NC Medicaid Electronic Visit Verification Update for Providers Using a Third Party / Alternate EVV Vendor
Service location field must be included for claim validation

Beginning Jan. 1, 2023, home health care provider agencies subject to electronic visit verification (EVV) can use an Alternative EVV system (Alt EVV) of their choice and submit records to the Sandata Aggregator. This will comply with the 21st Century Cures Act for Electronic Visit Verification.

Personal Care Services (PCS) provided in the home through State Plan PCS, Community Alternatives Program for Children and for Disabled Adults (CAP/C and CAP/DA), and the Innovations and Traumatic Brain Injury (TBI) waivers must comply with the 21st Century Cures Act for Electronic Visit Verification (EVV). Beginning Jan. 1, 2023, home health care providers will also be required to comply. Provider agencies subject to EVV can use an Alternate EVV system (Alt EVV) of their choice and submit records to the Sandata Aggregator.

Capturing the location where visits are performed is one of the requirements of EVV. Effective Oct. 5, 2022, all records submitted to the Sandata Aggregator by an Alt EVV vendor must indicate the location of each visit, specifying home or community in the service location field for a visit to be validated in the Sandata Aggregator.

When the service location field is not completed, the Alt EVV vendor will receive an exception notice from Sandata that will prevent the visit data history from transmitting to NCTracks for claim processing.

Alt EVV vendors are requested to work with Sandata to identify system updates or modifications needed to begin including home or community in the service location field with their verified visits that are transmitted to the Sandata Aggregator.

Sandata is implementing a new release effective Oct. 5, 2022, that will include the service location field requirement. 

Contact

Medicaid.EVV@dhhs.nc.gov

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