The Electronic Visit Verification (EVV) system is used to collect visit information, record required data fields and generate a unique visit key specific to that service, date and individual. The visit key created by the system is tied to call-in, call-out, visit date, time and beneficiary. For NC Medicaid Direct claim adjudication subject to EVV, NCTracks matches the required data fields and visit key to the claim. EVV claims for NC Medicaid Direct that reuse the same EVV visit key for multiple dates of service, MIDs, NPIs or procedure codes will deny. Additionally, claims without verified visits will be denied.
Visit keys are unique to each date of service. Providers modifying EVV data to reuse a visit key generated specifically for a date of service or individual to adjudicate claims for additional dates or individuals will be subject to referral to the Office of Compliance and Provider Integrity for investigation.
To prevent visit keys from adjudicating multiple claims, NCTracks has enabled validation that will deny a claim if the same visit key is used for multiple dates of service, MIDs, NPIs or procedure codes, as each of these should have their own verified visit. Providers reusing visit keys will receive the following denial reason on the EOB ELECTRONIC VISIT VERIFICATION NOT FOUND FOR CLAIM LINE DATE OF SERVICE.
Contact
NCTracks Call Center: 800-688-6696