Electronic Visit Verification (EVV) is a technology used to verify that home or community-based service visits occur. The purpose of EVV is to ensure that services are delivered to members and that providers only bill for services rendered.
In Colorado, EVV has been mandatory since August 3, 2020
If you provide services that require EVV and have not yet enrolled, you MUST complete enrollment immediately to avoid potential denied claims!
What's New with EVV
October 16, 2024
Pediatric Behavioral Therapy Providers who are currently Provider Type 25 and re-enrolling as Provider Type 83 may be required to re-attest for Electronic Visit Verification (EVV) when a new Health First Colorado Provider Program ID (Medicaid Provider ID) is created.
If this is you, then to set up your new EVV Sandata Account (STX) go to the Provider Enrollment & Update Forms section on the Provider Forms page and get the Electronic Visit Verification (EVV) Attestation Form. Follow the instructions contained in the form.
If you need assistance with EVV contact us using the EVV Inbox Submission Form
For more information regarding Pediatric Behavioral Therapies, visit the Pediatric Behavioral Therapies Billing Manual webpage.
December 27, 2024
The Department of Health Care Policy & Financing (HCPF) will be making updates to the live-in caregiver (LIC) exemption process using the Gainwell Provider Web Portal.
HCPF is implementing a tiered approach to help billing providers transition to the new formalized EVV exemption request process using the Provider Web Portal. This phased strategy begins with the release of the revised EVV Exemption Form, soon followed by a “soft-launch" phase of the revised EVV Exemption Process, then leading to the “hard-launch” of the revised EVV Exemption Process. This phased approach is designed to reduce the administrative burden and financial impact.
Billing providers will still be responsible for ensuring accurate and complete documentation for each EVV exemption. The following highlights key components of the new EVV Exemption process:
- A new EVV Exemption Form will replace the old “EVV Live-in Caregiver Attestation Form”.
- The EVV Exemption Form, which includes instructions and supporting documentation requirements will be made available on the EVV Newsletters and Resources webpage in January 2025. Once an EVV Exemption Form is completed, the new formalized process requires billing providers to submit EVV exemption requests through the Provider Web Portal within 30 days of the member’s attestation date.
- The transition to utilizing the Provider Web Portal does not change the billing provider's responsibilities.
- Providers will receive notifications 60 and 30 days before expiration, on the day of expiration, and 30 days after.
See the October and July 2024 EVV Stakeholder Meeting Presentations or recordings for more information. In the future, additional information will be shared via Operational Memo(s).
There’s more to come! Get updates when you subscribe to the EVV Newsletters and don’t forget to attend the EVV Stakeholder Meetings.