In this article, we want to clarify some confusion between two similar terms, EVV and eClaims. First, each of these is an abbreviation of the terminology used in the Personal Care industry. EVV is the abbreviation for Electronic Visit Verification, while eClaims stands for Electronic Claims. With the new mandates that have come out due to the 21st Century Cures Act regarding EVV and eClaims, it’s easy to get the two terms confused.
EVV
Let’s start by providing you with some information on EVV. EVV is an electronic system that verifies a client’s shift. Appropriate care is completed as authorized by a specific caregiver at a particular time and location. A third-party auditor accumulates, checks, and stores this ended shift information in many states. These are also known as “aggregators.” (Of note: each state chooses its aggregator.) The Federal (United States) government mandates EVV to verify that a client received legitimate care during the visit. They demonstrate the visit electronically through GPS on the caregiver’s smartphone or a hard line on Telephony, using the client’s landline. EVV is also specific to Medicaid.
eClaims
eClaims deals with the monetary aspect of providing care. eClaims involve filing electronic claims to the Payer to be paid/reimbursed for providing care. Some states now require that you use eClaims (837i and 837p) to be paid. Other states will allow your agency to continue filing paper claims (UB-04 and CMS-1500). Another thing to note is that some aggregators are also clearinghouses. A clearinghouse collects the transactions and claims and then forwards them to the correct Payer.
If you are interested in finding out more about EVV or eClaims, and whether your organization needs to make appropriate changes in your EVV or eClaims processes, please reach out to us for a free consultation. Our team looks forward to working with your office, and changing the way you care! Thank you again for reading today’s article.
