandata portal in near-real time. Information from third-party vendors through the Sandata aggregator will be updated frequently, but the frequency will depend on the vendor.

NEW! Will provider agencies be able to manually correct visit time?

Yes, the DHS-provided EVV system allows administrators at the provider agency or FEA to manually update a visit when necessary.

How can I submit EVV questions?

You can contact DHS by emailing the EVV mailbox.

Program administrator (HMO, MCO, fiscal employer agents) questions

NEW! When will training begin?

In response to the COVID-19 pandemic, DHS is delaying the start of training. We will announce a new timeline when it is available.

NEW! What language options are available through the Sandata portal and applications?

The Sandata app and Telephonic Visit Verification (TVV) will offer 15 language options including those most frequently utilized in Wisconsin. Workers and those receiving care can set their language preferences separately. Choices include English, Hmong, Laotian, Burmese, Spanish, French, Russian, Serbian, Somali, Swahili, Arabic (Egyptian), Hindi, Chinese (Mandarin), Nepali, Vietnamese. 

Sandata's portal for administrative processing is available in English.

NEW! Will claims without required EVV data be denied?

DHS will begin EVV with a soft launch. During the soft launch period, claims will not be denied for missing or incomplete EVV data. It is a time to cooperatively overcome any initial hurdles and help establish processes.

A later hard launch date will require claims to include EVV information. Claims that do not have the required EVV information at the time of hard launch may be denied. DHS may exclude such personal care costs from managed care capitation rate development.​

NEW! How quickly will visit information be available in the Sandata portal?

Information from visits will be updated in the Sandata portal in near-real time. Information from third-party vendors through the Sandata aggregator will be updated frequently, but the frequency will depend on the vendor.​

NEW! Will HMOs, MCOs, and FEAs verify an EVV record exists prior to paying claims?

Yes.

How can HMOs, MCOs, and FEAs submit questions?

You can contact DHS by emailing the EVV box.

Working to answer in the near future

DHS received the following questions, and they will be answered once decisions are finalized.

Provider Agency, Worker, and Association Questions

  • When will the mobile app be available?
  • Will EVV change how claims are submitted or processed?
  • Will the implementation of EVV require any regulation changes?
  • What will the process be for clocking in and out for EVV?
Last Revised: March 27, 2020