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- Reminder of income tax filing deadline
Reminder, don't forget to file your personal income tax returns due April 15, 2022. IHAS as your FMSA files your employer tax reports for the wages and taxes of your Medicaid funded employees. If you have paid employees from non Medicaid funding sources, you will need to account for those according to the source of the funding (private, other) and any related IRS rules.
- Daylight Saving Time Reminder
Don't forget to change your clocks this Saturday, 3.12.2022 for daylight savings. Lets SPRING forward.
- Annual Employer EVV Training
EVV CDS Employer training due annually. HHS Learning Portal- EVV training- HHS Learning Portal: Log in to the site (texas.gov) Vendor EVV Training- TRAINING - Vesta EVV Please submit your certificate of completion to your CDS consultant.
- Need further EVV Assistance?
Meet our EVV Specialist, Natalie Medina. Natalie previously gained experience as a CDS consultant through our payroll department and has taken on the role as our EVV Specialist.Natalie’s main focus is to assist you in tackling any issues you are facing with the EVV system in order to make it a smooth experience. We understand that the new requirements can raise issues, but we are here to help you continue your journey with the CDS option. To schedule an EVV training with Natalie, please email her at nmedina@ihastx.com or call (346) 293-8338.
- In Memory of Gene Whitten-Legé by CTD Executive Director Dennis Borel
CTD bids farewell to a founding father of the CDS program in Texas, Gene Witten-Legé. Please click the link below to view this news article. https://www.txdisabilities.org/news-events/in-memory-of-gene-whitten-lege?fbclid=IwAR1VW7o5CxhiSkUoTC1v4uxvuJdDE43-VU5IsxuuCpypAhpCHG1SRUZEDb4
- EVV Training Requirements Checklist
Electronic Visit Verification Training Requirements Checklists Electronic Visit Verification (EVV) Training Checklists are included for program providers, Financial Management Services Agencies (FMSAs), Consumer Directed Services (CDS) employers and service providers (service attendants and CDS employees) required to use EVV. The programs, services and service delivery options required to use EVV is located on the Texas Health and Human Services Commission (HHSC) EVV website. For more information and details about EVV training requirements, refer to the HHSC EVV Training Policy. The HHSC EVV Training Policy requires program providers, FMSAs and CDS employers to complete all required EVV training prior to using either an EVV vendor system or an EVV proprietary system and yearly thereafter. Training Checklists Use the applicable checklist to track EVV training requirements and completion of requirements. Click on the applicable option below or scroll throughout the document to access a checklist: Agency Service Delivery Option ● EVV Training Checklist for Program Providers ● EVV Training Checklist for Service Providers (Service Attendants) CDS Service Delivery Option ● EVV Training Checklist for FMSAs ● CDS employers should access the appropriate EVV training checklist below, based on the option selected on Form 1722, Employer's Selection for Electronic Visit Verification Responsibilities: >EVV Training Checklist for CDS Employers – Option 1 Chosen on Form 1722 > EVV Training Checklist for CDS Employers – Option 2 Chosen on Form 1722 > EVV Training Checklist for CDS Employers – Option 3 Chosen on Form 1722 ● EVV Training Checklist for Service Providers (CDS Employees) For more information visit: https://www.hhs.texas.gov/doing-business-hhs/provider-portals/long-term-care-providers/resources/electronic-visit-verification https://learningportal.hhs.texas.gov/course/index.php?categoryid=26
- EVV Update
EVV Update as of November 10, 2021: Thank you for your valuable participation in the required EVV implementations. As a CDS Employer your collaboration and feedback is very important to us. We all faced many challenges this year. Along with having to deal with COVID-19, we were also required to implement the first phase of the Electronic Visit Verification (EVV) federal mandate. As the rules become more strict, our goal is to stay in communication with you. This year IHAS doubled the efforts to assist with the many EVV requirements. We have received your concerns and suggestions throughout the implementation. We continue to improve EVV processes and communications. Every employer should have already completed the following EVV Steps: 1. Training Requirements: a. FMSAs, Employers, and Employees are all required to be trained every year. b. Employer Training Requirements: See enclosed Electronic Visit Verification Training Requirements Checklists c. Employees Training Requirements: Employer responsibility to train the employees. 2. Employer Option Selection (Form 1722): With the 3 listed employer options, employers are to ensure all employees are using the EVV system to clock in/out for all daily shifts/EVV services. a. Option 1 (You’re the Boss!) – You as employer have all the responsibility to ensure the visits are correctly registered in the EVV system and approve the authorized time. b. Option 2 (IHAS assists with Visit Maintenance) - requires a signed time sheet to do visit maintenance. Time should reflect the time in the EVV system, and the corrections needed. c. Option 3 (IHAS assists with Visit Maintenance and Approving time in the EVV system) - requires a signed time sheet to do visit maintenance and to approve the time in the EVV system. Time sheet should reflect the clock in/ out visits/shifts/EVV Services as reflected when clocking in/out or as reflected in the EVV system and the corrections needed. 3. Choosing a Method for employees to clock in/out of the EVV system: a. Mobile App – Preferred method b. Landline c. Alternative Device 4. Ensuring: a. Employees are properly clocking in/out using the EVV system. b. Visit Maintenance is completed every other Monday based on the System of Payroll to avoid delayed payroll. This includes submitting time sheets on time for option 2 and 3. c. Hours are not overlapping. d. Hours worked are not over the allowed weekly budgeted hours set by the Payer. e. The correct EVV service is selected. 5. Employers Option 1 only: Visit Maintenance Unlock Request by the CDS Employer. See enclosed requirements Electronic Visit Verification Visit Maintenance Policy on page 7 for more details. Please look for the IHAS survey form to update us on how we are doing. It is also available online www.ihasurvey.com This survey is due by December 15, 2021. Your feedback helps us continue to improve in different areas on how to better assist you. You may also provide constructive feedback at any time throughout the year at: www.inhometexas.com/feedback Sincerely, Pat Whitten-Legé President GP
- EVV Visit Maintenance Policy Revisions
Electronic Visit Verification Visit Maintenance Policy Policy Effective July 1, 2021, the Texas Health and Human Service Commission (HHSC) revised the Electronic Visit Verification (EVV) Visit Maintenance Policy to: • Require the program provider, Financial Management Services Agency (FMSA) or Consumer Directed Services (CDS) employer ensure that each EVV visit transaction is complete, accurate and validated. • Incorporate the Visit Maintenance: Last Visit Maintenance Date Policy. • Incorporate the Visit Maintenance Unlock Request Policy. Visit maintenance is the process used by the program provider, FMSA or CDS employer to correct the identification and visit data in the EVV system to accurately reflect the delivery of service. EVV visit maintenance is similar to correcting a paper timesheet. Instead of making the correction on the paper timesheet, the program provider, FMSA or CDS employer will make the correction in the EVV system. For more information about identification and visit data, see the EVV Data Collection Policy. The program provider, FMSA or CDS employer must complete all required visit maintenance and ensure the EVV visit transaction is accepted by the EVV Aggregator before a program provider or FMSA submits an EVV claim. If additional visit maintenance is completed after a claim is submitted, the program provider or FMSA must submit an adjusted claim to match the updated visit transaction. If a program provider or FMSA submits an EVV claim before required visit maintenance is complete, the payer (HHSC or a managed care organization) may deny or recoup the EVV claim as part of contract oversight. If a program provider or FMSA delegates visit maintenance responsibilities to a third party (such as a sub-contractor), the program provider or FMSA is always responsible for actions taken by the third party. If the program provider or FMSA delegates visit maintenance responsibilities to a third party, the program provider or FMSA is responsible for any actions taken by the third party and must ensure that the third party follows all privacy and security protocols, including when the sub-contractor or third party accesses EVV data. If the CDS employer delegates visit maintenance responsibilities to their Designated Representative (DR), the CDS employer is responsible for any actions taken by their DR and must ensure that the DR follows all privacy and security protocols, including when the DR accesses EVV data. Required Visit Maintenance The program provider, FMSA or CDS employer must complete visit maintenance when the: • EVV system cannot “auto-verify” (automatically confirm an EVV visit based on existing identification and visit data in the EVV system). • EVV system identifies exceptions (errors). • EVV Aggregator (centralized database that collects, validates and stores statewide EVV visit data transmitted by an EVV system) rejects the EVV visit transaction due to incorrect or missing data. • Program provider, FMSA or CDS employer reduces bill hours (quarter hour increments) after the EVV system auto-verifies the EVV visit transaction. • EVV system is unavailable. • Service provider or CDS employee fails to use the EVV system. Auto Verification, Exceptions and Schedules Auto Verification Each time a service provider or CDS employee clocks in or clocks out during service delivery, the EVV system will: • Record the visit data. • Verify the clock in and clock out method. • Compare the visit data to the member’s data in the EVV system. If all the visit data and the identification data in the EVV system match, the EVV system will automatically verify the visit, also known as “auto-verify” or “autoconfirm.” An auto-verified visit means the EVV system found no exceptions or errors. If the EVV visit transaction is missing a clock in or a clock out or if the data collected at the time of clock in or clock out does not match the data elements in the EVV system, the EVV system will notify the program provider or FMSA of an exception. The program provider, FMSA or CDS employer must clear all exceptions through visit maintenance. Clearing Exceptions The EVV system may generate one or more exceptions when the EVV system cannot auto-verify the data collected at the time of clock in or clock out. To clear an exception, the program provider, FMSA or CDS employer must complete visit maintenance in the EVV system by: • Updating the identification or visit data for a member, if required. (Refer to the EVV Data Collection Policy for more information) • Selecting the most appropriate EVV Reason Code(s), if required. • Confirming the visit. Selecting the most appropriate EVV reason code(s) explains the reason for completing visit maintenance. The process involves: • Selecting an EVV Reason Code Number. • Selecting an EVV Reason Code Description. • Entering required free text, if applicable. Refer to the EVV Reason Code Policy and Current HHSC EVV Reason Codes for more information. The following are some examples that describe when the EVV system will not autoverify a service visit: • Clock in or clock out time is less than or greater than an existing scheduled visit in the EVV system • Clock in time or clock out time is missing • Service delivery is outside the home and the service provider or CDS employee is not using the mobile method to clock in or clock out • Service provider or CDS employee calls from a number not registered in the member’s profile Program policy requirement for schedules Program providers must enter schedules in the EVV system if program policy or rule requires schedules in the EVV system. CDS employers may choose to use a schedule regardless of the program requirement. CDS employers should communicate with their FMSA to determine the use of schedules. The EVV system and schedules The EVV system does not require schedules. If program policy does not require entering schedules into the EVV system, schedules are optional. A schedule in the EVV system documents the planned begin and end time when the service provider or CDS employee will provide authorized services to a member (a person receiving Medicaid services). If a schedule is entered into the EVV system, the EVV system compares the following data elements collected at the time of clock in and clock out with the schedule entered in the EVV system for the member: • Visit date • Visit begin and end time • Service provider or CDS employee name • Visit duration • Service type for the visit If the data elements collected at time of clock in and clock out match the schedule entered in the EVV system, the EVV system will auto-verify without exceptions. If the data elements collected at time of clock in and clock out do not match the schedule entered in the EVV system, the EVV system will flag the exception for visit maintenance. No Schedules If there is no schedule in the EVV system for an EVV visit, the EVV system will validate the following data elements: • The identity of the service provider or CDS employee • The identity of the member • The actual hours worked • The clock in and clock out method(s) • The service type for the visit If the above data elements match the data in the member’s profile, the visit will auto-verify without exceptions. If any of the above data elements do not match, the EVV system will not autoverify the EVV visit and visit maintenance must be completed. Manually Entered EVV Visits When the service provider or CDS employee fails to clock in or clock out of the EVV system or an approved electronic verification method is not available, the program provider, FMSA or CDS employer must manually enter the EVV visit into the EVV system. Manually entered visits will negatively impact the EVV Usage Score. Refer to the EVV Compliance Oversight Reviews Policy for more information. If the service provider or CDS employee fails to clock in or clock out of the EVV system for any reason, program providers, FMSAs or CDS employers must complete the following steps: • Verify the service provider or CDS employee delivered services according to program policy and requirements • Receive and retain service delivery documentation from the service provider or CDS employee. Service delivery documentation must include the following visit data: o Member Name o Date of the Visit o Actual Time In and Actual Time Out o Service provider and CDS employee First and Last Name o Location of the Visit; in the home or in the community o CDS employee and CDS employer signature, for CDS o Any additional program requirements for documenting service delivery • Enter visit data manually into the EVV system • Complete visit maintenance using the most appropriate EVV Reason Code(s), EVV Reason Code Description(s) and free text, if applicable • Ensure the visit is accepted at the EVV Portal EVV System Validation Once the EVV system has verified a visit, the EVV system conducts additional system validation checks on the EVV visit transaction before sending the EVV visit transaction to the EVV Aggregator. The EVV system validation ensures the identification data and visit data is in the correct format and compares the critical data elements to Texas Medicaid data stored at Texas Medicaid and Healthcare Partnership (TMHP). An EVV system must perform the following types of system validation before sending an EVV visit transaction to the EVV Aggregator: • Verifies that no required visit data elements are missing • Verifies that all required visit data elements are in the correct format (length, alphanumeric, only valid values) • Verifies that all required identification data elements are in the correct format (NPI, API, Provider Number) • Verifies the service group and service code or Healthcare Common Procedure Coding System (HCPCS) and modifier combination is valid for the member or EVV visit transaction. If an EVV visit transaction fails the system validation, the EVV system will: • Not send the EVV visit transaction to the EVV Aggregator. • Notify the program provider, FMSA or CDS employer of the exceptions that must be corrected. To clear EVV system validation exceptions, the program provider, FMSA or CDS employer must complete visit maintenance. Once the program provider, FMSA or CDS employer clears the exceptions, the EVV system will send the EVV visit transaction to the EVV Aggregator for final processing. EVV Aggregator Validation The EVV Aggregator performs numerous validations of all data elements on the EVV visit transaction. The EVV Aggregator validations include verifying the: • NPI or API for the program provider or FMSA to ensure it is active for the visit date. • Provider Number is valid for the NPI or API on the visit date. • Member’s payer matches the Medicaid data. • Member has Medicaid eligibility for the visit date. • Service group, service code or HCPCS and Modifier on the visit date. Based on the above validations, the EVV Aggregator will either accept or reject the EVV visit transaction received from an EVV system then display the status in the EVV Portal. After the EVV Aggregator accepts an EVV visit transaction, the program provider or FMSA can submit an EVV claim associated with the EVV visit transaction. When the EVV Aggregator rejects an EVV visit transaction, the EVV Aggregator returns the EVV visit transaction to the EVV system with the reason for the rejection (rejection code). The program provider, FMSA or CDS employer must complete visit maintenance. After visit maintenance is complete the program provider or FMSA must resubmit the EVV visit transaction to the EVV Aggregator. EVV Visit Maintenance Time frames Program providers, FMSAs and CDS employers have 95 calendar days from the date of service delivery to complete visit maintenance; this is known as the visit maintenance time frame. HHSC may extend the visit maintenance time frame as needed. After the visit maintenance time frame has expired, the EVV system locks the EVV visit transaction and the program provider, FMSA or CDS employer may only complete visit maintenance if the payer approves a Visit Maintenance Unlock Request. EVV Visit Maintenance Unlock Request A Visit Maintenance Unlock Request allows a program provider, FMSA or CDS employer the opportunity to correct data element(s) on an EVV visit transaction(s) after the visit maintenance time frame has expired. A program provider, FMSA or CDS employer may request the payer unlock EVV visit transaction(s) for visit maintenance. If the request is submitted by the CDS employer, the CDS employer must notify their FMSA in writing. Approvals and denials of Visit Maintenance Unlock Requests are at the payer’s discretion and are determined on a case-by-case basis. If the request is submitted by the CDS employer and the payer has approved or denied the request, the payer must also notify the FMSA. The payer will deny requests to create manual visits after the visit maintenance time frame unless the reason for creating a manual visit is due to payer or EVV system error. Making corrections to EVV visit transactions during a Long-Term Care Fee-for- Service (LTC FFS) contract monitoring review or after it has occurred will not change any type of contract action (recoupment, settlement reviews, etc.) taken as result of the LTC FFS contract monitoring review. Unlock Request Process To request an unlock of EVV visit transaction(s) for visit maintenance after the visit maintenance time frame has expired, program providers, FMSAs and CDS employers must complete a Visit Maintenance Unlock Request found on the payer’s website. Initial Request to Payer Payers must process Visit Maintenance Unlock Requests from the program provider, FMSA or CDS employer within the following time frames: • Ten business days after receiving a secure and complete request o Email requests not sent securely may result in the payer denying the request due to a violation of the Health Insurance Portability and Accountability Act (HIPAA). o Contact the payer for assistance with sending a secure email request. • Thirty business days after receiving a secure and complete request o If the request was submitted as supporting documentation of a claims appeal. Payer Request for Additional Information The payer may request additional information from the program provider, FMSA or CDS employer. The program provider, FMSA or CDS employer must submit the additional information back to the payer within the following time frames: • Ten business days of the request for additional information o If the payer does not receive the additional information within 10 business days, the payer may deny the request and the program provider, FMSA or CDS employer must submit a new Visit Maintenance Unlock Request. • Fifteen business days of the request for additional information o If the request for additional information is part of a claims appeal. Payer Denial of Request If the payer denies the request, the payer: • Must notify the program provider, FMSA or CDS employer through email within 10 business days of the request with the reason for the denial. o The email notification must include at a minimum the following information on how to: ▪ Submit a new Visit Maintenance Unlock Request ▪ Request a claims appeal ▪ Submit a formal complaint against the payer The payer may automatically deny a Visit Maintenance Unlock Request for the following reasons: • The request was not sent through a secure method • The request is incomplete or missing required information Payer Approval of Request If the payer approves the Visit Maintenance Unlock Request, the payer will: • Send the approved Visit Maintenance Unlock Request to the EVV vendor or EVV Proprietary System Operator (PSO) within three business days of the approved request. o Only approved data elements listed on the Visit Maintenance Unlock Request will be unlocked for editing. o The EVV vendor or EVV PSO must only allow changes to the fields approved by the payer. Payer Incorrect, Incomplete, or Retroactive Authorization Approvals The payer must approve the Visit Maintenance Unlock Request under the following circumstances: • When the payer previously provided incorrect or incomplete information on the prior authorization for a member and the updated authorization will require updates to EVV visit transactions outside of the EVV visit maintenance time frame. • When the payer submits a retroactive authorization for a member that will require the program provider, FMSA or CDS employer to resubmit an EVV visit transaction or EVV claim outside of the EVV visit maintenance time frame. • Upon request by HHSC and within the initial request time frame specified in this policy. EVV Vendor and EVV PSO Approval and Denial Once the EVV vendor or EVV PSO receives the approved Visit Maintenance Unlock Request from the payer, the EVV vendor or EVV PSO must validate the information submitted. The EVV vendor and EVV PSO have 10 business days from receipt of the approved Visit Maintenance Unlock Request to complete visit maintenance or schedule a meeting with the program provider, FMSA or CDS employer to complete visit maintenance. If the information submitted by the program provider, FMSA or CDS employer is incorrect, invalid or missing data elements, the EVV vendor will: • Not unlock EVV visit transaction(s) for visit maintenance. • Return the Visit Maintenance Unlock Request to the program provider, FMSA or CDS employer. • Notify the payer, program provider, FMSA or CDS employer why the EVV visit transaction(s) cannot be unlocked for visit maintenance. If the information submitted by the program provider, FMSA or CDS employer is incorrect, invalid or missing data elements, the EVV PSO will: • Not unlock EVV visit transaction(s) for visit maintenance. • Notify the payer, program provider, FMSA and CDS employer (if applicable) why the EVV visit transaction(s) cannot be unlocked for visit maintenance. Once the information is corrected, the program provider, FMSA or CDS employer must submit a new Visit Maintenance Unlock Request to the payer. Visit Maintenance and Billing EVV Claims It is the responsibility of the program provider, FMSA and CDS employer to ensure all required data elements are correct and visit maintenance is completed prior to the program provider or FMSA submitting an EVV claim to the appropriate claims management system. If the program provider, FMSA or CDS employer needs to complete visit maintenance on an accepted EVV visit transaction that has already been billed, the program provider or FMSA must: • Complete visit maintenance on the EVV visit transaction(s). • Ensure the EVV Aggregator accepts the corrected EVV visit transaction. • Resubmit the EVV claim in accordance with the payer’s corrected claim process (e.g. negative bill the original claim and resubmit a corrected claim). Note: The EVV Visit Maintenance Unlock Request does not override the timely filing deadline for submission of a new and corrected claim. Last EVV Visit Maintenance Date The Last Visit Maintenance Date field on the EVV visit transaction identifies the last date visit maintenance was completed. Payers may review the Last Visit Maintenance Date on the EVV visit transaction and the date and time TMHP received the associated EVV claim. If the Last Visit Maintenance Date is after the EVV claim receipt date, the EVV claim is subject to recoupment. To avoid recoupment, program providers and FMSAs must submit an adjusted claim if visit maintenance is completed after initial claim submission. The EVV system will update the Last Visit Maintenance Date when any of the following fields are updated: • API • NPI • Contract Number • Member Medicaid Number • Service Group • Service Code • HCPCS Code • Modifier • Clock in and clock out time • Bill Hours • Units • Adding a Reason Code Number • Adding a Reason Code Description • Entering Reason Code Free Text The program provider or FMSA may review the Last Visit Maintenance Date on the EVV Visit Log Report and the EVV visit detail screen located in the EVV Portal. EVV Rounding Rules The EVV system calculates bill hours on an EVV visit transaction by rounding the actual hours worked to the nearest quarter hour increment. The EVV system rounds up to the next quarter hour increment when the actual hours worked is eight minutes or more than the previous quarter hour increment. The EVV system rounds down to the previous quarter hour increment when the actual hours worked is seven minutes or less from the previous quarter hour. Rounding rules examples: • If a service provider works 2 hours and 53 minutes of actual hours for a shift, the bill hours will round up to three hours. • If a service provider works 2 hours and 52 minutes of actual hours for a shift, the bill hours will round down to 2.75 hours. • If a service provider works 4 hours and 10 minutes of actual hours for a shift, the bill hours will round up to 4.25 hours. • If a service provider works 4 hours and 6 minutes of actual hours for a shift, the bill hours will round down to 4 hours. The EVV system does not round each clock in or clock out time. The EVV system only rounds the total duration of the actual hours worked for each visit. The program provider, FMSA or CDS employer may downward adjust bill hours if the actual hours worked, captured in the EVV system, are incorrect or if the program provider or FMSA intends to bill Medicaid for less time than actual hours worked in the EVV system. The program provider, FMSA or CDS employer may never increase bill hours beyond the actual hours worked. Program providers and FMSA must bill according to the EVV Service Bill Codes Table and follow program rules and policies, including any additional program or MCO requirements regarding rounding. EVV Visit Maintenance Reduction Features EVV visit maintenance reduction features are available in the EVV vendor systems for all program providers and FMSAs who enter schedules in the EVV system. These features do not apply when the program provider or FMSA has not entered a schedule in the EVV system. EVV visit maintenance reduction features help to: • Reduce visit maintenance. • Increase auto-verified visits. • Provide more flexibility for clocking in or out of the EVV system. Note: When EVV visit maintenance reduction features are enabled, the program provider or FMSA must check with their EVV vendor to verify how the features are applied. Call Matching Window The 24-hour call matching window is an EVV system default setting that is in effect when using schedules and allows a visit to auto-verify if the EVV visit is delivered for the duration of the scheduled visit on the scheduled day. The visit must occur between 12:00 a.m. and 11:59 p.m. on the scheduled day and the duration of the EVV visit (represented in bill hours) must equal the duration of the scheduled visit. The visit will auto-verify if there are no additional flagged exceptions for the EVV visit. For example: • The schedule in the EVV system is 10:00 a.m. – 12:00 p.m., the duration of the scheduled visit is two hours. o The service provider or CDS employee clocked in at 8:00 a.m. and clocked out at 10:07 a.m., actual hours worked are 2 hours and 7 minutes. o The EVV system will automatically round down the bill hours to 2 hours. o The EVV system will auto-verify the EVV visit to the schedule in the EVV system if no other exceptions are flagged. o If the service provider or CDS employee clocked out at 10:08 a.m., the EVV system will round up to the next quarter hour increment (2.25 bill hours), and the EVV visit will not auto-verify to the schedule in the EVV system because the bill hours are .25 over the scheduled visit of two hours. Optional Expanded Time for Auto-Verification The Optional Expanded Time for Auto-Verification is a feature that the program provider or FMSA must enable to allow a visit to auto-verify if the duration of the EVV visit is no more than .25 bill hours greater or less than the duration of the scheduled visit with no additional flagged exceptions. An example of a scheduled EVV visit auto-verifying: • The schedule in the EVV system is 1:00 p.m. to 3:00 p.m., the duration of the scheduled visit is 2 hours. o The program provider or FMSA has enabled the Optional Expanded Time for Auto-Verification. o The service provider or CDS employee clocked in at 12:45 p.m. and clocked out at 3:00 p.m. o The actual hours worked are 2 hours and 15 minutes which rounds to 2.25 bill hours. o The EVV visit will auto-verify because 2.25 bill hours is .25 bill hours greater than the scheduled duration of the EVV visit. An example of a scheduled EVV visit not auto-verifying: • The schedule in the EVV system is 1:00 p.m. to 3:00 p.m., the duration of the scheduled visit is 2 hours. o The program provider or FMSA has enabled the Optional Expanded Time for Auto-Verification. o The service provider or CDS employee clocked in at 12:45 p.m. and clocked out at 3:09 p.m. o The actual hours worked are 2 hours and 24 minutes which rounds to 2.50 bill hours. o The EVV visit will not auto-verify because 2.50 bill hours is not within .25 bill hours of the scheduled duration of the EVV visit. Optional Automatic Downward Adjustment The Optional Automatic Downward Adjustment is a feature that the program provider or FMSA must enable to adjust bill hours automatically downward by .25 to match the duration of the scheduled visit. This optional adjustment is only available if the program provider or FMSA also enables the Optional Expanded Time for Auto- Verification in the EVV system. The Optional Automatic Downward Adjustment only applies to bill hours and does not change actual hours worked. For example: • The schedule in the EVV system is 1:00 p.m. – 3:00 p.m., the duration of the scheduled visit is 2 hours. o The program provider or FMSA has enabled the Optional Automatic Downward Adjustment and Optional Expanded Time for Auto- Verification. o The service provider or CDS employee clocked in at 12:45 p.m. and clocked out at 3:00 p.m. o The actual hours worked are 2 hours and 15 minutes which rounds to 2.25 bill hours. o 2.25 bill hours is within .25 bill hours of the scheduled duration of the EVV visit. o The EVV visit will auto-verify and automatically downward adjust the bill hours to 2.00. Important Note: EVV PSOs may also choose to offer EVV visit maintenance reduction features. Program providers, FMSAs or CDS employers must follow the members’ authorized service plan. Although EVV Visit Maintenance Reduction features are available and add some flexibility, the needs of the member must always come first. For example, if a member needs their service provider or CDS employee to be at the home at the scheduled time of 8:00 a.m. to receive help getting out of bed, the service provider or CDS employee must be there on time. The program provider, FMSA and CDS employer must document all situations as needed and in accordance with program policy and licensure requirements.
- Electronic Timesheets Available Now!
Electronic Timesheets are now available for all CDS participants. eTimesheets makes submitting your employee's hours quick and easy. Say goodbye to paper and fax machines and input time data directly into our billing system. Search and view your time sheet history from your computer. Did you remember to send in a timesheet last pay period? Just log on to your eTimesheet account to find out. Simply click on the Resources Tab and select the eTimesheet button to get started. With eTimesheets, being an employer has never been easier!
- Texan's Home Health Makes National News
The Washington Times reports on Home Health issues facing Texans. Click here to view the full article
- Abilities Expo Comes to Houston
NRG Park The Abilities Expo has scheduled it's Houston event for Friday, August 4th through Sunday, August 6th. The expo features informative workshops as well as helpful products and services and is admission free. Visit the Houston Chronicle Senior Living section for more information. Click here for more info