Electronic Visit Verification (EVV) is a technology solution designed to bring transparency and accountability to the delivery of in-home care services. This system uses electronic methods to verify that authorized services are delivered to the correct patient at the scheduled time and location, replacing outdated paper-based documentation with a standardized digital record. This technology modernizes documentation and ensures the integrity of public healthcare funding for home-based care.
Defining Electronic Visit Verification and the Mandate
The requirement for Electronic Visit Verification stems from a federal mandate, specifically Section 12006 of the 21st Century Cures Act, Public Law 114–255. This law requires all state Medicaid programs to implement an EVV system for certain Medicaid-funded personal care services and home health services. The mandate was established to improve program oversight and ensure that taxpayer dollars are spent on services that were verifiably provided.
A compliant EVV system must capture and electronically verify five distinct pieces of visit data. This includes the specific type of service performed, along with the identity of the individual receiving and providing the service. The system must also record the date and time the service begins and ends, offering a precise duration of the care delivered. Finally, the system must capture the precise location where the service was delivered, confirming the caregiver was at the patient’s authorized residence.
The federal requirement set deadlines for compliance, initially targeting personal care services and later extending to home health services. States were given flexibility regarding the technology they use, but they must ensure the collection of these five data elements for every qualifying visit. This framework standardizes how in-home care is documented across the country.
How EVV Systems Function
EVV systems operate using several technological methods to capture the required time and location data at the point of care. One common method involves mobile applications used by caregivers on smartphones or tablets, which utilize Global Positioning System (GPS) technology. When a caregiver arrives and “clocks in” for a visit, the app records the coordinates and time stamp, which is then verified against the patient’s registered service address.
An older but still widely used method is telephony, where caregivers call a toll-free number from the patient’s landline or an approved mobile device to clock in and out. This system verifies the location by using Automatic Number Identification (ANI) to match the incoming phone number with the patient’s home phone number on file. This method is often preferred in areas with poor cellular service or for patients without accessible Wi-Fi.
For patients who do not have a landline and whose caregivers may not have a compatible mobile device, some systems use fixed verification devices. These small electronic units are installed in the patient’s home, and the caregiver uses them to check in and out upon arrival and departure. Another option includes portable electronic tokens or fobs used by the caregiver to register the visit data. Regardless of the method, the data is instantly transmitted to a secure system for compliance review.
The Impact on Home Health Operations and Patients
The implementation of EVV has changed the financial and operational landscape for home health providers. Non-compliance immediately risks reimbursement, as state Medicaid programs can face a reduction in federal funding. This financial penalty, which can increase incrementally each year, is then passed down to providers as denied or delayed claims.
A primary driver for the EVV mandate was the need to combat Fraud, Waste, and Abuse (FWA) within the Medicaid system. By electronically verifying the time and location of a visit, the system prevents common fraudulent practices, such as caregivers billing for services not actually provided or falsifying time sheets. This increased accountability helps safeguard public funds and improves the integrity of the home care industry.
For patients, the effect of EVV is generally positive, translating into better service coordination and consistency. Accurate, real-time data on visit times ensures that patients receive the full duration of care outlined in their service plan. This data allows agencies to quickly identify missed or shortened visits, enabling timely adjustments to staffing and ensuring continuous, reliable service delivery.