The federal government will soon require electronic visit verification for CMS-funded home care visits. How can agencies comply?
With the federal electronic visit verification (EVV) mandate taking effect on January 1, most home care agencies are still wrapping their heads around EVV compliance. But some states and agencies have been using EVV for years to curb Medicaid fraud. One of those agencies was the inspiration for Tellus EVV.
Tellus was founded in 2013 as a professional services business that would build custom software to solve unique problems for clients. Their first big client was a home care agency from Miami-Dade County, where Medicaid fraud is particularly prevalent.
“The client wanted to build an EVV solution to streamline workflows and gain more transparency into field operations,” explains Vicki Timiney, vice president of marketing and customer engagement for Tellus. “So, our founders acquired a bare-bones solution and developed it from there.”
The timing was serendipitous. While Tellus was building its EVV solution, Congress passed the 21st Century Cures Act with the EVV mandate. Suddenly, EVV compliance wasn’t a unique challenge for one business; it was a priority for thousands of businesses.
Today, Tellus offers a full suite of EVV compliance solutions. What does the solution do, and what are the benefits?
More Than Just a Mobile App
Tellus EVV has three key components: a mobile app for caregivers, an administrator console for agencies and a claims engine.
At the beginning of each visit, the caregiver logs into the mobile app using a unique username and password or biometric recognition. The app confirms the caregiver’s GPS location, even without a cellular connection. Then it shows the caregiver a list of tasks to perform and lets them check items off the list as they go. When they’re finished, they simply check out. For further verification, a signiture can be captured. There’s no paperwork to complete or deliver to the home office. The app sends all the information back to the administrator portal.
“As soon as they check out, the information is sent to our database,” says Timiney. “If we are the vendor of choice for the health plan, the data is automatically synced to the prior authorization from the health plan to verify whether the services that were supposed to be performed were actually performed. An agency administrator can see right away that the visit was completed and whether it matched the prior authorization. If it didn’t, they can proactively follow up.”
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The most sophisticated part of the solution — the Tellus claims engine — applies the matching rules, validates claims and enables agencies to submit claims.
“In addition to what the 21st Century Cures Act mandates, the health plan can also put in their business rules. For example, they might say the caregiver can’t start a visit if they’re more than a mile from the location. So if someone checks in too early, the claims engine will say the visit didn’t match the business rules. It also applies rules from the state and the agency.”
Tellus integrates well with other EVV vendors, so even agencies that don’t use the Tellus mobile app can use the claims engine. In some states, agencies are required to do so. “For example, Florida has an open EVV vendor model, so agencies can choose their own mobile solution, but we are the vendor for the state, so all other EVV vendors have to send us their data. We aggregate that data, normalize it, scrub it and apply all the rules in the claims engine. Then agencies can review and submit their claims.”
Beyond EVV Compliance: Four Benefits of Tellus
With EVV solutions in high demand, there are many new options. What makes Tellus special?
- A Robust EVV Solution: “For most other companies in this space, EVV is an add-on,” says Timiney. “They have focused on building agency management solutions, or electronic health records, or HR and billing. And now they’ve just tacked on some EVV capabilities. We focus entirely on EVV, and we think our technology is superior because of that.”
- Faster Speed-to-Reimbursement: In the past, agencies needed to collect paperwork from each caregiver (who might only come into the office once or twice a week). Someone had to process the paperwork, fill out more forms, and submit those to the payer. With Tellus, the agency just reviews the digital claim and hits submit.
- Fraud-Proof Technology: Some states and agencies use interactive voice response (IVR) technology that lets caregivers verify visits by calling a toll-free number from an approved line. But Timiney says IVR can be fooled with a mobile phone number. “With GPS location, we have the exact coordinates. Sometimes caregivers report the GPS isn’t working properly, but when we dig into it, the GPS is always working fine. They just weren’t where they said they were. So, the agencies can curtail fraud before claims are submitted, which reduces their chances of being denied claims or audited.”
- More Efficient Operations: Scheduling and messaging capabilities in the Tellus app enable agencies to update schedules on the fly and reroute workers in real time. For example, if a patient cancels a visit an hour before the appointment, the agency can change the caregiver’s schedule, send them an alert and reroute them. The agency also knows when a caregiver is running behind and can dispatch another caregiver for backup. Sophisticated reporting and business intelligence features also allow the agency to track trends and monitor performance. “Right now, most agencies have no insight into what’s happening in the field until the paperwork shows up a week later,” says Timiney. “With Tellus EVV, they have real-time information.”
Mobile Device Selection
The Tellus mobile app can be installed on just about any smartphone, so it supports care agencies taking a BYOD approach. But Tellus encourages clients to consider corporate-owned devices, and more specifically, to consider Samsung smartphones.
“With our app, all the information is encrypted while it’s on the device and in transit, but with corporate-owned devices, agencies can add a mobile device management (MDM) application, so they can lock or erase phones if they’re lost or stolen. Agencies can also control what apps are on the device, which helps ensure their caregivers’ time is spent delivering care and not getting distracted.”
Timiney acknowledges providing smartphones might be a financial burden for smaller agencies. That’s why Tellus has partnered with Samsung and Mobility CG to offer a bundled EVV solution including a Samsung smartphone, the Tellus EVV solution, a cellular data plan and other benefits for personal care agencies.
Samsung’s diverse device portfolio makes it easy for agencies to find the right device for their unique needs and budget. All devices are HIPAA-ready and secured by the built-in Samsung Knox platform. Larger agencies that want added security can add on Samsung’s MDM solution, Knox Manage.
“Samsung offers our clients a much better deal with this partnership than they could get paying retail prices,” says Timiney. “This is a Medicaid market. Caregivers don’t have a ton of money, patients don’t have much money and agencies are usually pretty bootstrapped too. Any opportunity to make our solution easier to adopt, the better it is for everyone.”
Understand everything you need to know about the EVV mandate, and how EVV can boost efficiency and profitability for your agency, with our free white paper. Or, learn about the Mobility CG bundle featuring Tellus EVV, Samsung smartphones, a Verizon data plan and more.