Electronic Visit Verification (EVV)

Electronic Visit Verification (EVV) is a computer-based system that electronically documents and verifies service delivery information, such as date, time, service type and location, for certain Medicaid service visits.  Texas Health and Human Services Commission (HHSC) determines when a program provider, Financial Management Services Agencies (FMSA) or Consumer Directed Services (CDS) employer must use EVV based on the services delivered. EVV is required for all programs and services listed in the Programs and Services Required to Use EVV .

Important Contact Information

Blue Cross and Blue Shield of Texas (BCBSTX) Contact Information:

  • For EVV questions, call Provider Customer Service at 1-877-784-6802 or email the EVV Mailbox at BCBSTX_EVV_Questions@bcbstx.com
  • For Service Coordination needs, call 1-877-301-4394 (TTY 7-1-1)
  • Information on how to submit a Complaint or Appeal

For EVV Visit Maintenance Unlock Request (VMUR) :

Health and Human Services EVV Contact Information:

TMHP EVV Contact Information:

Vendor Contact Information:

DataLogic Software, Inc. / Vesta First Data Government Solutions / AuthentiCare

Phone: 1-844-880-2400
Email: info@vestaevv.com

Phone: 1-877-829-2002
Email: AuthentiCareTXSupport@firstdata.com

 

EVV Compliance Oversight Reviews

EVV Compliance Oversight Review is currently under revision. Review Section 10000 EVV Compliance Reviews from the EVV Policy Handbook for more information.

State Fiscal Year (SFY) 2022 

Usage Score Compliance

SFY2022 Quarter

# Agency Provider’s in Compliance

# Agency Provider’s not in Compliance

# FMSAs in Compliance

# FMSAs not in Compliance

# CDS Employers in Compliance

# CDS Employers not in Compliance

SFYQ1

10

6

1

8

Grace Period

Grace Period

SFYQ2

12

4

2

6

Grace Period

Grace Period

SFYQ3

10

4

3

5

Grace Period

Grace Period

 

SFY 2022 Compliance Report

SFY2022 Quarter

# Agency Provider’s in Compliance

# Agency Provider’s not in Compliance

# FMSAs in Compliance

# FMSAs not in Compliance

September 2021

9

6

4

4

October 2021

6

8

1

7

November 2021

12

3

3

4

December 2021

11

3

1

6

January 2022

10

5

1

6

February 2022

10

5

2

5

March 2022

9

6

2

5

April 2022

8

6

2

5

May 2022

8

5

1

6

 

Most Common Reasons for Denial

Each quarter, this section is updated with the top reasons for denial of EVV-relevant claims.

  1. Units Mismatch
  2. Date of Service Mismatch
  3. Provider Terminated
  4. Service Mismatch
  5. Provider Mismatch

Most Common Reasons for Recoupment

Each quarter, this section is updated with the top reasons of recoupment for EVV-relevant claims.

BCBSTX process our first recoupment and it only includes these four items.

  1.  EVV06 - Units Mismatch
  2.  EVV05 - Service Mismatch
  3.  EVV03 - Date of Service Mismatch
  4.  EVV04 - Provider Mismatch

Span Billing Guidelines

BCBSTX allows for EVV claims to be submitted with a span date. If a provider chooses to submit a claim with a span date, the provider must ensure that:

  • Each date within the span has one or more matching EVV visit transactions.
  • The total units on the EVV claim must match the combined total units of the matched EVV visit transactions.