HHSC will publish a notice to remind program providers, FMSAs and CDS employers that the EVV system must be used. The topics were selected based on past issues and feedback received related to Visit Maintenance Unlock Requests, such as request for creating a manual visit.
This notice is intended for program providers, Financial Management Services Agencies (FMSAs) and Consumer Directed Services (CDS) employers requesting to use Electronic Visit Verification (EVV). The topics are about using an EVV system.
The topics are about using an EVV system.
- Manually Entered Visits: If the service provider or CDS employee fails to clock in and clock out of the EVV system for any reason, the program provider, FMSA and CDS employer must manually enter the visit into the system within the visit maintenance time frame.
If the visit maintenance time frame has expired, the program provider, FMSA or CDS employer must obtain an approved Visit Maintenance Unlock Request from the payer to manually enter the visit. 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 a payer or system error. Manually entered visits are measured as part of the EVV Usage Score.
- Missing Clock In and Clock Out Times: If a service provider or CDS employee fails to clock in or clock out of the EVV system for any reason, the program provider, FMSA or CDS Employer must:
- Complete Visit Maintenance.
- Enter an appropriate reason code.
- Ensure the missing clock in or clock out time is entered into the free text.
This includes entering missing clock in and clock out times when creating a manual visit.
The EVV vendor systems assist with entering missing times in the free text through different methods. Contact your EVV vendor for information about how their system supports this requirement.
- Waiting to Receive an Alternative Device: When a program provider, FMSA or CDS employer has determined a member needs an alternative device, they have 10 business days to order an alternative device from the EVV vendor. The EVV vendor has 10 days to process an order and ship the alternative device to the requestor upon receipt of a complete order. Depending on the shipping method, it may take more days to deliver the order.
HHSC requires service providers or CDS employees to clock in and clock out of the EVV system using one of the HHSC-approve clock in and clock out methods (mobile method or home phone landline) while waiting to receive an alternative device.
If one of these methods is not available, the program provider, FMSA or CDS employer must manually enter the visit into the EVV system within the visit maintenance time frame.
- EVV System Outages: If a service provider or CDS employee is unable to use the EVV system due to a system outage, the program provider, FMSA or CDS employer must manually enter the visits within the visit maintenance time frame.
The EVV vendors will communicate in the following matter when there is a system outage:
- First Data AuthentiCare will send out an email blast.
- DataLogic Vesta will post a notification to their Vesta dashboard
Program providers, FMSAs and CDS employers should report unexpected system outages to their EVV vendor or to the TMHP EVV Mailbox at email@example.com
- No Service Authorization on File: HHSC is aware that there could be instances when a service authorization for member services is delayed.
Program providers and FMSAs who choose to continue services while waiting for a service authorization must still require service providers and CDS employees to use the EVV system.
Service providers and CDS employees should capture their time worked through the mobile method, the home phone landline or alternative device. If the service provider or CDS employee does not clock in or clock out electronically, then the program provider, FMSA or CDS employer must manually enter the visit in the EVV system.
For information about how to use the EVV system while waiting for a service authorization, contact your EVV vendor.
If you have not received an authorization from your payer, you may use the contact information in the table below.
Contact your managed care organization (MCO), in this case Community First, for more assistance in determining factors for late authorizations.
If an MCO is non-responsive and you would like to file a formal complaint for a severely delayed authorization, you can email MCCO at HPM_Complaints@HHSC.State.TX.US.
EVV Vendor Contact Information
For additional information, contact the Provider Relations Division at (210) 358-6294 or ProviderRelations@CFHP.com.