Improve Your EVV Compliance

Electronic Visit Verification (EVV) is a visit confirmation method allowing Caregivers to Clock-In and Out of visits from the Patient’s home. EVV provides reliable time confirmations and helps to verify that the Caregiver is physically with the Patient when Clocking-In and Out.

Electronic Visit Verification (EVV) is a federal requirement in the United States, mandated by the 21st Century Cures Act, requiring accurate tracking and reporting of home care services provided to Medicaid beneficiaries.

Pavillio provides reporting to support the tracking of EVV compliance via the EVV Compliance Report, found under Reports > Compliance > EVV Compliance. Below is an overview of how Pavillio calculates EVV compliance within that reporting.

The following criteria are verified against a visit to determine if the visit meets the requirement for EVV compliance. If any of these data elements are missing, the visit is considered non-compliant and the provider’s compliance percentage decreases.

Live-in Caregiver Visits do not count towards compliance calculations.

  • EVV clock in: If a visit is missing a clock in, it is considered non-compliant.

  • EVV clock out: If a visit is missing a clock out, it is considered non-compliant.

  • EVV clock in/out: If a visit is missing a clock in and clock out, it is considered non-compliant.

  • Caller ID (when visit is confirmed via IVR): If a visit is missing a phone number on the call in OR the call out when utilizing IVR, it is considered non-compliant.

  • GPS coordinates (when visit is confirmed via mobile application): If a visit is missing GPS coordinates on the call in OR the call out when utilizing the mobile application, it is considered non-compliant.

  • Manual edit of visit start time AND/OR visit end time: A visit is considered manually edited when the visit start time and EVV call in or the visit end time and EVV call out are not matching. If this occurs, the visit is considered non-compliant.

  • EVV compliance percentage (%) = (Compliant visits/Confirmed visits) * 100

    Example:

    • Compliant visits = 60

    • Confirmed visits = 100

    • Compliance percentage (%) = 60%

Follow these steps to boost your EVV Compliance Rates:

  • Regularly review your EVV Compliance Report to identify non-compliant visits.

  • Correct missing or incorrect visit data, such as missing clock-ins/outs or GPS/Caller ID. For a complete list of data that can affect your EVV Compliance, see the EVV Compliance Criteria dropdown above.

  • Correct flagged exceptions quickly to boost your compliance percentage.

The following webinars provide helpful information about improving your EVV Compliance Rates:

EVV Compliance Reporting:

Raising the Bar: How to Reach A 90% (or Higher) EVV Compliance Rate:

What You've Always Wanted to Know About EVV and Billing Compliance: