Is Your Agency Ready? Avoiding Reimbursement Delays with Compliant EVV

Written by Brittco Team | June 25, 2025

For agencies providing Homemaker Personal Care (HPC) services to individuals with intellectual and developmental disabilities (I/DD) in Ohio, the Electronic Visit Verification (EVV) mandate isn't just a suggestion – it's a requirement for timely and accurate reimbursement. Non-compliance can lead to significant delays in payments, impacting your agency's financial stability and, ultimately, the care you provide.

At Brittco, we understand the critical importance of a smooth and compliant EVV system. That's why our Alternate EVV solution is meticulously designed to meet Ohio Medicaid's stringent requirements while simplifying the process for your agency, caregivers, and the individuals you support.

The Stakes are High: Understanding Potential Reimbursement Delays

The Ohio Medicaid EVV mandate, driven by the 21st Century Cures Act, aims to bring greater transparency and accountability to the delivery of personal care services. While this ultimately benefits both providers and recipients, navigating the complexities of compliance can be daunting. Failure to adhere to the specific technical and functional requirements outlined by the Ohio Department of Medicaid (ODM) can result in:

Claim Denials: If visit data isn't captured and verified according to state guidelines, your claims may be rejected.

Payment Delays: Even if claims aren't outright denied, errors or incomplete EVV data can lead to significant delays in reimbursement processing.

Increased Administrative Burden: Trying to rectify non-compliant EVV data can consume valuable administrative time and resources.

Is Your Current System Up to Par? The Alternate EVV Demonstration Checklist

For agencies utilizing an Alternate EVV system (a system other than the state-mandated Sandata system), demonstrating compliance to ODM is a crucial step. The ODM requires a live demonstration to ensure your chosen system meets specific functionality requirements.

To help your agency prepare for this vital demonstration and ensure your EVV system is ready for seamless reimbursement, we've compiled a checklist based on ODM's guidelines. This checklist highlights key areas that will be assessed during the demonstration:

Comprehensive Visit Data Capture (Near Real-Time): Your system must reliably capture all required visit data elements in near real-time. This includes:

- Location at the start and end of the visit (Home or Community).
- Date and accurate start/end times of the visit.
- Identity of both the recipient and the direct care worker.
- The specific service provided, using standard values.
- Action for your agency: Can your caregivers easily and consistently capture all this information at the point of service? Does your system have robust mechanisms to ensure this data is recorded accurately and immediately?
Robust Manual Entry and Edit Capabilities with Audit Trails: While real-time capture is paramount, your system needs to allow for manual entry and editing of visits when necessary (e.g., in cases of technical difficulty). Crucially, any such manual actions must:
- Utilize standard reason codes for all entries and edits.
- Require an attestation confirming supporting documentation.
- Maintain a complete and unalterable audit trail, detailing the date/time of entry/change, the person who made the entry/change, and what specifically was altered.
- Action for your agency: Does your system provide clear, guided processes for manual entries and edits? Can you easily access a comprehensive history of every change made to visit data?
Accurate Exception Calculation and Management: Your EVV system must be able to accurately identify, calculate, and apply standard exceptions as defined by ODM (e.g., Missing Service, Unauthorized Service, Unknown Recipient, Missing Medicaid ID). Furthermore, it needs to:
- Use standard reason codes to document and acknowledge these exceptions.
- Allow providers to easily edit visits to clear exceptions while maintaining an audit trail of these corrections.
- Action for your agency: Does your system flag common errors automatically? Does it guide you through the process of resolving these exceptions and ensure all necessary documentation is in place?
Complete Direct Care Worker and Recipient Record Management: Beyond individual visit data, your system needs to efficiently manage essential records for both direct care workers and recipients. For direct care workers, this includes unique identifiers and contact information. For recipients, it encompasses:
- Association with payers, multiple payers, programs, and multiple services.
- Accurate entry of Medicaid IDs and dates of birth.
- The ability to store multiple addresses and phone numbers.
- Action for your agency: Is your master data for workers and recipients clean, complete, and easily managed within the system? Can you quickly link individuals to their relevant services and payers?
Integration with State Aggregator and Secure Data Transmission: Ultimately, your EVV system's compliance hinges on its ability to securely and accurately transmit validated visit data to the Ohio Medicaid state aggregator. This requires:
- Adherence to all technical specifications for data exchange.
- Robust security measures to protect sensitive health information (PHI).
- Action for your agency: Does your EVV vendor have a proven track record of successful integration with the Ohio Medicaid system? What security protocols are in place to protect your data during transmission?

Brittco: Your Partner in EVV Compliance

At Brittco, our Alternate EVV system is built to seamlessly address all the requirements outlined in the ODM's demonstration. We provide a user-friendly interface, robust data capture methods, comprehensive reporting capabilities, and stringent security measures to ensure your agency remains compliant and avoids costly reimbursement delays.

Ready to Streamline Your EVV and Secure Your Reimbursements?

Don't let the complexities of EVV compliance hinder your ability to provide vital services. Brittco offers a reliable and efficient Alternate EVV solution designed specifically for the needs of I/DD agencies in Ohio.

Book A Demo

Let us demonstrate how Brittco's EVV system can help your agency navigate the Ohio Medicaid mandate with confidence, ensuring accurate data capture, timely reimbursements, and ultimately, allowing you to focus on what matters most – providing exceptional care to the individuals you support. Contact us today to schedule your personalized demonstration and take the first step towards worry-free EVV compliance.

Brittco's Alternate EVV Demonstration Readiness Checklist:

(Based on ODM's "Alternate Electronic Visit Verification (EVV) Demonstration Checklist" - April 2024)

Direct Care Worker Records

[ ] E1: Does your system require entry of the Social Security Number for direct care workers and administrative staff?

[ ] E2: Does your system require entry of an email address for all direct care workers with administrative roles, allowing direct information entry and editing?

[ ] E3: Does your system prevent the use of the same email address for multiple direct care workers?

[ ] E4: Does your system prevent the reuse of an email address from a former direct care worker for a new direct care worker?

Recipient Records:

[ ] C2: Does your system allow you to associate a recipient with a payer?

[ ] C3: Does your system allow you to associate a recipient with multiple payers when applicable?

[ ] C4: Can you associate a recipient with a program?

[ ] C5: Can you associate a recipient with multiple programs when applicable?

[ ] C6: Can you associate a recipient with a service?

[ ] C7: Can you associate a recipient with multiple services?

[ ] C8: Does your system allow you to enter a Newborn Indicator and recipient Payer ID (N/A for DODD-only services)?

[ ] C9: Does your system allow you to enter a PIMS ID as a Recipient Payer ID when the only payer is ODA (N/A for DODD-only services)?

[ ] C10: Does your system require the entry of a Medicaid ID for non-ODA/newborn recipients?

[ ] C11: Does your system require the entry of the recipient’s date of birth?

[ ] C12: Does your system allow you to enter 3 or more addresses for a recipient?

[ ] C13: Does your system accommodate sending only a P.O. Box in place of a physical address if requested by the recipient?

[ ] C14: Does your system allow you to enter multiple phone numbers for a recipient?

Visit Capture:

[ ] V2: Does your primary visit capture method record the location at the start of the visit ("Home" or "Community")?

[ ] V3: Does your primary visit capture method record the location at the end of the visit ("Home" or "Community")?

[ ] V4: Does your system capture the date of the visit in near real-time?

[ ] V5: Does your system capture the start time of the visit in near real-time?

[ ] V6: Does your system capture the identity of the recipient receiving services in near real-time?

[ ] V7: Does your system capture the identity of the direct care worker in near real-time?

[ ] V8: Does your system capture the service provided in near real-time using standard values?

[ ] V9: Does your system capture the end time of the visit in near real-time?

[ ] V10: Can you manually enter a visit directly into the system, including all data elements from V2-V9?

[ ] V11: Does your system use standard reason codes for manually entered visits?

[ ] V12: Does your system collect an attestation for manually entered visits, confirming supporting documentation?

[ ] V13: Does your system maintain a complete audit trail for manually entered visits (date/time of entry, person entering)?

[ ] V14: Does your system offer a third method of visit capture that records all required data elements (V2-V9)?

[ ] V15: If telephony is the third method, is the call's originating phone number captured in near real-time?

[ ] V16: Does your system capture the call type for all visits per the Alternate EVV Technical Specifications?

Visit Maintenance:

[ ] M1: Does your system allow manual editing of visits before and after submission to the State Aggregator?

[ ] M2: Does your system use standard reason codes for manual edits?

[ ] M3: Does your system collect an attestation for manual edits, confirming supporting documentation?

[ ] M4: If direct care workers can alter visit data, does your system have a process for employer of record approval?

[ ] M5: Does your system maintain a complete audit trail for manual edits (date/time of change, person making change, what changed)?

[ ] M6: Does your system appropriately calculate and apply the Missing Service Exception?

[ ] M7: Does your system appropriately calculate and apply the Unauthorized Service Exception?

[ ] M8: Does your system appropriately calculate and apply the Unknown Recipient Exception?

[ ] M9: Does your system appropriately calculate and apply the missing Medicaid ID Exception?

[ ] M10: Does your system appropriately calculate and apply the Unknown Employee Exception (N/A if telephony is not an alternate method)?

[ ] M11: Does your system appropriately calculate and apply the Visit Without In-Call Exception?

[ ] M12: Does your system appropriately calculate and apply the Visit Without Out-Call Exception?

[ ] M13: Does your system appropriately calculate and apply multiple exceptions to a single visit?

[ ] M14: Does your system appropriately calculate and apply exceptions after provider edits?

[ ] M15: Does your system use standard reason codes to document and acknowledge exceptions?

[ ] M16: Does your system capture an attestation confirming supporting documentation for visits with exceptions?

[ ] M17: Does your system allow providers to edit visits to clear exceptions?

[ ] M18: Does your system maintain a complete audit trail when exceptions are cleared (date/time of change, person making change, what changed)?

Brittco: Your Partner in EVV Compliance

At Brittco, our Alternate EVV system is built to seamlessly address all the requirements outlined in the ODM's demonstration checklist. We provide a user-friendly interface, robust data capture methods, comprehensive reporting capabilities, and stringent security measures to ensure your agency remains compliant and avoids costly reimbursement delays.

Ready to Streamline Your EVV and Secure Your Reimbursements?

Book A Demo

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