Electronic Visit Verification Information

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What’s New?

In this section, you will find any changes and new information, as well as updates you should be aware of as you move forward with EVV implementation.

New Information

The recording of the AuthentiCare demo, presented by Fiserv on 7/28/2020, is now available on the provider portal (HTML, new window).

If you have not already done so, please complete the EVV selection declaration form as soon as possible.

Updates

  • In the EVV webinar held on July 14, we stated that landlines would only be accepted for the beneficiary. However, we have received clarification from CMS and we can now accept beneficiary cell phones.

  • Beneficiary signatures will not be required at this time due to the circumstances around Covid-19.

EVV Overview

The 21st Century Cures Act—which was signed into law in 2016—requires state agencies to implement a system of electronic visit verification (EVV) for personal care services and home health care services provided and reimbursed under Medicaid. The EVV mandate is designed to enhance quality and accuracy of care services.

On October 22, 2019, CMS approved the Arkansas EVV Good Faith Effort Exemption request. This means the State has until January 1, 2021 to implement the EVV program. For this initial implementation, EVV will be used for personal care, attendant care and respite services. EVV is required to be implemented for Home Health by January 1, 2023.

Electronic Visit Verification is a process that uses electronic means to verify care provider visits for personal or home health care services. The information collected during visits includes:

  • the date of service provided
  • the start time and end time for service provided
  • the type of health care service performed
  • the location of the service provided
  • information about the service provider.

EVV offers a modern way for care providers to record their visits by location, time, and tasks. Visits can be logged using an app on the caregiver’s cell phone or the member’s landline phone.

Provider Enrollment Requirements

  • All caregivers who will be using EVV for personal care, attendant care and respite services must enroll with Arkansas Medicaid. This is a mandatory requirement that must be met for agencies to bill services.
  • The enrollment process is currently open and must be completed by September 30, 2020.
  • Caregivers can enroll online through the Provider Portal, or by filling out and mailing in a paper application.
  • Once the caregivers are enrolled, they will be given a provider number which may also be called a PIN (personal identification number).

More information about enrolling as a Medicaid provider can be found on the Provider Portal.

Training Information and Important Dates

Training Information

View the EVV training information spreadsheet (Excel, new window). This spreadsheet includes registration links within the training calendar, as well as training module descriptions.

Please note the following:

  • Fiserv utilizes a train-the-trainer model, which means one or two people from your agency attend training, then go back to your agency and train the rest of your staff. They will be responsible for training your individual caregivers. All caregivers must be trained prior to the go-live date of December 4th, 2020.

  • There are various options for training dates, and you may register for the dates that work with your schedule. While multiple dates exist, you must register for the modules that correspond with the system you have selected.
    • If you are using AuthentiCare, you must attend:
      • Mobile Application
      • Web Portal
      • Train-the-Trainer
      • Reports
      • IVR
    • If you are using a third-party vendor, you must attend:
      • Web Portal
      • Reports

AuthentiCare Web Portal
Training for Providers, state staff and designated contractors addresses the administrative hub for AuthentiCare. This includes claims, scheduling, visit maintenance, onboarding workers and system monitoring.

AuthentiCare Reports
Providers and state staff will be trained on the usage and production of standard AuthentiCare EVV reporting.

AuthentiCare 2.0 Mobile Application
Providers and Caregivers are trained on administrative and user functions of the AuthentiCare Mobile app.

AuthentiCare Interactive Voice Response (IVR) System
Providers and Caregivers are trained using real-life scenarios within the IVR environment.

AuthentiCare Train-the-Trainer
Nominated provider staff receive training in how to deliver AuthentiCare modules to the caregiver community.

Important Dates

August 7, 2020: EVV System Selection
All provider agencies must choose to use either the State-sponsored EVV solution (AuthentiCare) or choose to use a third-party EVV vendor. Agencies must notify DHS of this choice by the date above.

August 31, 2020: Training Registration Period Opens
Detailed information about the different training modules and registration links will be available for provider agencies.

September 23, 2020: Pilot Provider Agency Training Begins
Fiserv trains provider agencies on AuthentiCare website, mobile application and the interactive voice response (IVR) system.

September 28, 2020:  
Provider training workshops begin this week for Authenticare Users and Third Party Aggregator Providers.

September 30, 2020: Enrollment Ends
All caregivers must be enrolled in Arkansas Medicaid by applying for a practitioner ID number (PIN).

Immediately Following Train-the-Trainer Sessions: Caregiver Training Begins
Provider agencies train their own staff on mobile application and the interactive voice response (IVR) system.

December 4, 2020: EVV System Go-live

Fiserv and AuthentiCare

DHS has partnered with Fiserv (formerly First Data Government Solutions) in the implementation of an Electronic Visit Verification (EVV) system. Fiserv, headquartered in Wisconsin, was established in 1984 and now serves clients in more than 100 countries. Fiserv enables innovative financial services experiences for the way people live and work today. Their solutions connect organizations in secure and reliable ways.

As Arkansas prepares for an EVV system implementation, Fiserv will bring expertise with their product, called AuthentiCare. AuthentiCare is an automated solution that streamlines operations and promotes quality of care. AuthentiCare is smartphone compatible and can be used on multiple devices in a flexible and secure way. It offers real-time reporting and monitoring. Fiserv’s team is committed to working with DHS to ensure a smooth implementation of the EVV system.

The AuthentiCare solution, provided by Fiserv, is an electronic application. AuthentiCare’s mobile application is available on Android and iOS, and simply requires the user to download and install the app from the Google Play Store or the Apple App Store. AuthentiCare is also accessible from the beneficiary’s landline, if available. Check out the AuthentiCare webpage (HTML, new window) for more detailed information and to get a look and feel of how the system may function for you.

Third-Party EVV Option

The declaration form on this page is for Medicaid fee-for-service only, not PASSE. You do not need to complete another declaration form for the PASSE’s, just one indicating which system (AuthentiCare or third-party) your agency will be using. They will be reaching out to you about the process to work with their EVV vendor.

Arkansas has opted to use an open vendor model; this is a hybrid model in which the State contracts with one EVV system vendor and allows providers and managed care organizations (MCO) the option to use either the State-selected EVV vendor or a third-party vendor (new or existing) as long as it meets the State’s requirements.

Arkansas has contracted with Fiserv to offer AuthentiCare as the State-selected EVV system vendor for agencies at no cost. You may still use your existing EVV system vendor if it meets the following criteria:

  • Must be able to comply with 21st Century Cures Act
  • Must be able to configure your system to match the Arkansas DHS EVV System Rules and provide attestation that the configuration settings have been applied
  • Must be able to capture all the data fields required as specified in the AuthentiCare Data Aggregator Interface Guide and successfully transmit the information via one of the approved transport methods to Fiserv for upload into AuthentiCare for daily claims processing

If your chosen EVV system vendor cannot meet the above criteria, you must either choose a new EVV system vendor or move to the State-selected EVV vendor—AuthentiCare.

All Arkansas Medicaid provider agencies must inform DHS of their decision by completing the Arkansas EVV Declaration Form (HTML, new window). This form must be completed whether you choose to use AuthentiCare or a third-party system.

The Arkansas DHS EVV System Rules for a third-party EVV system vendor can be found below. Please send any questions you may have to ARthirdpartyevv@dhs.arkansas.gov.

Documents and Resources

Here you will find required documentation and resource materials, including previous communication that may have been shared via email.

An AuthentiCare demonstration was held on July 28th, 2020. This demo provided an overview of basic system functionality to help inform agencies during system selection. If you were unable to attend, the demo was recorded and can be found on the provider portal.

Required for Third-Party Integration

Arkansas DHS EVV System Rules

The provider or third-party EVV system vendor must be able to meet the requirements as defined in the AuthentiCare Data Aggregator Interface Guide (PDF, new window) and are required to transfer/upload a daily visit file for claims processing.

All third-party EVV systems must be in compliance with the 21st Century Cures Act and must capture the following elements:

  1. The type of service performed
  2. The individual receiving the service
  3. The date of the service
  4. The location of the service delivery
  5. The individual providing the service
  6. The time the service begins and ends

The third-party EVV system vendor must configure the system with the following rules:

  1. Scheduling is not mandatory
  2. English and Spanish languages must be available
  3. Check in and out must be available via mobile and Interactive Voice Response (IVR) landlines
  4. Geo Fence must be set at 1/8 of a mile
  5. Early visit threshold must be set at 7 minutes
  6. Last visit threshold must be set at 7 minutes
  7. Missed visit threshold must be set at 30 minutes
  8. Unit calculation must follow DHS guidelines:

    Please note that items 5,6, and 7 above only apply if scheduling is used. The State did not require scheduling to be mandatory due to agency feedback, but it is optional.

    Minutes Units
    0 min–7 mins 0 units
    8 mins–22 mins 1 unit
    23 mins–37 mins 2 units
    38 mins–52 mins 3 units
    53 mins–67 mins 4 units
    68 mins–82 mins 5 units
    83 mins–97 mins 6 units
  1. Passwords must meet the following criteria:
    • Minimum of 9 characters, at least 1 uppercase letter, 1 lowercase letter, 1 number, and 1 special character
    • The user’s password cannot be one of the last 10 passwords
    • Passwords are required to be changed every 60 days
    • The user will be locked out after 3 failed login attempts
  2. Access must be role-based driven access
  3. The third-party EVV system must be able to receive prior authorizations and client membership information from Arkansas DHS sources
  4. The third-party EVV system must be able to handle exceptions as noted below:

    Exception Exception Level Exception Description
    Authorization Units Critical The visit was performed for a number of units that is beyond the units available on the authorization.
    Duplicate Visit Critical This visit was found to be a duplicate of a previously filed visit.
    Client Eligibility Critical The client was ineligible at the time of the visit.
    Worker Eligibility Critical The worker was ineligible to perform services at the time of the visit.
    Out Of Fence Check In Critical The check in location does not match the client’s location.
    Out Of Fence Check Out Critical The check out location does not match the client’s location.
    Activity Code Missing Informational The visit requires an activity code to be entered upon check out, and no activity code was entered.
    Phone Check In Critical The visit check in phone number does not match the authorized phone number for the client.
    Phone Check Out Critical The visit check out phone number does not match the authorized phone number for the client.
    Overlapped Service Critical The client is receiving multiple services at the same time.
    Overlapped Claim Critical The provider is providing services for a member for multiple services at the same time.
    Overlapped Worker Critical The worker is providing services to multiple clients at the same time.
    Attestation Informational This visit does not have client attestation.

Frequently Asked Questions for Providers

General Questions

Enrollment Questions

Communication Questions

Training Questions

Mobile Devices and Frontier Mode Questions

Claims and Billing Questions

EVV System / PASSE Related Questions

What is EVV and why is it being implemented?

Centers for Medicare and Medicaid Services (CMS) mandated that all states implement Electronic Visit Verification (EVV) for agencies and/or caregivers providing in home personal care, attendant care and respite services. This federal requirement is the result of the 21st Century Cures Act (HTML, new window). EVV protects clients and ensures they get the care they need.

Visits will be electronically verified with the following information:

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

What is required of the agency?

Arkansas is providing a State-funded EVV solution called AuthentiCare, which means there is no cost to providers for the software. You can choose to use a different EVV vendor, but at your expense. If you do this, it is critical that your chosen vendor integrates with the State’s vendor, Fiserv. This is called Third Party EVV integration. Your vendor will be required to send the EVV data the State needs to verify visits and validates claims. If going with a non-State solution, please ensure integration capabilities.

AuthentiCare is a bring-your-own-device model that is simple to use. Staff complete reporting of visits via an AuthentiCare application (app) on their smartphones or member’s landline. This will streamline reporting activities, increase accuracy, and make the process easier for provider organizations.

Can an agency opt-out?

You must comply with the 21st Century Cures Act, whether through the State-funded solution or through a third-party EVV vendor. If you chose to opt-out, you will not be reimbursed by Arkansas Medicaid for Personal Care, Respite, or Attendant Care services rendered.

As an agency, is this going to cost me anything?

There is no charge to the provider agencies for the State-funded EVV system. If you choose a different solution the State will not cover those costs.

Is the system tracking me everywhere I go?

No. GPS only activates at the time of check-in and check-out, and location is turned off as soon as you close the app.

Do the Electronic Visit Verification (EVV) changes apply to Home Health and Private Duty?

No, the change currently does not apply to Home Health or Private Duty at this time. Home Health goes into effect in 2023.

Do we still have to do timesheets?

AuthentiCare acts as your clock in and clock out mechanism and logs the information electronically. However, it is your decision as an agency whether you would like to continue to use timesheets.

I have completed the EVV Choice form, is there anything I need to do in addition to letting DHS know my EVV choice?

No, more information will be coming out on the Arkansas Medicaid website about training at a later time.

Will each of my caregivers need to apply for an individual PIN?

Yes, each caregiver will need to apply for their own PIN. The process to obtain a PIN is found on the Arkansas Medicaid website for EVV under Enrollment.

When does enrollment need to be completed by?

Caregiver enrollment must be completed by September 30, 2020.

How will I be kept up to date on EVV?

The State will continue to update the Arkansas Medicaid website with more EVV information. Providers may also receive communication thru email and provider bulletins. Please check this page regularly for new information. Additionally, provider enrollment information is located on the “What’s New” section of the Provider Enrollment Portal (HTML, new window).

What do I tell my employees?

Both Fiserv and the State have resources to help you communicate the change to employees. We encourage you to communicate often because accurate, timely, and transparent information is essential to helping employees understand and feel comfortable with the change.

How can I ask questions and offer feedback?

There will be an opportunity in all training sessions to both ask questions and provide feedback. Additionally, if you need to communicate to someone directly and outside of a training, please contact: EVVarkansas@dhs.arkansas.gov

Will training be offered?

Yes. Fiserv will conduct training for providers, with assistance from the State. Fiserv will provide user manuals, presentations, and other training material for your staff. The Fiserv training team will work with providers to make sure you feel equipped to use AuthentiCare moving forward.

Will there be a separate training for direct care workers?

The State offered training is for provider agencies only. Provider agencies are responsible for training direct care workers. Fiserv and the State will equip providers with all necessary training materials and resources in order to do this.

When will we receive training and what kind of training?

The training information will be posted out on the Arkansas Medicaid website shortly. Additional EVV/program training will also occur by DPSQA (Division of Provider Services and Quality Assurance).

Does the mobile device have to be registered?

Yes, each mobile device must be registered within the AuthentiCare application.

Caregivers can run through multiple devices; how can the registration be updated?

CMS requires that a single device be assigned to a caregiver, and caregivers are not allowed to share devices. However, when a caregiver gets a new phone or wants to use a different device, registration of the mobile device can be done at any time in AuthentiCare.

If there are multiple services being provided (i.e. Personal Care/Attendant Care back to back) can the employee select multiple services, or do they have to clock-in and clock-out for each service?

The employee would need to do separate clock-in and clock-outs for each service provided.

What if there is no cell service at the location?

AuthentiCare Mobile Application works in Frontier Mode, which allows the data to be captured at the time of clock-in and clock-out and will be automatically uploaded when the caregiver returns to an area that has cell coverage.

What happens if the system goes down?

Data is still captured using Frontier Mode and sent to the system when the system is restored.

Are caregivers able to clock-in using Frontier Mode?

Yes, if a caregiver is in Frontier Mode, they will still be able to clock-in and clock-out. The data will be saved and pushed to the system when cellular or WIFI signal is restored on their mobile device.

Will paper claims still need to be done as a backup?

No, paper claims will not be necessary for AuthentiCare provider users. If you use a different vendor, please refer to that vendor’s requirements, as it may be different than AuthentiCare.

Can billing information be uploaded to a payroll software?

Yes, AuthentiCare has options for exporting out data including Excel, CSV and XML.

Can the MMIS Portal still be used for billing?

No, the MMIS Portal billing for Personal Care, Respite and Attendant Care will no longer be available once EVV goes live.

Is the billing still done in 15-minute increments?

Yes. However, please see the specific updates regarding rounding on the Arkansas DHS EVV System Rules section of this webpage.

What tasks are different between Attendant Care and Personal Care?

The tasks are very similar between Attendant Care and Personal care and are taken directly from the Arkansas Medicaid Policy Manual.

If we choose a third-party vendor, will billing still have to be submitted through AuthentiCare, or can we continue to use our clearing house?

For Personal Care, Respite and Attendant Care, billing will be required to go through AuthentiCare.

Is scheduling mandatory?

No, the State did not require scheduling to be mandatory due to both feedback from providers, and project time constraints (mandatory scheduling would have taken additional configuration time). Scheduling is optional. Please note that if a PASSE wants to make scheduling mandatory, they can do that.

Why is the geofence set at 1/8th of a mile?

DHS did a lot of research and had discussions with other states to set the 1/8th of a mile geofence. This is the generally accepted number among other states who have implemented or are implementing EVV. The geofence is a CMS mandate.

What is an early visit threshold and why is it set to 7 minutes?

This refers to if an agency is doing scheduling, which is optional. The State considered an “early visit” to be 7 minutes ahead of the scheduled visit, based on what was gathered from discussions with other states. This is just an informational flag that a caregiver arrived early. It can be used for agencies if they are doing scheduling and want to keep up with how early a caregiver arrives at a location. The same thing applies for a late visit. There is a 7-minute threshold and it provides a heads up that the caregiver has not yet arrived. Again, this is information for the agency. There is also the “missed visit” informational flag, which was set up for agencies who decide to use scheduling. This notifies the agency at the 30-minute mark if no one has arrived at the visit.

If I am a PASSE and want to customize our EVV system, are we able to make any customizations?

Yes, as long as you have the minimum requirements per the State.

Does the EVV system have client attestation?

Yes, the mobile application at clock-out will provide an opportunity for the caregiver to obtain client attestation via e-signature. However, beneficiary signatures will not be required at this time due to the circumstances around Covid-19. This could change in the future.

What happens if DHS hasn’t extended the authorization (for the new month) and the claim rejects? Will this system automatically rebill once the prior authorization is extended?

In this instance, the claim is marked with an exception, moved from “pending” once an authorization is received, and will need to be confirmed by the provider to be sent for billing.

Will AuthentiCare receive the prior authorizations into their system?

Yes, the authorizations from eQHealth, AFMC and the State will be sent to AuthentiCare.

What documentation would there be in case of an audit?

Providers would still be required to keep any notes or documentation required for audit purposes. AuthentiCare would be able to provide details of the visit to support any audit.

Can clients be uploaded from a different software, and if so, what format does the data need to be in?

No, clients will be loaded from the MMIS—providers will not need to load clients into the AuthentiCare system.

Frequently Asked Questions for Beneficiaries

What is EVV and why is it being implemented?

Centers for Medicare and Medicaid Services (CMS) mandated that all states implement Electronic Visit Verification (EVV) for agencies or caregivers providing in home personal care, attendant care and respite services. This federal requirement is the result of the 21st Century Cures Act. EVV protects you as beneficiaries and ensures you get the care you need.

Your caregiver will use EVV, and their visits with you will be electronically verified with the following information:

  • Type of care
  • Date of service
  • Location of service
  • Name of caregiver
  • Your name
  • Begin and end time of service

This electronic reporting will either be done using an application on your caregiver’s mobile device or by using your own home landline telephone to call into the system.

What is required of me?

We ask for your understanding and patience as your caregiver works to learn a new system. It will likely be an easy transition, but there could be bit of a learning curve early on.

We are also asking that if your caregiver does not have their own mobile device, that you make your home landline telephone available for them to call in to the system. The call from your phone must only occur if you have a landline.

If I do not want to have my caregiver use my phone, will I still receive services?

Yes. Electronic Visit Verification will never impact the services you are provided. If you do not wish to allow your caregiver to use your landline phone to call into the EVV system, there are multiple other options for your caregiver to capture their time that do not require your phone.

Will I need to have anything installed in my house for EVV to work?

No. Your caregiver will use their mobile phone to capture their visit information. If they do not have a mobile phone, they will use your landline to call in to the system.

If I move, or change care providers, will I need to do anything to keep EVV going?

No. Electronic Visit Verification does not require any actions on your part. If you change your caregiver, or move to a new residence, the EVV system will continue at your new location and will be performed in the same way by your new caregiver.

Am I being recorded or tracked with this system?

No. GPS is only tracked on the caregiver’s mobile phone at the time of check-in and check-out.

How will I receive information about EVV?

You can continue to check this webpage for updated information about EVV. Your caregiver and/or provider agency will also communicate with you regarding their EVV implementation.

How can I ask questions and offer feedback?

If you have any questions about EVV, or wish to provide feedback, please contact your caregiver and/or provider agency.

Where can I get more information?

You can read about EVV and the 21st Century Cures Act by visiting this website: https://www.fda.gov/regulatory-information/selected-amendments-fdc-act/21st-century-cures-act (HTML, new window)