What happens if a provider refuses to use EVV?
EVV use will be required for those services subject to EVV. Providers who fail to use EVV will risk not getting paid once EVV is fully implemented. DHHS strongly encourages providers to use EVV from the first date available to them to help prevent any impact to payment.
If a provider has already implemented EVV can they continue to use that vendor?
Yes. DHHS has chosen to implement the open model allowing providers to use their own EVV systems (often referred to as a 3rd party EVV Vendor). Providers using 3rd party EVV Vendors will be responsible for the costs of that solution. 3rd party EVV systems will also be required to comply with the rules set by DHHS. 3rd party EVV system requirements will be posted to the DHHS EVV webpage.
When will providers be required to use EVV?
The early adopters group is expected to go live in September 2020. The remaining providers will be phased in shortly after the pilot. More specific dates will be provided in the near future.
What happens when the location of the client is not at home, for example visiting family or a doctor appointment?
Tellus EVV is designed to work in home and community-based settings. Visits can be scheduled and recorded at any location using the mobile app. The Tellus EVV system also allows the start location and end of service location to be different.
How would we change hours for our agency providers, if their times change weekly?
Existing schedules can be adjusted quickly and easily in the Tellus Portal.
What if a provider forgets to clock in or clock out?
If a provider forgets to complete a visit on the mobile app then the visit must be completed manually in the Tellus Portal. Since a GPS location cannot be identified, a reason code is required for the manual entry.
When it comes to the billing aspect, how are we to know that the claim was received? When we send in claims now, if something is wrong, they will return the whole packet back.
Providers will release claims, in the Tellus portal, for each service provided. Claim status is updated and displayed in the Tellus Portal for each service. The claims statuses you will encounter are as follows:
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Released: The visit has been released for payment.
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Submitted: The visit has been “Submitted for payment; this status will change to “Accepted" when it is received by the Payer or “Rejected."
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Accepted: The claim has been accepted by the Payer and it has been assigned an Internal Control Number (ICN) that the Payer uses to identify claims.
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Denied: The claim has been “Denied" by the Payer and will not be paid; in some cases, you can create a new claim and resubmit it. Note: You can create new claims and resubmit them only for claims that have an incorrect diagnosis, incorrect provider ID, or incorrect member ID. You cannot create a new claim to submit for claims that have been denied for untimely filing, if there is no Prior Authorization associated with it, the member is not eligible, or if primary insurance information is missing.
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Paid: The Payer has paid the agency for the services it provided to the Recipient.
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Paid Partial: The Payer has partially paid the agency for the services it provided to the Recipient. You may choose to adjust and resubmit these claims.
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Rejected: The claim was part of a batch that was rejected for incorrect data or processing and will need to be resubmitted by Tellus. You do not need to take any action on “Rejected" claims
If a provider selects a 3rd party for EVV, what would Tellus' provision of training, customer support and outreach look like?
Tellus is committed to supporting third-party system implementations. Tellus will train providers on how to submit claims via the Tellus Portal once the selected third-party vendor has successfully integrated. Tellus will provide customer support for all provide
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Who is inputting the scheduled visits in the Tellus EVV system?
Tellus will receive the service authorizations from DHHS electronically, however, the providers will be responsible for scheduling the visits for their participants based on those service authorizations.
Will a provider that uses a 3rd party EVV have access to the authorizations and tasks?
DHHS Service Authorizations will be displayed in the Tellus Portal for all providers to access and review. How tasks are displayed in mobile app will depend on the 3rd party EVV systems functionality. Tasks will auto populate in the Tellus mobile app.
Does a visit need to be scheduled before it is started?
The visit must be set up in the system prior to starting the visit. The timing of the setup is up to the provider.
How does a provider end a visit, but release payments to be paid weekly?
In the Tellus EVV system, the visits are stored in the Tellus Portal. When a provider is ready to submit claims, all visits ready for claims submission will be available.
Will Tellus be doing training in person or only on a webinar?
Tellus provides training via live webinars and on-demand videos and user guides. Tellus does not provide in person training.
Who will enter the authorized tasks and times allowed?
Tellus will receive the service authorizations from DHHS electronically. This will contain the tasks and hours allotted for a participant.
Are the current Service Authorizations going to be updated to allow the information to be pulled over to Tellus?
Yes. Tellus will receive the service authorizations from DHHS electronically.
Will family members be required to use EVV if their family member is the one who is being cared for at home?
Although CMS has indicated EVV is not required for providers who live with their participants, DHHS has chosen to include this in the EVV Program. CMS has given states the ability to include services in the EVV Program that may not be part of the 21st Century Cures Act. Each state reviews their Programs carefully when deciding whether or not a service or situation is applicable to EVV.