Frequently Asked Questions
Core Concepts and Federal Mandate
Understanding the basics of EVV and federal requirements
What is the Electronic Visit Verification (EVV) ?
- EVV is a technology-based system that electronically verifies when and where Medicaid-funded home and community-based services (HCBS) visits occur. It captures the six required data elements to ensure service delivery matches authorized claims.
What federal law mandates the use of EVV?
- The 21st Century Cures Act, passed in December 2016, mandates that all state Medicaid programs implement an EVV system for all personal care services (PCS) and home health care services (HHCS) that require an in-home visit.
What are the six federally required data elements for every EVV visit?
- Type of service performed.
- Individual receiving the service (client/member)
- Individual providing the service (caregiver/aide)
- Date of the service
- Location of service delivery (start and end)
- Time the service begins and ends (start and end)
What is the role of Travora in the EVV data pipeline?
- Travora functions as a certified Pass-Through or Router system for the provider. It sits between the provider's core systems (EMR, scheduling, payroll) and the Payer's EVV Aggregator. Travora's primary job is to correctly map, transform, and transmit the visit data to ensure it meets the Payer's Aggregator technical specifications and compliance rules.
What is the difference between a Payer's EVV Aggregator
and an EMR Pass Through ike Travora?
- Payer EVV Aggregator: The mandated system responsible for receiving EVV data from all providers in the state. EMR Pass-Through (Travora): A provider-side certified vendor solution that receives data from the agency's primary EMR and transforms/encrypts it before sending it to the Payer's EVV Aggregator.
Data Integrity and The Travora Pass Through
How Travora ensures accurate and compliant data transmission
What is the Data Flow Sequence when using Travora?
- Caregiver clocks in/out using the EMR application
- Raw visit data is saved in the provider's EMR system
- Travora receives the data from the EMR, maps it to the Payer's required schema, and sends it to the Payer's EVV Aggregator
- The Payer's EVV Aggregator validates the data and stores the record
- The provider submits the financial claim
- The claim successfully matches against the EVV record stored by the Payer's EVV Aggregator
What does Travora do to ensure data formatting compliance?
- Travora translates the data fields from the provider's EMR (which may use proprietary names like VisitStartTimestamp) into the precise, standardized field names and data types (e.g., ISO 8601 format) required by the Payer's EVV Aggregator's specification.
Does Travora perform Geofence validation?
- Travora does not perform Geofence validation. This is typically handled at the EVV capture level by the EMR.
What are the most common reasons Travora rejects a data record internally?
- The most common reason is Mandatory Field Missing: when a required field (like the Client ID or Service Code) is empty in the EMR.
How does Travora handle the security of PHI ?
- Travora must adhere to HIPAA rules, ensuring that all Protected Health Information (PHI) received from the EMR is securely encrypted using the mandated protocol before being transmitted over to the Payer’s EVV Aggregator
Claims Matching and Technical Integration
Understanding the technical aspects of EVV integration
What is Claims Matching?
- The process where the payer’s claim adjudication system attempts to match a submitted financial claim (via CPT/HCPCS codes) to a corresponding, validated EVV record that was routed through Travora and stored by the Payer’s EVV Aggregator
What are the common identifiers used by Travora to link data ?
- The most critical linking identifiers received and mapped by Travora can be: Client Medicaid ID, Provider NPI or Provider ID, Caregiver ID, and Date of Service and Start/End Time.
Why might a provider choose to use Travora instead of building their own integration?
- Building direct EMR-to-Payer Aggregator integrations is complex, time-consuming, and requires ongoing maintenance for every state or payer policy change. Travora provides a pre-certified, pre-built conduit, saving the EMR significant development costs and compliance risk.
How is data synchronization managed between the EMR and Travora?
- Synchronization can be real-time (API), where Travora receives data immediately upon visit approval, or batch, where data is received and transmitted on a scheduled hourly or daily basis. Real-time is generally preferred for immediate compliance feedback.
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