Electronic Visit Verification

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Dear Provider,

The Nebraska Department of Health and Human Services (DHHS) is sharing an important update to help providers ensure continuity of care and avoid delays in Electronic Visit Verification (EVV) claim payments due to National Provider Identifier (NPI)​ enrollment issues.

If you already have an active NPI in Netsmart, you may disregard this message.

Temporary Allowance for Force Pay Requests to Address NPI Critical Errors:

To help maintain continuity of care, DHHS will temporarily allow force pay requests (FPS) for claims with NPI-related errors. This is intended to support providers as they complete the NPI enrollment process, which may take up to 15 business days. Please plan ahead to avoid delays.

Compliance Deadline – September 1, 2025

Starting September 1, 2025, the following will apply:

• All providers must be fully enrolled and compliant with EVV requirements to receive payment for EVV claims.
• FPS requests will be denied if the provider's NPI is not active in Netsmart.
• In accordance with 471 NAC 2-007.01(A), you have the right to appeal this denial within 90 days of the date of this notice. If you want to appeal, you may submit a written request for a hearing to the MLTC Appeals Coordinator, P.O. Box 94967, Lincoln NE 68509-4967. The request must identify the basis of the appeal. At that time, you may submit documentation or written arguments against the denial. The appeal form can be found here: https://public-dhhs.ne.gov/Forms/DisplayPDF.aspx?item=232​

We appreciate your continued partnership in delivering high-quality care to Nebraska Medicaid members while meeting compliance requirements.

Thank you,

Nebraska Department of Health and Human Services​

The Department of Health and Human Services (DHHS) is posting this announcement to provide clarification for providers who are subject to EVV for personal care services. Through recent discussions with providers, we have learned that there is confusion and misunderstanding regarding how the three educational interventions for caregivers are applied for all visits/claims after a caregiver has reached their three educational interventions.  

As background, DHHS implemented the requirement for all visits to have approved visit verification methods, using a GPS enabled device or interactive voice response (IVR), on visits for the visit to be allowed for billing.

In response to provider feedback regarding the enforcement of the 21st Century Cures Act requirement, DHHS communicated that we would allow each caregiver three opportunities to have visits approved for payment via the “Force Pay by State Adjustment Request" process in Monday.com​​ when t​​he approved visit verification methods are not used.

After a caregiver exhausts their three educational interventions, any completed visits which do not contain the required visit verification methods will trigger the critical error and will not be approved via the “Force Pay by State Adjustment Request" process in Monday.com. At that time, a formal appeal will be necessary for consideration of payment.

After a caregiver is allowed their three educational interventions, any completed visits which do contain the required visit verification methods and other required information will not trigger the critical error and will be allowed for billing.

The educational intervention process does not disqualify or prohibit the provider or caregiver from continuing to provide services or prevent valid visits from being billed to the department. 

Please reach out to DHHS.MedicaidFA-EVV@nebraska.gov for any questions regarding this communication.