Effective 7/1/24 EVV- Tailored Plan Physical Health Providers

Section 12006 of the Twenty First Century Cures Act (Cures Act) and the Centers for Medicare & Medicaid Services (CMS) requires the State of North Carolina to begin utilizing an Electronic Visit Verification System (EVV) for all the Tailored Plan Programs by July 1, 2024. The Cures Act mandate requires all visits to be timestamped via an electronic verification method utilizing EVV tools to record the member, caregiver, time the service begins and ends, location of the service, date of the service and the type of service performed.

To ensure that the provider community complies with the Cures Act mandate requirements, the state of North Carolina will require all Personal Care Services (PCS) and Home Health Care Services (HHCS) providers for the Tailored Plan Programs by July 1, 2024. As a result, Partners will continue their partnership with HHAeXchange as its EVV solution. In preparation for the PCS hard launch and HHCS soft launch on July 1, 2024, we want to ensure your agency is ready to start using HHAeXchange Provider Portal for your patients.

PCS Hard Launch Guidelines effective July 1, 2024:

  • All providers are expected to be fully compliant with EVV requirements.
  • EVV data must be validated prior to claims adjudication.
  • Claims without the required EVV criteria will deny.

HHCS Soft Launch Guidelines effective July 1, 2024:

  • HHCS providers are encouraged to submit EVV visit information to HHAeXchange through the duration of the soft launch period to ensure all systems are operating as intended for a successful hard launch.
  • If you experience challenges with claim submission through HHAeXchange during soft launch, you are able to submit claims outside of HHA while working collaboratively with Partners and HHA to resolve any barriers.

The EVV program will operate as “Pay and Report.” Claims will not deny if EVV visit information is not submitted to HHA. A warning edit will be applied noting the missing EVV validation. We understand that some agencies may have an enterprise EVV solution already in place to help you be compliant. Our intention is not to replace the EVV solution you have in place, but to ensure that we are able to collect the visit data for Partners and provide options for providers that support our members to make this process as easy as possible. As one of the options, HHAeXchange will provide a payer-funded EVV solution to manage EVV compliance for the members you service. Please see the action steps below that are required to ensure your path to success for the July 1, 2024, go-live.

Step #1: Choosing your EVV provider selection & the HHAeXchange Platform

HHAeXchange offers an EVV solution at no cost to providers. The system can be used directly or set-up as a data integration workflow for providers who already have EVV software. The options available with HHAeXchange are outlined below, please review and determine which is right for your agency based on your EVV set up:

  • Option 1 – Agencies currently without an EVV Solution: use the payer-funded EVV tools provided by HHAeXchange & Partners.
  • Option 2 – Agencies currently using another 3rd Party EVV Solution: use your existing EVV system and import visit data into HHAeXchange – HHA will route visit data to Partners.
  • Option 3 – Existing providers that currently utilize the HHAeXchange provider platform will be linked with the new service codes in scope.

Step #2: Complete HHAeXchange Provider Onboarding Form

If your agency does not have a portal with HHAeXchange, we ask that you promptly complete the HHAeXchange Provider Onboarding Form. If your agency already has a portal set up with HHAeXchange for PCS and you will be providing HHCS services, you do not need to complete the onboarding form again. This should be done as soon as possible, and no later than May 15, 2024, for HHAeXchange to understand which EVV option you are selecting and create a new portal if needed. The HHAeXchange team and Partners team will continue to follow up until the HHAeXchange Provider Onboarding Form is complete as it is a requirement to ensure visit data is aggregated accurately on behalf of your agency and Partners to NC DHHS. Please note, the HHAeXchange Provider Onboarding Form only needs to be completed once. The HHAeXchange Provider Onboarding Form link can be found here:

Step #3: Register & attend an Information Session

HHAeXchange will hold two Information Sessions beginning June 4th at 2 p.m. The link to register is below. You are only required to attend one session.

  • June 4, 2024, 2 p.m.
  • June 6, 2024, 2 p.m.

Click Here to Register.

Have Questions?

For questions on navigating the HHAeXchange system or with completing your HHAeXchange survey, please email HHAeXchange or visit us at North Carolina Tailored Plans.