On Jan. 21, 2021, NC Medicaid posted an Electronic Visit Verification (EVV) update stating the end of EVV flexibilities on Jan. 31, 2021. NC Medicaid acknowledged challenges with implementing EVV and provided flexibility through Jan. 31, 2021 for providers to resolve any challenges with their EVV solution and begin capturing visits for all beneficiaries subject to EVV.
As some of these challenges continue to be impactful, NC Medicaid will not recoup claims paid for services subject to EVV for dates of service Jan. 1, 2021 – March 31, 2021. Providers who make a good faith effort to connect with their EVV vendor of choice, documenting efforts and tracking issues that have prevented connection, will not be subject to recoupment for dates of service Jan. 1, 2021 – March 31, 2021.
As previously stated, NC Medicaid will operate the first 90 days of EVV as Pay and Report. This means claims will not pend based on failed validation. During this period, if a claim fails validation the system will generate a report of the validation issue and allow the provider to cure the issue. Providers who have demonstrated a good faith effort to connect to EVV will not experience recoupment of claims that fail validation during this period.
NC Medicaid continues to monitor the progress of alternate EVV solutions and their ability to complete interface testing with Sandata. To ensure that NC Medicaid meets implementation timelines and can fully integrate EVV through claims adjudication for all providers, alternate EVV solutions must complete testing by Feb. 12, 2021. NC Medicaid will work with alternate EVV solutions and Sandata to monitor progress through testing completion. As we track progress, if needed, adjustments may be made to the Feb. 12, 2021 deadline. Provider agencies working with alternate EVV solutions who initiated testing with Sandata prior to Jan. 1, 2021, and have not been notified of the solution’s testing completion will not be subject to recoupment of claims through March 31, 2021.
Alternate EVV solutions experiencing technical difficulties that they believe will not allow them to meet the Feb. 12, 2021 deadline, should contact NC Medicaid through the NC Medicaid EVV email at NCAltEVV@Sandata.com or Sandata Alt EVV Support Line at 844-289-4246.