EVV Update Reminder June 2023
Date: 06/22/23
***This notice is intended for providers subject to the Electronic Visit Verification requirements**
Please review this entire communication for up-to-date information on Electronic Visit Verification (EVV) requirements and guidance.
1. Hard claim edits began January 1, 2023
- EVV services are paid or denied based on visit data loaded in Sandata matching or not matching to services submitted on your claim
2. You must maintain documentation standards that validate the provision of EVV services as well as the standard requirements outlined in your Provider Participation Agreement.
- If you are unsure as to whether the EVV mandate is required for your organization, please visit the AHCCCS EVV web page and read information provided within the Providers and Services Subject to EVV under Information for Providers and MCOs, including general information about services requiring EVV and resources to support providers to initiate the compliance process.
3. Agency EVV Contact
You must have an EVV contact on file to set up a Sandata account or access the Sandata Aggregator if you use alternate EVV vendors.
- The Aggregator contains detailed information about visit data Sandata, AHCCCS, and the MCOs are receiving.
- Please use the directions found on the AHCCCS EVV web page in the document EVV Contact and Update within both the Sandata EVV System Resources and Technical Assistance and Alternate EVV System Requirements and Technical Specifications sections. You may also use this process if you need to update your EVV Contact
4. Information for Sandata EVV System Users
Please contact Sandata Customer Care at 855-928-1140 for technical support for the system including:
- Accessing training,
- Finding your welcome kit
- Changing your EVV Contact
- Importing your employees, and
- l other technical issues experienced by users on devices or the EVV portal
5. Commonly reported problems are members or authorizations missing from the agency accounts.
- There can be a few different reasons why this might occur
- Members show up in the agency account when they are tied to a prior authorization from the MCO or when you have entered information into the AHCCCS EVV Service Confirmation Portal that links your agency to a member (in lieu of an authorization) when prior authorization is not required for a service
- If you are experiencing missing members or authorizations, please use the Missing Authorization and Member Checklist available on the EVV web page in the section entitled Sandata EVV System Resources and Technical Assistance to research and determine what steps should be taken before contacting Sandata.
6. Information for Alternate EVV System Users
If you are using an alternate EVV system, it’s critical you ensure the vendor’s compliance with AHCCCS business requirements and technical specifications.
- One practical way for you to understand and monitor what information Sandata is receiving from the alternate vendor is to access the Sandata Aggregator
- The Aggregator contains detailed information about the visit data that Sandata, AHCCCS, and the Health Plans are receiving
- You can find more information on how to access the Aggregator using the Sandata Aggregator Information document located on the EVV web page under section titled Alternate EVV System Requirements and Technical Specifications
- Please verify your alternate vendor is using the correct payer ID when they submit your visit information to Sandata. An incorrect payer ID submitted with your visit will result in a payment denial because Sandata will not find a match between your visit and the submitted claim. Additional information is included below and on page 26 of appendix 9.1
| Payer ID | Payer Program | Payer Name | Program ID |
|---|---|---|---|
| AZCCCS | 1115 Waiver | AHCCCS | AHCCCS |
| AZDDD | 1115 Waiver | AZ-DDD | AHCCCS |
| AZACH | 1115 Waiver | Arizona Complete Health | AHCCCS |
| AZBUFC | 1115 Waiver | Banner-University Family Care | AHCCCS |
| AZCHP | 1115 Waiver | Care1st Health Plan | AHCCCS |
| AZMCC | 1115 Waiver | Magellan Complete Care | AHCCCS |
| AZMYC | 1115 Waiver | Mercy Care | AHCCCS |
| AZSHC | 1115 Waiver | Steward Health Choice Arizona | AHCCCS |
| AZUCP | 1115 Waiver | UnitedHealthcare Community Plan | AHCCCS |
| AZCDMP | 1115 Waiver | Dental and Medical Plan | AHCCCS |
- For technical issues related to the current alternate system technical specifications, please contact Sandata Customer Support at AZAltEVV@sandata.com or 844-289-4246.
7. Provider Resources
AHCCCS has resources to support compliance with EVV. The following resources can be found on the AHCCCS EVV web page: https://www.azahcccs.gov/AHCCCS/Initiatives/EVV/. Refer to section General Resources and Frequently Asked Questions:
- Sandata EVV Workflow,
- Alternate Vendor EVV Workflow,
- EVV Billing Checklist, and
- Billing FAQ (updated).
8. Stay Informed
Please sign up for email notices on the EVV web page.