What is EVV?
Electronic Visit Verification Explained
Verifiable Proof of Care Delivery
Electronic Visit Verification (EVV) is a technology solution used to verify that home healthcare services were actually delivered to the consumer at the approved location and time. Mandated nationwide by the 21st Century Cures Act, the solution was required to ensure the highest standards of accountability and reliability in Medicaid-funded Personal Care Services (PCS) and Home Health Care Services (HHCS) markets.
Essentially, EVV replaced manual paper timesheets with a digitally recorded and authenticated record of the visit, providing verifiable proof that care was delivered, which is essential for protecting vulnerable populations and ensuring they receive the care they deserve
Electronic Visit Verification (EVV) is a technology solution used to verify that home healthcare services were actually delivered to the consumer at the approved location and time. Mandated nationwide by the 21st Century Cures Act, the solution was required to ensure the highest standards of accountability and reliability in Medicaid-funded Personal Care Services (PCS) and Home Health Care Services (HHCS) markets.
Essentially, EVV replaced manual paper timesheets with a digitally recorded and authenticated record of the visit, providing verifiable proof that care was delivered, which is essential for protecting vulnerable populations and ensuring they receive the care they deserve
The Six Federally Required Data Elements
To be considered fully compliant, every EVV system must capture and report these specific data points
What service was performed
When the service began and ended
Who provided the service (caregiver/aide)
Where the service was performed (location)
Who received the service (patient/member)
How EVV Works in Practice
The typical workflow from service delivery to payment
Visit Capture
Caregiver clocks in/out using an EVV app, telephony, or fixed device
Caregiver clocks in/out using an EVV app, telephony, or fixed device
Data Collection
The EVV system captures all six required data elements.
The EVV system captures all six required data elements.
Data Validation
Data is validated against authorizations and business rules
Data is validated against authorizations and business rules
Record Transmission
Visit records are sent to the payer’s EVV aggregator.
Visit records are sent to the payer’s EVV aggregator.
Record Storage
The aggregator validates and stores the record.
The aggregator validates and stores the record.
Claim Submission
Provider submits the financial claim.
Provider submits the financial claim.
Payment Matching
Claim matches against the verified EVV record for payment.
Claim matches against the verified EVV record for payment.
Why EVV Matters
Protects Vulnerable
Ensures that seniors, individuals with disabilities, and those needing in-home care actually receive the necessary services.
Ensures that seniors, individuals with disabilities, and those needing in-home care actually receive the necessary services.
Reduces Fraud & Waste
Reduces billing for services not rendered and helps identify patterns of fraud, waste, and abuse in Medicaid programs.
Reduces billing for services not rendered and helps identify patterns of fraud, waste, and abuse in Medicaid programs.
Improves Data Quality
Replaces paper timesheets with accurate, timestamped digital records that improve oversight and program management.
Replaces paper timesheets with accurate, timestamped digital records that improve oversight and program management.
