Electronic Visit Verification isn't optional for Medicaid-funded personal care and home health visits, it's a federal requirement under the 21st Century Cures Act, enforced state by state through systems like HHAeXchange, Sandata, and Netsmart. Which one your agency has to use often isn't even your choice, it's set by the state Medicaid program or managed-care payer you bill through, which is exactly where most of the real confusion starts.
The hardest part of EVV compliance usually isn't the clock-in/clock-out mechanic itself, it's that different states and different payers mandate different aggregator systems, and an agency billing across state lines or through multiple managed-care plans can end up needing to satisfy two or three EVV systems at once, each with its own data format and submission rules. We start from which state and payer requirements actually apply to your agency, and make sure whatever scheduling or care-management platform you run actually feeds the right EVV aggregator correctly, not just generically. Getting your caregiver and visit data mapped into the required aggregator format is real integration work we handle directly, and when your agency bills through more than one EVV system because of a multi-state or multi-payer mix, we build the logic that submits correctly to each instead of a biller manually re-entering the same visit twice.
HHAeXchange, Sandata, and Netsmart each dominate EVV compliance in different states and through different managed-care payers. We start by confirming exactly which aggregator your specific state and payer mix actually requires, since building toward the wrong one wastes real integration time.
An agency operating across state lines, or billing through several managed-care plans within one state, can end up needing to satisfy two or three separate EVV systems for the same visit data. We build the logic that formats and submits each visit correctly to every required aggregator, not just the first one.
A mismatch between what a caregiver's EVV check-in shows and what the schedule says was assigned is a common source of claim denials. We tie EVV visit data directly to your scheduling platform so the two records agree before a claim ever gets submitted, not after it bounces back.
Tell us which states and payers your agency bills through, and how clock-in/clock-out data currently gets from a caregiver's visit into your EVV submission. We'll tell you honestly which aggregator setup actually applies to you, or whether your multi-state or multi-payer mix needs submission logic built custom.
Get a free quote → →Electronic Visit Verification is a federal Medicaid requirement under the 21st Century Cures Act for personal care and home health visits. It's not optional if you bill Medicaid for these services, and non-compliance can mean claim denials or payment holds, not just a warning.
Often not entirely. Many states mandate a specific aggregator, HHAeXchange, Sandata, or another, either directly or through the managed-care payers you bill. We confirm exactly what's required for your specific state and payer mix before building anything.
Frequently, yes, which is one of the more common compliance headaches we see. We build the logic to format and submit visit data correctly to each required aggregator instead of leaving a biller to re-key the same visit for a second system.
No, though the two need to agree with each other. Scheduling software plans and records the visit; EVV compliance verifies and submits that visit data to a state-mandated aggregator. We tie the two together so a mismatch doesn't trigger a claim denial.
Yes, this is one of the more direct financial consequences of a poorly integrated system. A mismatch between the schedule and the EVV check-in record is a common, avoidable denial reason we build reconciliation logic specifically to prevent.
We do the integration work. HHAeXchange, Sandata, and Netsmart maintain their own aggregator systems; connecting your scheduling platform to submit correctly, especially across multiple states or payers, is work we handle directly.