CareBridge coordinates with Third-Party Electronic Visit Verification (EVV) Vendors to ensure the necessary data integration between systems and MCOs. This allows provider agencies to keep their current EVV solution while still sending the required data back to the health plan or state.
On or before your state's mandated EVV compliance date you will be required to begin sending your EVV visit data for aggregation and to submit compliant and completed visits for claims processing. We have included a checklist below of items for you to complete to ensure a successful implementation.
The diagram below illustrates the basic flow of data starting with your EVV Vendor through payment by the MCO.
Once your vendor has successfully submitted at least one claim via CareBridge, this checklist will apply.
1. Develop/Confirm the process to address pre-billing validations with your Vendor. Claims will not be generated until all the errors for a visit are resolved.
These errors will be resolved in your EVV system, not in the CareBridge provider portal.
- CareBridge returns validations to Third-party EVV vendors in 2 ways:
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- A response file is generated for each data file received and sent to your EVV vendor.
- Appointment Error Report, which is sent to your EVV vendor daily.
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- This information is important because it is how CareBridge is communicating pre-billing validation errors that need correction to you and your EVV vendor.
- Some errors will need to be addressed by your EVV vendor.
– This would include errors such as incorrect formatting of DateTimes, this is a field outlined for your EVV Vendor in the CareBridge Technical Specifications. - Other errors may require you to take action to resolve them in your EVV system.
– This would include errors such as an overlapping visit, which would require a manual visit edit. - Other errors would be resolved by contacting your MCO's local Utilization Management Team.
– This would include an appointment that exceeds the authorization max units. - All pre-billing validation errors must be resolved before a claim can be generated.
It is important that you discuss with your vendor how your agency will receive pre-billing validation error details, and how you should resubmit the visit once you have resolved the error.
2. Identify the date you will start to send visits for claims processing.
On or before your state's mandated EVV compliance date, you will need to connect with your vendor to determine a date to begin submitting claims. This means that you are no longer sending claims via your current process.
- As part of the integration process with CareBridge, EVV vendors will submit an initial visit (with the intent to claim) to the CareBridge production environment. This is to validate that the process is set up correctly.
- Your EVV vendor should be communicating with you throughout this process. If there are pre-billing validations to resolve, you may be required to take action in your EVV system.
- Once the initial visit has been successfully submitted to CareBridge and fully adjudicated, your agency should begin to submit all EVV visits to CareBridge for claims processing.
Claims may be denied after your state’s mandated EVV compliance date if not sent via CareBridge.
If you have any questions related to the data Integration process, feel free to reach out to us at
evvintegrationsupport@carebridgehealth.com or 1 (844) 920-0989.