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.

General

Why is Wisconsin implementing EVV?

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. States that do not implement EVV will experience financial penalties from the federal Centers for Medicare & Medicaid Services.

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 to DHS the encrypted data points for each visit to match it with a future claim/encounter and for validation.

Do live-in workers need to use EVV?

Although DHS does not require EVV use for live-in workers, health maintenance organizations (HMOs), managed care organizations, and provider agencies may independently require live-in workers to use EVV.

IRIS (Include, Respect, I Self-Direct) fiscal employer agents (FEAs) cannot require participant-hired live-in workers to use EVV.

Refer to ForwardHealth Update 2021-05 (PDF) for more information about live-in workers.

Can EVV be used for services outside the home?

Policy requires Medicaid and BadgerCare Plus fee-for-service members receive personal care services in their home. EVV does not change this requirement.

For services provided through BadgerCare Plus and Medicaid SSI HMOs, provider agencies should continue to work with their HMO regarding place of service details.

For all services provided through Family Care or IRIS, EVV should be used for services authorized to be provided outside the home. 

What is a soft launch?

DHS is rolling out EVV in two phases—a "soft launch" and "hard launch."

Soft launch is an implementation period during which EVV is required for some services and programs. During this period, missing EVV data will not result in denied claims, and encounters will continue to be included in future rate setting.

The soft launch is a time to cooperatively overcome any initial hurdles and help establish good processes. Soft launch began in Wisconsin on November 2, 2020.

What is a hard launch?

DHS is rolling out EVV in two phases—a "soft launch" and "hard launch."

January 1, 2022, is the hard launch date for EVV in Wisconsin. Required EVV data must be captured for dates of service on and after January 1, 2022.

Fee-for-service personal care service claims will be required to have a corresponding EVV record. If there is no corresponding EVV record for a claim detail, the detail will be denied.

HMOs and MCOs have the authority and will likely deny provider agency claims without EVV data.

HMO and MCO encounters that do not have a matching EVV record for personal care services or applicable supportive home care services may be excluded from future capitation rate development.

IRIS participants, as the employer, are responsible to make sure their participant-hired workers are using EVV to remain enrolled in the IRIS program. IRIS FEAs will pay participant-hired worker claims in a timely manner and work with participants and participant-hired workers to resolve inaccurate EVV data.

IRIS FEAs will deny provider agency claims without matching EVV data.

Who is responsible for training workers to use EVV?

Visit the DHS EVV training webpage and scroll to the "How do workers, provider agencies, FEAs, and program payers get trained?" heading. Select the appropriate dropdown menu for training information.

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.

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

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

  • 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

  • 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)

Members and participants

Will the member or participant be required to use EVV to verify a visit and provide a signature?

DHS does not require member or participant verification and signature. Provider agencies or IRIS FEAs can choose to incorporate client verification and signature into their business processes for EVV.

How does Sandata protect information?

Sandata upholds rigorous standards for 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.

Does the EVV GPS monitor location?

EVV identifies the location at the start and end of the visit. It does not track location before, after, or during the visit.

How can members or participants update their address or phone number?

The process for changing a member’s or participant’s address and phone number has not changed with EVV.

The member or participant has the responsibility to keep this information up-to-date. 

The member or participant address should be kept up-to-date with all other applicable entities including the Social Security Administration and the foster care system. See below for instructions by program.

How does a member in the Medicaid and BadgerCare Plus fee-for-service program update their information?

The member can report changes to their local income maintenance agency or tribe, online on the ACCESS website, or by using the Information Change Report.

How does a member in a BadgerCare Plus HMO or Medicaid SSI Medicaid HMO update their information?

The member can report changes to their local income maintenance agency or tribe, online on the ACCESS website, or by using the Information Change Report.

How does a member in the Family Care or Family Care Partnership program update their information?

The care team in Family Care and Partnership can us use Form F-02404 (Word).

The member can use this form to report changes themselves. The member can report changes to their local income maintenance agency or tribe, online on the ACCESS website, or by using the Information Change Report.

How does an IRIS participant update their information?

The participant can do one of the following:

  • Contact their IRIS consultant, who can update that information in the DHS IRIS system. The IRIS consultant can use Form F-02404 (Word).
  • Contact their IRIS Consultant Agency.
  • Contact the IRIS Call Center for assistance at 888-515-4747.

Provider agencies, workers, and associations

What if the member’s or participant’s address is not accurate?

The process for changing a member's or participant's address and phone number has not changed with EVV. It is the responsibility of the member or participant to keep this information up to date. Instructions to update this information are provided in this FAQ in the “Member and participant questions” section.

If a change to member or participant information is delayed, the provider agency can add a valid and verifiable address or phone number in the Sandata EVV Portal client profile. This will only update the Sandata system and will not update the Medicaid file in any other system.

The “Modify Clients” section in PowerPoint 4: Client Format shows the steps for the provider agency administrator to update the member or participant information. 

What EVV technologies are available from Sandata?

  • Sandata Mobile Connect (also known as Mobile Visit Verification (MVV)): A mobile application to collect visit information.
  • Sandata Telephonic Visit Verification (TVV): When using a member or participant's landline or fixed VoIP phone to call in visit data.
  • Sandata Fixed Visit Verification (FVV): A small, in-home device available from Sandata, when no other visit collection methods are possible or available.
  • Sandata Aggregator: Allows provider agencies to use a third party EVV system as long as it meets technical requirements

Does EVV require internet access?

In the DHS-provided system, cellular, internet, and Wi-Fi availability are not required at the point of care for workers to check in and check out. Cellular, internet, or Wi-Fi are required at a later time to send the visit information.

How will EVV be used for workers with a contracted daily rate or for workers who split shifts, such as a morning and an evening visit?

DHS encourages workers who are providing “per day” services to log in and out when they begin and end services for each visit, as opposed to once a day. These are service codes T1020 or S5126.

Workers should check in at the beginning of each visit and check out at the end of each visit.

The Sandata Mobile Connect app will automatically end a visit after 25 hours. Workers must check out and back in for visits lasting longer than 24 hours. For visits less than 24 hours, one check-in and one check-out is sufficient, even if the visit lasts across two calendar days.

Are workers who provide care for multiple clients at one location required to check in and out of EVV separately for each client visit?

No. The Sandata EVV solution includes a group visit functionality so the worker does not need to check in and out for each client one by one, as long as each client in the group has the same payer.
Refer to training videos for more information about group visits:

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

No, there is no charge for use of the DHS-provided EVV system through Sandata.

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

The FVV device itself will be paid for by DHS and does not require data or complex installation. (It is “fixed” to a surface in the member or participant’s home using an adhesive tape.)

FVV devices give codes that must be called in. This means that the agency, worker, or member or participant must have a phone. Any type of phone, from any location, may be used to call in FVV codes.

What language options are available for workers using Sandata EVV?

The Sandata app and TVV prompts offer 15 language options, including those most frequently used in Wisconsin. Workers and members or participants can set their language preferences separately. Choices include English, Spanish, Hmong, Arabic (Egyptian), Burmese, Chinese (Mandarin), French, Hindi, Laotian, Nepali, Russian, Serbian, Somali, Swahili, and Vietnamese.

Written training materials are available in multiple languages. Additional languages can be requested via email. Please allow 30 business days for translation and delivery.

Sandata's EVV Portal for administrative processing is available in English.

Are all workers required to have a worker ID?

Yes, all workers are required to have a worker ID even if they are not be required to use EVV.

Workers are assigned one worker ID from the secure ForwardHealth Portal. This one ID identifies the worker across any provider agency they work with.

Does every worker need to have an email address?

Yes, all workers who are required to capture EVV will need to have a unique email address. It cannot be a shared email account.

How should workers log visits for EVV if they perform multiple types of personal care services during a single visit?

Workers choose a broad service code that covers many tasks, including helping someone bathe, get dressed, and brush their teeth. There is no need to check in and out for individual tasks. As a reminder, tasks are not required by DHS, but an HMO, MCO, FEA, or provider agency can require that tasks are included in EVV.

Can a verified visit be canceled or deleted in the system?

No. Once a visit has been verified, its status may be changed, but visits cannot be deleted from the audit trail.

Does the DHS-provided Sandata system allow provider agencies to capture EVV visit information for billing codes that are not on the DHS list of required codes?

No. Only services billed under procedure codes T1019, T1020, S5125, and S5126 are included in EVV. Service codes for EVV use in home health (required in 2023) have not been determined yet. Provider agencies interested in including other service codes may want to use an alternate EVV system.

What will happen to the claim if a worker checks in late at the beginning of their shift?

The DHS-provided Sandata system does not include a scheduling component to identify late shifts.

If the provider agency needs to correct check-in or check-out times to reflect an accurate visit duration, reference PowerPoint 9: Visit Maintenance, P-02754.

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

Will EVV replace paper timesheets?

EVV does not change or replace current requirements regarding the completion and retention of time sheets, record of care, or other documentation. After hard launch, fee-for-service provider agencies can choose to use EVV to capture some records. Workers should check with their provider agency, HMO, MCO, or FEA regarding documentation requirements.

How quickly could provider agency administrators view or verify visit information in the Sandata EVV Portal?

Provider agency administrators using the DHS-provided EVV system can view worker check-in and check-out times through the Sandata EVV Portal in near-real time. Information from alternate EVV vendors through the Sandata aggregator will be updated frequently, but the frequency will depend on the vendor.

Does the Sandata EVV system provide a change log or a report when provider agencies manually edit visit data?

The DHS-provided EVV system allows administrators at the provider agency or FEA to manually correct a visit when necessary. Provider agencies that need to correct check-in or check-out times to reflect an accurate visit duration can find instructions in PowerPoint 9: Visit Maintenance, P-02754.

Sandata’s EVV Portal keeps an audit trail of manual edits. A log description of visit changes is visible within the view of each visit and also through the Visit Verification Activity Report, accessible in the Sandata EVV Portal.

The DHS Office of the Inspector General will be closely monitoring manual corrections to EVV data.

Is there a cut-off date for provider agencies to make changes to visit information?

No, provider agencies using the DHS-provided EVV system can always access any visit recorded after the soft launch date on November 2, 2020. However, claims submission timelines and requirements remain the same and are not impacted by EVV.

How do workers and administrators reset passwords?

Workers can refer to EVV PowerPoint 6: Sandata Mobile Connect (PDF) for instructions on resetting passwords.

Administrators can refer to the Sandata Provider Agency Training Guide (PDF) for password reset instructions.

Find password reset information in Issue 8 of Your Key to EVV.

Last Revised: July 27, 2021