Important Update to Electronic Visit Verification (EVV) System
Date: 04/15/22
The 21st Century Cures Act requires providers delivering home health, private duty nursing (PDN) and personal care services to validate services and submit claims through a compliant Electronic Visit Verification (EVV) system. In collaboration with our providers, Sunshine Health and the Children’s Medical Services (CMS) Health Plan, have been moving towards full utilization of the EVV platform, including verifying visits and submitting all claims via an EVV platform.
We want to thank you for your continued partnership and for your continued commitment to our members. Sunshine Health has been working diligently to correct barriers that may have been preventing our home-based providers from utilizing HHAeXchange, which is our Electronic Visit Verification platform.
You are receiving this letter because you have been identified as provider who would use the EVV system. This applies to all providers of home health (including PDN) and personal care services.
We are contacting many providers before May 1, 2022, to ensure that any identified barriers have been resolved and all elements that providers need to deliver care and submit claims through the EVV platform (HHAeXchange) are available for use. Our goal is to prepare our providers to fully utilize HHAeXchange and move away from direct billing Sunshine Health before May 1, 2022.
We also want you to know about an important change effective May 1, 2022.
On that day, we will no longer allow the direct bill option to the health plan for EVV services for dates of service starting May 1, 2022. The direct bill option was a temporary process that was put in place for dates of service from Oct. 1, 2021, through April 30, 2022. All claims for dates of service after May 1, 2022, must be billed through HHAeXchange.
In accordance with Agency for Health Care Administration guidance, claims submitted outside of the EVV portal for dates of service starting May 1, 2022, will be subject to denial for non-compliance with using the EVV system. A compliant EVV system is available through HHAeXchange at no extra cost. See the guidelines.
Enclosed are technical and training resources available to assist you with navigating the HHAeXchange portal. The system is free to use. Please report any technical difficulties to HHAeXchange by completing the Florida EVV Adoption Technical Issue Notification form.
We’re grateful for you staying with us as we worked through the authorizations loading and other areas that you identified as barriers. We appreciate your partnership and are thankful that you continue to see our members.
If you have any additional questions or concerns, please contact your Provider Engagement Representative so we can work to quickly address them. Stay up to date on Sunshine Health providers notices by reviewing and bookmarking Provider News.
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