CareBridge EVV Integration Guide and Technical Specifications

OVERVIEW

Welcome! This Integration Guide is intended to help providers and EVV Vendors throughout the process of integrating with CareBridge to provide EVV data for the purposes of data aggregation. If at any point you have questions, our team here is here to help: evvintegration@carebridgehealth.com. A PDF version of this document is available here.

 

WHAT IS CAREBRIDGE?

CareBridge is a company formed to support care for people who receive Long-Term Services and Supports (LTSS). We offer LTSS solutions including an Electronic Visit Verification Platform that can be utilized via a mobile phone, GPS-enabled tablet, landline and web-based portal to record service delivery and facilitate day-to-day management of members’ appointments. CareBridge also supports a wide array of EVV data aggregation solutions in which CareBridge builds an integration with a provider’s EVV system, allowing provider agencies to keep their current EVV solution while still providing required data back to the health plan or state.

INTEGRATION OVERVIEW

CareBridge will engage providers that choose to integrate CareBridge's Platform with a 21st Century Cures Act compliant EVV solution. CareBridge's Platform supports data aggregation by way of accepting EVV Visit Data from Third-party vendors and subsequently generating claims to be submitted to the clearinghouse and state.

All EVV Visit and Claims data must ultimately be reflected in the CareBridge Platform for state receipt, payment, and monitoring.

The following is a description of the steps in the data aggregation process:

1. Appointments / Visits data file is placed in SFTP folder by provider and/or Third-party vendor.
2. CareBridge imports and processes Appointments / Visits file.
3. CareBridge places response file in SFTP for review by provider and/or Third-party vendor.
   • Provider takes action on response errors and resubmits visits.
     • It is the responsibility of the Third-Party EVV Vendor to ensure providers can correct errors within their EVV system and are able to resubmit the corrected visits to CareBridge.
     • CareBridge provides daily reports on outstanding pre-billing errors via the supplemental
       Pre-Billing Validation Report.
4. CareBridge utilizes visits data to generate claims and submits to clearinghouse / state.
5. CareBridge provides daily updates on visit status via the supplemental Appointment Status Report.
6. Providers can continue to receive claim remittances through previously established mechanisms (Availity).

The supplemental report specifications can be found on the CareBridge EVV Data Integration web page: http://evvintegration.carebridgehealth.com, under Additional Documents for Third-Party Vendors.

Appointments / visits data should be submitted to CareBridge at least once daily for all appointments / visits that have had incremental changes since last submission.

Do not continue to re-send appointments / visits that have not changed unless instructed by CareBridge. If a visit has been sent with ClaimAction 'N', do not re-submit until it reaches a terminal status (Rejected, Paid, Denied), or an error was included for that visit in the CareBridge Response File.

SFTP CONFIGURATION REQUIREMENTS

• CareBridge test environment: sftp.dev.carebridgehealth.com
• CareBridge production environment: sftp.prd.carebridgehealth.com
• Port: 22
• Login Credentials: Vendor's public SSH key
• When transferring files via SFTP, select BINARY mode

SFTP FOLDER STRUCTURE

/input – Used to send files to CareBridge for import into the CareBridge system
/output – Used to retrieve Response Files from CareBridge

SFTP RETENTION POLICY

• Once files have been downloaded from /output, they should be deleted. If they are not deleted, they will be retained for 30 days.
• Files will be deleted from /input upon load and processing by CareBridge.

FILE FORMAT SPECIFICATIONS

• File type: CSV (pipe-delimited).
• Values can be enclosed with double quotes (and should be when a pipe could exist in the data).
• Headers should be included.
• One row per appointment / visit.
• All DateTime fields should be UTC.
• Visit data will be rejected if there is already an existing ApptID that has been claimed but has not yet reached a terminal status (Rejected, Paid, Denied).

NAMING CONVENTION

Visit Files from Third Party EVV Vendors

The general naming convention is as follows:
VISITS_WY_ProviderTaxID_YYYYMMDDHHMMSS.CSV

For Test Files, “TEST” will prepend the file name as follows:
TEST_VISITS_WY_ProviderTaxID_YYYYMMDDHHMMSS.CSV

Note: The state initials are required for files to be processed.

 

CareBridge Response File

VISITS_WY_ProviderTaxID_ERROR_YYYYMMDDHHMMSS.txt

For Test Files, “TEST” will prepend the file name as follows:

TEST_VISITS_WY_ProviderTaxID_ERROR_YYYYMMDDHHMMSS.txt

TESTING INSTRUCTIONS

Testing Overview 

Vendors are required to complete testing scenarios in order to begin sending production data to CareBridge. To start integration testing, please complete the EVV Intake Form. 

The goal of the testing process is to ensure that data is able to be successfully transmitted from Third-party vendors to CareBridge. CareBridge has created several test cases designed to ensure specific scenarios are understood and passed by vendors prior to production go-live.

The test cases are outlined in a separate document: Wyoming - Third-Party EVV Vendor Integration Testing Process Guide, available on the CareBridge EVV Data Integration web page: http://evvintegration.carebridgehealth.com, under Additional Documents for Third-Party Vendors > Wyoming - Third-Party EVV Vendor Integration Testing Process Guide. 

Note: the Wyoming - Third-Party EVV Vendor Integration Testing Process Guide will be available soon.

Additionally, there are 3 different testing milestones summarized below:

• Connection Testing – Vendors credentials are working properly and they are able to successful connect to the SFTP site.
• File Validation Testing – Vendors are able to successfully send files in accordance with file specifications.
• Data Validation Testing– Vendors are able to send records in accordance with data specifications.  A full list of CareBridge Pre-Billing Validations can be found under Technical Specifications for Third-Party Vendors > Pre-Billing Validation Errors

Initial Production Data Go-Live

Once a vendor has successfully completed the required test cases and is approved to send data to production, they can begin sending production appointment/visit data to the production environment.

CareBridge highly recommends that EVV Vendors follow the process outlined below:

1. Send a file in the production environment with actual visit/appointment data.

   a. Only sending 1-5 rows of data initially.
   b. Sending visit data with the ClaimAction field as null.
   c. At least one row of data be visit data rather than appointment data.

2. Download the response file in the /output folder and review the pre-billing errors.
3. Update data to remedy those errors; email evvintegration@carebridgehealth.com with questions about specific errors.
4. Repeat steps 1-3 until you receive a response file with headers only. This means that there were no row level errors and the data was processed successfully.
5. Repeat steps 1-4 for each unique provider agency TIN for whom you provide EVV services.
    

Claim Submitted via CareBridge

Once a vendor is able to successfully send a file of appointment/visit data without errors on behalf of a provider, they can coordinate with the provider to submit their first claim.

• Re-send the visit data previously sent in Initial Production Data Go-Live with the ClaimAction field as 'N'. This will generate a claim for those visits.

Note: If visits sent in Data Validation Testing – Production included the ClaimAction field as 'N' rather than null, both Data Validation in Production and Claim Submitted via CareBridge would be completed simultaneously.

Integration "Go-Live" 

Once a vendor is able to successfully submit a claim via CareBridge, they can begin implementation of Integration Go-Live – submitting all claims via CareBridge.

This will require coordination between the vendor, the agency(ies) they support and CareBridge.

The process is as follows:

1. Direct providers using your system to the CareBridge Integration Document for Providers site. It contains instructions for their expectations and next steps.
2. Identify a go-live date with each agency to begin sending all data and communicate that date to CareBridge.
3. Develop a process with your agency for resolving response file errors on an ongoing basis.
   • It is up to vendors and their agencies whether response files will be passed to their agencies directly or incorporated into the Third-party EVV system’s UI.
   • It is required that vendors leverage both the:
     1. The Pre-Billing Validation Report in addition to response files to ensure providers have the most up-to-date information regarding outstanding visit errors.
     2. The Appointment Status Report to ensure providers have accurate information regarding visit or claim status over time.
        • The supplemental report specifications can be found on the CareBridge EVV Data Integration web page: http://evvintegration.carebridgehealth.com, under Additional Documents for Third-Party Vendors.
   • Integrating agencies will not be able to make updates to their data in the CareBridge EVV portal. Updated data should be sent via integration process.

DATA FIELD SPECIFICATIONS

CareBridge Response File Format

In addition to these 5 fields, the CareBridge response file will also contain each field included in the inbound data file for Third-Party EVV Vendor reference.

File Level Validation

 
Appointments / Visits Data File Format