Understanding the differences between Electronic Visit Verification (EVV) and Electronic Claims Submissions (eBilling)
Published on August 24, 2023 by Shelley Scott
Across the nation, home care agencies find themselves looking for ways to become compliant with Electronic Visit Verification (EVV). Every state is at a different stage in the implementation process of EVV as they work to meet this mandate for Medicaid clients.
But what about other payers, such as the VA and Managed Care Organizations (MCOs)? How does this process differ when it comes to Electronic Claims Submission (eBilling)?
In this article, we will dive into the differences between EVV and eBilling, and how Smartcare Software is equipped to handle both while empowering caregivers and improving workflow.
What is EVV?
Electronic Visit Verification (EVV) is a method used to verify home healthcare visits to ensure patients are not neglected and to cut down on fraudulently documented home visits. EVV is required by most states for State Medicaid providers as part of the 21st Century Cures Act.
EVV ensures service delivery by electronically capturing:
- Date of the visit (used to support claims and is not required by all payers for payment)
- Clock in time and location
- Clock-out time and location
- A client who received the service
- Caregiver who provided the services
- Service that was delivered
This information is captured by Smartcare and sent to the state-selected aggregator for review.
Smartcare provides:
- One-on-one specialized training to configure caregivers, clients, and visits correctly for submission
- Integration with state-selected aggregator to transmit data
- EVV Management and KPIs are designed to simplify and streamline the submission process and reduce exception reasons that could result in payment delays or sanctions
“We are so happy to have moved to Smartcare’s EVV solution. Caregivers find the workflow is so easy and simple, I’m pleased with the GPS tracking that integrates to our state approved aggregator for Medicaid clients.”
Jamie, Home Care Owner in Ohio
What is eBilling?
Electronic Claims Submission (eBilling) — Smartcare assists users with the creation of a CMS-1500 to be converted by our clearinghouse to an 837p and transmitted to a specified payer for processing.
Electronic Claims Submissions are:
- Monitored for ‘clean claim’ submission
- Required for payment
- Sent through a clearinghouse
- Accepted by the majority of payers
- Utilizing a unit-based fee structure
- Receiving payments via ERA/835
Smartcare provides:
- One-on-one specialized training designed for proper claim creation and submission
- Integration with Quickbooks Online to improve and streamline the payment posting process
- A/R Aging Reporting population
“Now that we are using Smartcare’s ebilling solutions, we never miss a charge and get paid faster. It was so easy to implement. Before Smartcare I used to dread billing, now I have more time to spend on the business and bring more payments faster all without going to the bank!”
Angie M. Helping Hands Care, Ohio
Smartcare’s intelligent EVV tools and eBilling solutions keep home care providers safe from fraud and provide agencies with the leading digital solution for staying compliant and running a successful home care business.
For more information about Smartcare’s eBilling and EVV solutions and services, please give us a call or request a no-obligation, free demo.
