Electronic Visit Verification (EVV)



Electronic Visit Verification is a computer-based system that verifies the occurrence of personal attendant service visits by electronically documenting the time a visit begins and ends. Texas requires EVV for certain Medicaid funded home and community-based services provided through the Health and Human Service Commission and Managed Care Organizations.




Checklist:

EVV Training Requirements Checklists (PDF) Learn more about third-party links

Training Websites:

HHSC EVV Policy Training Learn more about third-party links

HHSC EVV Training webpage Learn more about third-party links

TMHP EVV Portal Training Learn more about third-party links

TexMedConnect:

TexMedConnect is an online application within TMHP that lets providers file claims, check claims status, confirm client eligibility, and more. There are two versions of TexMedConnect—acute-care and long-term care.

For more information about how to setup and use the acute care version of TexMedConnect, providers can refer to:

For more information about how to setup and use the long-term care version of TexMedConnect, providers can refer to:







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 – Complete either form:
    • Programs Providers and FMSA Form Excel Document
    • CDS Employers Form Excel Document

 

Health and Human Services EVV Contact Information:

EVV Email: EVV@hhs.texas.gov

EVV Website: Electronic Visit Verification | Texas Health and Human Services Learn more about third-party links

TMHP EVV Contact Information:

EVV Email: EVV@tmhp.com

EVV Website: Electronic Visit Verification (EVV) | TMHP Learn more about third-party links

EVV TMHP Proprietary System Website: EVV Proprietary Systems | TMHP Learn more about third-party links

EVV TMHP Vendor Website: EVV Vendors |TMHP Learn more about third-party links

Vendor Contact Information:

DataLogic Software, Inc. / VestaFirst Data Government Solutions / AuthentiCare

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

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


View Full Section:

Program Provider and FMSA EVV Contact Information Guide

CDS Employer EVV Contact Information Guide

EVV Service Bill Codes Table

EVV Compliance Oversight Reviews

Proprietary System Operator Onboarding Process

EVV Compliance Oversight Reviews

BCBSTX will update this section quarterly, by the last business day of the third month that follows the end of the fiscal year report quarter.

EVV Compliance ReviewsEVV Usage ReviewEVV Reason Code ReviewRequired Free Text ReviewEVV Allowable Phone Identification Reviews

Total # of Reviews Completed

24 

 24

24 

24 

Total # of Providers Non-Compliant

 13

 16

 18

Total # of Providers with Compliance

 11

 8

 21


BCBSTX is monitoring providers report based on the Compliance Oversight Reviews Policy. If any discrepancies or misuse is found, your agency will be contacted by BCBSTX staff prior to any recoupments, LDs, or contract actions being imposed.

 

Most Common Reasons for Denial

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

  1. Dates of Service Mismatch
  2. Provider not attested with the state
  3. Duplicate Claim
  4. Medicaid ID 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 has no specific EVV recoupments at this time. This section will be updated as applicable.

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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.