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ADvantage and SPPC Member – Electronic Visit Verification Information Letter

AGING SERVICES | MEDICAID SERVICES UNIT

ADvantage Administration | State Plan Personal Care

Office:918-933-4900|CareLine:800-435-4711

Dear ADvantage and SPPC Members,

Use of an Electronic Visit Verification system (EVV) is a federal mandate and the service providers who serve you in your home must use EVV.  Systems like these are used to prevent fraud, waste, and abuse in the delivery of the care you receive.  If service providers do not use EVV, the state will lose federal funding. This federal funding allows the state to offer in-home services to qualifying Members.

WHAT IS EVV?

EVV is an electronic scheduling and billing system for in-home care providers.  Providers create a record of services to be billed using your telephone. They can also use a smartphone app to create claims.  EVV software verifies the caregiver is present in your home, records the service performed and compares it to your approved services. 

HOW DOES EVV WORK?

  1. The caregiver enters your home to provide a service that has been prior approved on your service plan.
  2. The caregiver uses your home phone or your cell phone to call the toll-free EVV number or uses the free smartphone app to begin the process.
  3. The EVV system verifies the information for you and the caregiver.  The smartphone displays the information and allows the caregiver to verify it.
  4. The system verifies that the caregiver is appropriate to provide the service for you and advises the caregiver can "check in". 
  5. When the caregiver completes the service, they call the same toll-free number or use the smartphone app to "check out". 
  6. From the telephone call or use of the smartphone app, EVV generates a claim for the service provider.  After the provider reviews and approves the claim, it is submitted electronically for payment to the Oklahoma Health Care Authority.

WHY DOES YOUR PHONE HAVE TO BE USED?

  • The use of your phone or smartphone app allows the EVV system to locate where the service is performed, to ensure that the service is being provided to you, in your home.  

SERVICE TYPES THAT WILL USE EVV:  

  • Personal Care
  • Case Management
  • Transitional Case Management
  • Nursing
  • Advanced Supportive / Restorative Assistance
  • In-Home Respite
  • CD-PASS Personal Services Assistance
  • Advanced Personal Services Assistance
  • Various Therapies (Physical Therapy, Occupational Therapy)

HOW DOES THE EVV SYSTEM BENEFIT YOU?

  • EVV helps ensure your health and safety because the system alerts your provider and DHS when you do not receive services as authorized and scheduled.  
     
  • Use of an EVV service assures the state will receive the funding necessary to provide your services, by reducing inappropriate billing.

HOW CAN YOU FIND OUT MORE INFORMATION OR PARTICIPATE IN TRAINING?

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