Home Healthcare businesses face unique challenges like fraud claims, care coordination, and more. While they face complex scheduling and field management challenges, they also face razor-thin margins due to the nature of their business.
To overcome these challenges in home healthcare, electronic visit verification has been introduced in the healthcare industry. Electronic Visit Verification(EVV) has been a direct and positive contribution to an organization’s ability to provide quality care and improve their margins at the same time.
EVV has proven to be a valuable tool to individuals and healthcare organizations that are looking for faster, more efficient care delivery in their homes. It can replace paper visits, eliminate the need for in-home visitations, provide immediate communication with family members, improve the patient experience by reducing handling time, and improve the quality of care provided by clinical teams.
EVV helps to keep people safe from fraudulent care claims, provides employers with accurate information about employees’ home health care activities, and helps empower agencies of all sizes to safely deliver quality services and provide better customer service.
Most EVV software providers can bring more automation into these field operations, now they can not only address the complex logistical challenges of managing caregivers but also improve the organization’s margins and meet compliance requirements.
According to grand view research, the global home healthcare industry is expected to be worth $338.9 billion USD by 2022. This includes a forecasted CAGR of 7.94% over the next decade as demand for care at home continues to rise.
With the increase in demand for home healthcare, EVV is the need of the hour. Adopting new practices and technologies can be a challenge. And EVV is no exception. In this blog post, we discuss some of the questions and concerns that are typically raised during an EVV transition and help you create an action plan for a smooth process.
What is EVV?
Electronic Visit Verification (EVV) is a process that involves the use of advanced information technology to capture, compute, and verify visits submitted via electronic documentation systems. EVV allows for instant entry of medical information into the Electronic Medical Record (EMR), which can then be validated at various stages within the EMR.
It enables electronic verification of the patient history and it ensures accuracy. EVV also checks for its validity based on the information provided in the medical record and suggests updates to ensure accuracy.
EVV is important for any hospital as it can help in preventing medical malpractices such as fraud and mistakes from occurring. It also helps to deal with a large number of paper-based medical records which need to be digitized since they are prone to losses, thefts, and misplacements resulting in loss of data.
Thus, EVV is a type of healthcare fraud prevention developed to assist in the efficient administration of home care services. EVV has been available since 2012 when CMS established guidelines describing what is meant by an “electronic visit verification system”, defined as a technology that helps insurance claims personnel verify the services provided by a provider per the terms of a contract. It is designed to provide a secure and more convenient way for home care agencies across the US to collect and verify patient visits and care.
What challenges do field caregivers face?
While caregivers work for patient recovery and safety, their safety matters too. In the field, caregivers can feel unprepared or overwhelmed when faced with a situation that requires them to be both professional and assertive. From unsafe places to uncooperative patients, the healthcare industry has its share of dangers, but there are ways to reduce the risks. Here are some of the challenges that caregivers face:
- Time management
The manual process of assigning patients to caregivers raises much more challenges for field workers and time management is one of them. Either they are assigned multiple visits or long travels, in either case, at the end of the day, the caregiver will be exhausted and may not be able to provide the best customer care.
As per the statistics, home-health providers drive more than 5 billion miles every year.
Eventually, this might lead to absence from work or less productivity, which can be a risk for patients. The most effective way to handle this challenge is software that will help in better time management and scheduling patient visits.
- Patient Visit Coordination
Coordination of care delivery schedules is an essential element to ensure that HHAs meet their contractual obligations. This is to coordinate the care delivery schedule around patient and caregiver availability.
When there is no centralized system to coordinate with field workers, communication becomes difficult and scheduling visits can be daunting. Thus, it might happen: that two caregivers show up at the same time or there is confusion about who is assigned where.
- Mental and physical exhaustion
There are many challenges faced by field caregivers. Not only do they have to deal with frequent relocation but also have to spend a lot of time without family support. It leads to mental and physical exhaustion which might put the patient’s life as well as the caregiver’s life at risk.
According to research, 28% of people take a break after four or more consecutive hours of work. 26%, on the other hand, never take any breaks during their workday.
In this competitive field, any small mistake can have an undesirable impact on their future. It is necessary to keep track of their heavy workload by maintaining the right balance between work and family time.
What do field operations in home healthcare look like?
A typical homecare business has several caregivers they have to manage. An operations manager usually has the task of assigning jobs and schedules to them daily.
The scheduling process is usually manual and when you have more staff, it becomes a complex problem. The outcome is an inefficient process that results in longer routes, higher costs, and reduced client care standards.
Caregivers need to be informed of their assignments for the day. Then they go about their homecare visits making sure that they note their mileage drive, and time spent with clients, taking notes after examining the client, and then filing their reports and timesheets for payroll.
As you can imagine, it is a cumbersome process for caregivers to keep track of all this on top of doing their jobs. When they file their time sheets and mileage, studies have shown that there are many inaccuracies in these reports leading to higher-than-expected costs.
Managers have to collate the information collected by caregivers from each client and store it appropriately for audits and compliance purposes. They will also have to use this information to decide when the next visit should occur.
As caregivers make their visits, their safety at remote job sites is an issue that merits attention. A lone worker safety workflow that puts in place protocols to communicate with caregivers and mechanisms for them to get help if needed will indeed be reassuring.
From a compliance standpoint, EVV or Electronic Visit Verification is an important state compliance requirement that homecare businesses have to meet today. The 21st Century CURES Act, signed into law in 2016, requires that States set up an EVV system to verify that services for all Medicaid-funded personal care and home healthcare services occurred.
EVV is a method used to verify home healthcare visits to ensure clients are not neglected and to cut down on fraudulently documented home visits. State governments decide how to gather and report data that EVV vendors use, and whether to include additional EVV compliance rules. If managers are creating these compliance reports manually, it can be very time-consuming and error-prone.
As you can see, the issues facing homecare businesses are multifaceted. How should homecare businesses overcome these challenges? The simple answer is adopting automation. But what does that mean? Let’s examine how an EVV solution can address many of the challenges that homecare businesses face.
Why do providers need automation in EVV?
Healthcare is an industry that is rapidly evolving in terms of technologies and innovations. As a home healthcare business owner, you may be wondering how your business can reap the benefits of this growth by leveraging new technology to enhance the way you do business with your clients.
One of the most commonly overlooked tasks in home healthcare businesses is providing quality care to their clients, which is often left to the discretion of individual caregivers and unmonitored.
An automated EVV System can help in the digital verification of the visits as outlined in the care plan, automating the time and attendance of caregivers and providing a paperless, digital means to record the type of care and services provided to the client.
Furthermore, automation in the EVV system can help in scheduling visits as per the caregiver’s schedule and location, which will overcome the field operation challenges. With the safety of patients, this EVV software ensures the safety of caregivers as well through dynamic workflows.
Who can use an EVV solution?
All personal care services or home health visits that are reimbursed by Medicaid or Medicare are subject to the evidence of value requirement. So if this is true for your business, you need to make sure that you’re taking advantage of EVV requirements. It’s best to check with your state’s Medicaid website, as they’ll list all the programs requiring EVV.
How does EVV work?
EVV stands for electronic visit verification. Quoting from the mandate: The term “electronic visit verification system” means, concerning personal care services or home health care services, a system under which visits conducted as part of such services are electronically verified concerning:
(i) the type of service performed;
(ii) the individual receiving the service;
(iii) the date of the service;
(iv) the location of service delivery;
(v) the individual providing the service; and
(vi) the time the service begins and ends.
So, a modern EVV System just acts as a time and attendance verification tool for the in-home caregivers/workers by enabling them to “clock in” and “clock out” to record the time and the location at which the care services were rendered.
Electronic Visit Verification (EVV) helps home care agencies keep track of people’s medical visits and check in and manage incidents so they can be thoroughly and accurately reported in real-time.
It allows you to prove any number of aspects of the patient’s visit with call data records (CDRs) and other data sources, including the telephone number, date, time of day, duration of a call, and even the name of the physician involved in their visit.
You can then forward these collected EVV data files directly to your payers so they can accurately reimburse your providers for visits that were completed by either phone or office staff. This saves you time and money from paying incorrect claims from incomplete documentation due to technical discrepancies between provider and payer systems.
What are the benefits of using allGeo EVV?
Electronic Visit Verification Systems offers a reliable, dependable, and error-free means for care providers and home care workers to capture care delivery data in real time. An EVV System brings in loads of benefits such as digital verification of the visits as outlined in the care plan, automating time and attendance of caregivers, and providing a paperless, digital means to record the type of care and services provided to the client.
Since the data is recorded digitally, the program administrators not only can verify and validate the visit and the type of care but also will be able to pull up various reports and analytics to drive efficiency in the process.
Time and Attendance:
Caregivers can either clock in and out from the place of care or the system will automatically verify the visit to the location via geofencing technology.
The caregiver can easily capture additional information via the digital forms on the mobile app. The mobile forms can be customized to suit your needs and business workflow.
Concerning verification and safety monitoring, there are some basic capabilities that businesses need to be able to monitor to ensure that employees are safe:
- A communication channel between the field or home and headquarters
- Ability to share location information with headquarters
- Tracking mileage and other costs if an employee needs to travel to the job site
- Generating reports for documentation and audit
- Setting up a safety monitoring workflow
- Have a real-time broadcast/alerts channel for one-to-one or one-to-many communications
Here are some specific ways that safety monitoring can be addressed:
- An employee in distress can push the SOS button on an app or simply hit the phone’s ‘power’ button to trigger an SOS alarm.
- Set up periodic safety monitoring workflows to detect any threats. Support for multi-level validation and escalation which should include local emergency response details (e.g. PSAP information).
- A visual command-&-control dashboard is available via the web or a mobile app that enables headquarters to monitor & communicate with employees in the field.
Our recommendation for homecare businesses is that they first put in place an EVV workflow that will streamline their business operations and ensure that they address several issues all at once. It will also improve their customer service standards while reducing costs and growing their margins. They will ultimately be running a better business.
allGeo also offers customized reporting for time and hours (for payroll), mileage, costing needs, etc.
With such a system, you can define your business workflow and automate field operations using real-world triggers involving people, place, and time. The real-world events that trigger automatic actions can be highly customized.
For example, the use of IFTTT (if-this-then-that) customization helps add logic to the workflow based on conditions, triggers, and threats that can occur in the field.
How to implement EVV for Care Providers?
If you’re wondering how to implement an EVV system for care providers, there are many aspects of EVV that you need to consider. There is no “one-size-fits-all” model for the implementation of this system.
Each state has a different version of the EVV system, so you will have to take note of their unique requirements. For example, some states allow home visits while others do not. In addition, some states only allow paper-based data collection while others allow either one or both.
- State vendor’s model
In most cases, implementation is relatively straightforward when your state uses the state-mandated vendor model or MCO choice model. The same is not true if your agency/organization uses another type of contract or if you don’t know what your state will use. Some of the questions that might arise are:
- Either use a state system or an independent EVV solution
- Choosing the existing system or requesting a new customized system
- Select the EVV software provider to use
- Choosing a Data Collection Method
Data collection methods for your state-specific campaign can be as simple as you make them: pen and paper, a mobile app, IVR systems, or even something as simple as a desktop checkbox on the side of the road. There are many different data collection methods available to you depending on the laws in your state.
- EVV training for your organization
Giving patients and family members the right information is important. That’s why training is so crucial. Training caregiver groups should be given basic EVV requirements, regulations, benefits, guidelines on what they should be doing, privacy and security concerns, their roles in the system, and instructions for how to use it.
If you are using state EVV, then states are responsible for providing this kind of training, else when you pick a vendor like allGeo, they will be taking care of all the training, rules, and regulations.
- Technical and organizational issues
Whether it’s a lack of Wi-Fi, a malfunctioning device, or user error, patient information is not being recorded correctly. These systems often break down at inopportune moments and result in employees being unsure whether they have been paid for the time they were scheduled to work.
Caregivers start asking themselves questions like: “Did I clock out? Did they pay me?” and other similar concerns that can cause stress, fear, lack of productivity, and negative impacts on the bottom line.
There are often technical and organizational problems related to software and hardware. These can prevent caregivers from doing their job well. It is important to provide tech support that is convenient and easy to access. You should ensure that people can use multiple channels such as phone calls, chats, or email for tech support.
- Privacy and security requirements
The Electronic Visit Verification (EVV) system puts a unique spin on the way care is delivered. Programs using EVV are innovative and responsive to changing needs. HIPAA compliance requires that caregivers enter their patients’ personal information including their social security numbers, which raises privacy concerns.
Healthcare records are the most sensitive information within a hospital’s network and can make or break patients’ lives. Some EVV systems are completely isolated from the cloud. In practice, this provides a high level of privacy and security for both the patient and their caregivers.
There is no doubt that Electronic Visit Verification (EVV) systems have revolutionized the home healthcare industry. With EVV, agencies can now verify that services were provided, and caregivers can track their visits to ensure they are getting paid for all the work they do.
While there are still some things to be worked out with EVV systems, overall they have been shown to improve the quality of home health care while also reducing costs. If you are a home health care provider or agency, implementing an EVV system is something you should consider for the betterment of your business.