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Wisconsin - EVV Aggregation

Wisconsin - EVV Aggregation

Owned by Kristen Ziegler
Sep 29, 2023
5 min read

Electronic Visit Verification (EVV) tracks and monitors timely service delivery and access to care for members. EVV applies to all providers of these services, including paid family direct care workers. EVV is a federal requirement and is a mandatory program.

In Wisconsin workers are required to use an EVV system when providing personal care and supportive home care service (service codes T1019, T1020, S5125, S5126). These services are provided in the following programs:

  • Medicaid and BadgerCare Plus fee-for-service (ForwardHealth card)

  • BadgerCare Plus and Medicaid SSI HMOs

  • Family Care and Family Care Partnership

  • IRIS (Include, Respect, I Self-Direct)

EVV systems are secure and compliant with the Health Insurance Portability and Accountability Act (HIPAA).

Important Websites

Provider Best Practices

  • Identify team member(s) responsible for EVV visit maintenance

  • Log in to your aggregator portal daily

  • View EVV visits and aggregation status in the aggregator portal

  • Triage EVV errors with your state and/or aggregator as a first point of contact

  • Review DCI EVV Aggregation reports that are emailed to you daily

  • Perform visit maintenance in DCI to correct visit errors

  • Review all six required aggregation requirements

  •  

    • Type of service performed

    • Individual receiving the service

    • Date of the service

    • Location of the service

    • Individual providing the service

    • Time the service begins and ends

  • Review Social Security ID is required and the toggle button is selected Yes for “Allow SSN Retrieval” on the employee profile

  • If the error in DCI can not be resolved independently, submit a help desk ticket (Zendesk) for DCI

If you have not already started, please begin these activities. Please be advised the aggregator portal is the source of truth for whether a visit is accepted or rejected.

Common EVV Aggregation Failure Results

Failure Reason

Sandata Field

DCI Field

Reasons why aggregation is failing

Steps to Update/Correct

Failure Reason

Sandata Field

DCI Field

Reasons why aggregation is failing

Steps to Update/Correct

Employee SSN Failed

EmployeeIdentifier

Employee Profile:

SSN & Verify SSN > needs to be entered

Allow SSN Retrieval > Select Yes

 

  • Short version (4 digits) of SSN is being aggregated - full SSN required

  • Employee SSN is not entered into DCI

  1. Log in to DCI

  2. Click Home on the main menu

  3. Click Employees on the sub menu

  4. Use the filter to search for the employee, select the employee by clicking anywhere on the line in the table

  5. Click the Actions button

  6. Click Edit Employee in the Actions dropdown

  7. The Edit Employee form wizard will open

  8. On the Basic Demographics tab verify/update the following fields

  9.  

    1. SSN and Verify SSN - enter SSN for employee

    2. Allow SSN Retrieval - select Yes

  10. Click Save

  11. Click Yes in the confirmation alert window

Procedure Code Failed

ProcedureCode

Service Code:

Default HCPCS Code 

 

  • Missing default HCPCS code

  • Default HCPCS code incorrect

  1. Log in to DCI

  2. Click Settings on the main menu

  3. Click Funding on the sub menu

  4. Use the filter to search for the funding source, select it by clicking anywhere on the line in the table

  5. Scroll down and select the Service Code tab

  6. Select the Service Code with the error from the table

  7. Click the Actions button

  8. Click Edit Service Code in the Actions dropdown

  9. The Edit Service Code form wizard will open

  10. Update the Default HCPCS Code field

  11. Click Save

  12. Click Yes in the confirmation alert window

Client Address Value or Format Failed

ClientAddressLine1

Client Profile:

Address

 

  • Client address value incorrect (length should be between 1-30)

  • Client address format incorrect (can not contain special characters)

  1. Log in to DCI

  2. Click Home on the main menu

  3. Click Clients on the sub menu

  4. Use the filter to search for the client, select the client by clicking anywhere on the line in the table

  5. Click the Actions button

  6. Click Edit Client in the Actions dropdown

  7. The Edit Client form wizard will open

  8. On the Basic Demographics tab verify/update the following fields

  9.  

    1. Address

  10. Click Save

  11. Click Yes in the confirmation alert window

Reason Code Missing (can't be null)

ChangeReasonMemo

Funding Source:

Require Reason Code for Manual Entries > Select Yes

  • Reason code required for manual entries setting on the funding source needs to be turned on

Require Reason Codes for Manual Entries

  1. Log in to DCI

  2. Click Settings on the main menu

  3. Click Funding Source on the sub menu

  4. Use the filter to search for the funding source, select it by clicking anywhere on the line in the table

  5. Click the Actions button

  6. Click Edit Funding Source in the Actions dropdown

  7. The Edit Funding Source form wizard will open

  8. Update the Require Reason Code for Manual Entries field to Yes

  9. Click Save

  10. Click Yes in the confirmation alert window

Reason Code Memo Needed (can't be null)

ChangeReasonMemo

Reason Code:

Requires Free Text Note > Select Yes

  • Free text note needs to be entered and required for specific reason codes

Add Reason Code and Require Free Text Note

  1. Log in to DCI

  2. Click Settings on the main menu

  3. Click Funding Source on the sub menu

  4. Use the filter to search for the funding source, select it by clicking anywhere on the line in the table

  5. Click the Actions button

  6. Click Add Reason Code in the Actions dropdown

  7. Fill out the Reason Code form wizard

  8.  

    1. Select Yes for the field Requires Free Text Note

  9. Click Save

  10. Click Yes in the confirmation alert window

Edit Reason Code and Require Free Text Note

  1. Log in to DCI

  2. Click Settings on the main menu

  3. Click Funding Source on the sub menu

  4. Use the filter to search for the funding source, select it by clicking anywhere on the line in the table

  5. Scroll down and select the Reason Codes tab

  6. Select the Reason Code from the table 

  7. Click the Actions button

  8. Click Edit Reason Code in the Actions dropdown

  9. The Edit Reason Code form wizard will open

  10. Update the Requires Free Text Note field to Yes

  11. Click Save

  12. Click Yes in the confirmation alert window

Live In Caregiver

N/A

Employee Service Account:

Relationship Type > Select Live In Caregiver from the dropdown

  • The relationship type live in caregiver is not selected

  1. Log in to DCI

  2. Click Home on the main menu

  3. Click Employees on the sub menu

  4. Use the filter to search for the employee, select the employee by clicking anywhere on the line in the table

  5. Scroll down and select the Accounts tab

  6. Select the Account from the table 

  7. Click the Actions button

  8. Click Edit Service Account in the Actions dropdown

  9. The Edit Service Account form wizard will open

  10. Verify/update the Relationship Type field to Live In Caregiver by selecting it from the dropdown

  11. Click Save

  12. Click Yes in the confirmation alert window