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Electronic Visit Verification

The 21st Century Cures Act directs state Medicaid programs to require providers of personal care services and home health services to use an electronic visit verification (EVV) system to document services rendered. Federal law requires that providers use the EVV system to document the following information:

  • Date of service
  • Location of service
  • Individual providing service
  • Type of service
  • Individual receiving service
  • Time the service begins and ends

In accordance with federal requirements, the Indiana Health Coverage Programs (IHCP) requires providers to use an EVV system to document personal care services (covered under select Home- and Community-Based Services [HCBS] benefit plans) rendered on or after Jan. 1, 2021. Use of an EVV system to document home health services are required for dates of service on or after Jan. 1, 2024.

To help providers prepare for this requirement, the IHCP has developed a two-page resource with helpful information: Electronic Visit Verification Preparation guide. This resource describes the required steps for providers that wish to use the state’s EVV solution (Sandata), along with steps for providers that wish to use an alternative EVV vendor.

Request to Update Contact Information:
Providers that will be affected by the EVV requirement must ensure that their contact information (telephone numbers and email addresses) is up to date. See the Quick Reference Guide for Provider Healthcare Portal: Updating Contact Information for instructions on updating contact information via the IHCP Provider Healthcare Portal. Updates can also be made by mail, using the IHCP Provider Name and Address Maintenance Form available on the Update Your Provider Profile page. Providers should make updates as soon as possible to receive vital information on the EVV process.

The IHCP EVV Solution

The IHCP is using Sandata as the state-sponsored system for implementing federal EVV requirements. In partnership with Gainwell Technologies, the CoreMMIS claim-processing system has been configured to integrate with the Sandata EVV system.

Providers may choose to use an EVV system other than Sandata. However, those providers will be required to export data from their alternate system to the Sandata "Aggregator" for integration with CoreMMIS. The Aggregator will capture EVV data from both Sandata users and from users of alternate EVV systems.

For documentation, billing and reimbursement of applicable services, providers affected by this federal mandate are required to submit EVV data to the Aggregator (either through the Sandata system or via export from an alternate system), effective by the dates given previously on this page.

Resources for more information about the IHCP EVV solution are listed at the bottom of this page.

Alternate EVV System Specifications

Providers that choose to use an alternate EVV system (instead of the state-sponsored Sandata system) will need to work with their vendors to develop a daily file extract to integrate with the Aggregator, using the following specifications:

For providers using Sandata's Santrax Agency Management (SAM) alternate EVV system, see the following documents for exceptions and a checklist to follow:

Providers using an alternate EVV vendor will need to start the process for having their system interface with the Aggregator by sending an email to EVV@fssa.in.gov with the following subject line and details:

  • Subject: Request for EVV Vendor Certification [Vendor Name]
  • Provider name
  • Provider contact name and email address
  • Vendor name
  • Vendor contact name and email address

After a vendor is identified, the Sandata team will begin working with that vendor to perform testing of their file extract.

Services Requiring EVV

The IHCP has developed a list of personal care and home health services, provided through a Home- and Community-Based Services (HCBS) benefit, that require EVV documentation and verification. For a list of applicable procedure code/modifier combinations, see Service Codes That Require Electronic Visit Verification, accessible from the Code Sets page.

EVV Training

For a quick overview of covered services, security settings, reason codes and tasks performed, see the EVV Supplemental Training Material.

The IHCP delivers training via self-paced training. For providers using an alternate EVV system, training is also available via the Sandata Learning Management System (LMS).

See the Electronic Visit Verification Training page for links to training documents.

Resources for More Information

For clear and concise answers to common provider questions regarding EVV, see Electronic Visit Verification FAQs.

For information on preparing for EVV implementation, see the Electronic Visit Verification Preparation guide.

For providers that have chosen the state-sponsored Sandata EVV system and have completed training and received their login credentials, Electronic Visit Verification Helpful Tips & Tricks: Logging In is a handy resource for logging in to the Sandata solutions.

General questions or concerns about the EVV program may be emailed to inxixevv@gainwelltechnologies.com.

Links to recorded presentations from past EVV-related webinars are added as they become available:

The following IHCP bulletins and banner pages contain relevant EVV information:

  • BT2023145 – Date announced for full enforcement of electronic visit verification (EVV) for personal care services
  • BT202388 – IHCP announces new Sandata Mobile Connect
  • BT202311 – IHCP announces EVV explanation of benefits recoupment codes
  • BT2022114 – IHCP to begin recouping payments due to EVV noncompliance
  • BT202276 – IHCP announces EVV home health policy details
  • BT202248 – IHCP announces date of full enforcement of EVV for personal care services and other updates
  • BT202205 – IHCP excludes electronic visit verification requirement in 24-hour congregate settings
  • BT2020131 – IHCP to continue EVV post and pay
  • BR202050 – Sandata EVV webinar (virtual training) sessions available January 2021
  • BT2020123 – IHCP EVV implementation policy and FAQs provided as personal care service deadline nears
  • BR202040 – IHCP reminds personal care providers that alternate EVV vendors are required to begin integration by Oct. 1, 2020
  • BT2020100 – Alternate EVV vendors must begin integration by Oct. 1, 2020
  • BR202031 – IHCP announces updates to EVV requirements for documenting services
  • BR202030 – IHCP updates personal care services procedure codes that require EVV
  • BR202029 – IHCP reminds providers of EVV dates and personal care services procedure codes that require EVV
  • BT202060 – IHCP announces EVV policy updates
  • BR202013 – IHCP amends alternate EVV solution specifications and reminds providers about establishing the data interface
  • BR202009 – Sandata EVV self-paced training now available
  • BR201951 – CMS good faith exemption extends EVV soft launch
  • BT201951 – IHCP announces policy updates for the implementation of electronic visit verification
  • BT201946 – Checklist and timeline presented to prepare providers using an alternate EVV system
  • BT201945 – Sandata EVV train-the-trainer sessions start Aug. 28
  • BT201942 – Checklist and timeline presented to prepare providers using the Sandata EVV system
  • BT201938 – IHCP removes residential habilitation (daily) services from requirement to document using EVV
  • BT201937 – IHCP announces EVV annual fee and one-time vendor setup fee
  • BT201925 – IHCP provides electronic visit verification (EVV) updates and project timeline
  • BT201910 – IHCP providers alternate EVV solution details
  • BT201855 – IHCP announces EVV solution for personal care and home health services
  • BT201820 – Federal law requires use of EVV system for personal care and home health services

All IHCP bulletins and banner pages are accessible from the Bulletins, Banner Pages and Reference Modules page. To subscribe for email notification of new publications, see the Email Notifications page.

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