Table of Contents
What is EVV?
What is Electronic Visit Verification (EVV)?
Electronic Visit Verification (EVV) is a system designed to ensure caregivers are at the correct location to provide services for clients. For many states EVV is now required for any Medicaid or VA services being provided and it is increasingly being used in the private sector for increased accountability. There are two primary forms of EVV, the telephony system and the mobile app. Under the telephony system caregivers call a designated phone number to clock in and out while using the Mobile App caregivers login and clock in and out on their mobile phone. These systems are compatible with one another so if a caregiver clocks in using the RCA they can still clock out using the Telephony number.
Rosemark Caregiver App (RCA)
Most agencies use the mobile application. For some this is a requirement for Medicaid or VA services but most agencies elect to use the RCA as it has a number of additional features not available via Telephony. Some of these features include:
- Caregivers can review their schedule in advance on the app.
- Agency staff can send broadcast messages and shift offers which can be accepted or declined in the app.
- Most agencies find care plan task entry is easier to do via the app.
- For clients in rural areas there is an offline mode that many agencies find useful.
Telephony
Many agencies still have a Telephony line as a backup EVV system. Caregivers will call into the system from the clients landline phone, enter their caregiver number, the client number they are working for, and if applicable any task information that was completed on their shift. Some agencies continue to use the Telephony system because its easier for their staff to understand. For many caregivers having a familiar tool offsets the issues with getting them up and running on new technology.
Managing EVV events is one of the core aspects of Rosemark but the amount of work will vary based on your caregivers. If your caregiving team clocks in and out at the right time and place consistently there is very little work that needs to be done. However, if your caregiving staff struggles with this it will increase the workload on office staff.
To review EVV Events begin at the Home screen in the Web Portal. Click the EVV Events button.
The EVV Events window displays a list of your EVV events including the type, time, date, status, and source in addition to the client and caregiver.
EVV Sources and Statuses
The EVV source indicates what type of EVV event it is. There are three EVV sources:
- Mobile - The event was captured via the Rosemark Caregiver App (RCA)
- Telephony - The event was captured via the Telephony system
- Offline - The event was captured using Offline Mode via the RCA
EVV Events can have different statuses:
- Linked - The EVV event is connected to a shift, either automatically based on your On Time window or has been manually verified by a staff user.
- Attached - The system knows the EVV is associated with a shift but it needs to be manually reviewed for either being outside the On Time window or outside of your distance thresholds.
- Ignored - An event that agency staff are telling the system to ignore either for being incorrect or extraneous.
- Telephony Specific EVV:
- Loose - Loose EVV events are telephony events that have been logged but need to be manually linked. These events are similar to attached EVV events and are often handled the same way.
- Incomplete - Incomplete EVV events occur when a caregiver starts clocking in or out using telephony but does not enter the caregiver or client number. Often seen when a caregiver enters the wrong client or caregiver number and hangs up the phone to re-enter the correct information.
- Invalid - The EVV event is coming from an unauthorized device. Some agencies require caregivers to call from the client's phone, if they called from the caregiver phone when this requirement is in place the EVV event would be considered Invalid for not meeting the agency requirements.
Automatic Linking and the “On Time” Window
The most important aspect of EVV relates to how Rosemark links EVV events. If a caregiver clocks in and out on time and at the correct location Rosemark will automatically link the EVV event. What is considered on time and and within the correct distance threshold is controlled by the agency. In the images below you can see a fairly common example.
The first image is the "On Time Window". If a caregiver clocks in or out within this range Rosemark will automatically link the EVV event. If the event is outside of this time period, even by a few seconds, agency staff will need to manually review and link the EVV event. Some agencies explain this to their caregiving staff as a grace period to allow for traffic or other things that might pop up. The most common intervals are 5, 10, and 15 minute grace periods, and very few agencies go beyond the 15 minute window.
The second image is the Distance Threshold. If a caregiver clocks in outside of the distance range agency staff will need to manually review and link the EVV event. If caregivers are clocking in and out on time, and in the right place, the process can be entirely automated and requires no further oversight by agency staff. Common distance thresholds are 250, 500, and 1000 feet. The region you provide service in often dictates how large of a distance threshold is needed. If you primarily service residential homes a lower threshold is needed compared to rural areas.
Viewing EVV
If you click on an EVV event you can bring up additional data including the distance from the client's home, any travel or miscellaneous expenses, as well as any completed tasks. From this screen you can choose to Link or Ignore the individual EVV event by selecting the option in the top right corner.
Linking EVV
Linking EVV is one of the most important aspects of using Rosemark. The process itself is a simple one, but making sure agency staff understand the context is important. In the image below you can see the EVV event has not been linked. To link the EVV event click the Link button in the top right.
When linking an EVV event you will see three sections. At the top you will see the actual EVV data. In the middle you will see the scheduled time of the shift. At the bottom you will need to tell the system how you want to link the EVV to the shift, of which there are two options.
- You can link the EVV event to the original shift start or end which will not change the billing duration.
- You can change the shift time to match the EVV event. This will change the duration and could add or subtract billable time.
Agency staff must review any EVV event that is not linked.
EVV Linking Example
Linking Based on Shift Times
In the image below you can see that when linked to the the shift times instead of the actual EVV time that there can be a difference between the EVV duration and the Bill duration.
Linking Based on EVV Times
In the first image below you can see that when linking the EVV to the EVV time you will see a notification saying that it will recalculate the times.
In the Shift view you can see that when linked to the EVV time there is no difference between any of the durations.
When should an agency link based on Shift Time?
Some clients might a limited number of hours available to them (common in Medicaid, VA, and Long Term Care agreements). If a caregiver were to work longer than the duration you may only want to bill them for the original shift duration. Alternatively some agencies stipulate in their contracts with clients that time will be rounded to the nearest quarter, half, or full hour. Each agency should establish their own polices regarding EVV linking for a consistent experience for all clients.
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