EVV Policy & Procedure

Reviewed:  6/24/2020

Title: Electronic Visit Verification (EVV)
Reference in Administrative Code:
Other Reference(s): PA 097-0689, Sec 5-5f, subpart (g)
Effective Date: January 1, 2014

Overview

Pursuant to the Save Medicaid Access and Resources Together or SMART Act (Public Act 97-0689, Sec 5-5f (g)), DHS-DRS has implemented an electronic visit verification system for Home Services Program (HSP) providers with the purpose of verifying that a Customer receives the services authorized on his or her service plan for which the State of Illinois is billed.

Policy

Effective January 1, 2014, all HSP Individual Providers and Homemaker Service Agency Providers must use an EVV system to electronically track and document time spent in a customer's home when providing HSP services.

  • Homemaker Service Providers are required to utilize an EVV system that meets the Department on Aging's requirements at 89 Ill.Admin. Code 240.1531-Electronic Visit Verification (EVV) Requirements for In-Home Service Providers. Homemaker Service Providers in the employ of a homemaker agency shall use that agency's EVV system when providing services to an HSP Customer.
  • Individual Providers (IPs) are required to utilize Santrax, the Department's EVV system, when providing services to a Customer.
  • Customers are required to comply with program requirements and to ensure all IPs providing services to him or her comply with program requirements as well.

Procedure

  • Homemaker Service Providers should follow the timekeeping instructions for the EVV system provided by the homemaker agency they are employed with; however, in and out times are required each time services are provided by the Homemaker employee to an HSP customer.
  • IPs will receive information in the Individual Provider Packet regarding the use of the Santrax EVV timekeeping system. HSP will provide the Santrax ID once an IP is approved to work. Additional EVV information and training materials can be found at: DHS EVV Website.
  • Customers and IPs should follow the instructions listed below as appropriate:
    • Call In and Out - An IP should call the EVV system from the Customer's registered telephone at the beginning and end of each visit. The EVV Call Reference Guides provide instructions and Call-in numbers as follows:
    • Enter Santrax ID - An IP should enter his or her Santrax ID on every call. He or she should be sure to enter the number accurately and quickly, with no more than a two-second pause between numbers. If an IP does not know his or her Santrax ID, call the EVV Help Line at 1-888-713-5139 (1-888-575-0531 TTY).
    • Enter Task ID - When an IP calls out at the end of his or her work time, he or she will be asked to "enter task ID." Task IDs are: 13 for Personal Assistants, 11 for CNAs, 12 for LPN, and 14 for RN.
    • Write Down the Exact Time - The phone system will say the exact time of the call. The IP should clearly write this time on the paper Home Services Program Time Sheet (IL 488-2251) and include "AM" or "PM".
    • Sign and Discuss the Time Sheet - At the end of each pay period, both the Customer and the IP should sign the Home Services Program Time Sheet. The Customer should review the time sheet at the end of each Pay Period to ensure it is complete, accurate, and in accordance with the Customer's Service Plan. The Customer should discuss any discrepancies with the IP and work cooperatively with the IP to correct the time sheet. Once the Customer verifies the accuracy and completeness of the time sheet, he or she will approve, sign, and date it prior to submission to the DRS local office.
    • Submit the Time Sheet- The signed Home Services Program Time Sheet should be submitted to the local DRS Office within five (5) state workdays after the end of the pay period, or within the dates on the HSP Payroll Calendar, whichever is later. A current Payroll Calendar is available through the DRS local offices.

EVV Non-Compliance

Non-compliance occurs if one or more of the following applies when a time sheet is submitted for each pay-period:

  • NO EVV visits in the Santrax system
    • For example- IP is NOT using EVV at all to call in and out
  • MORE THAN 5 visits from the time sheet are missing in the Santrax system
    • For example- IP did not call in more than 5 time
  • MORE THAN 5 visits on the time sheet DO NOT match call times in the Santrax system
    • For example- IP entered different times on the time sheet compared to visits in the Santrax system
  • MORE THAN 5 visits in the Santrax system are from a Non-Registered EVV telephone number.
    • For example- IP is making calls from an unregistered EVV telephone number
  • MORE THAN 5 visits in the Santrax system must be ADDED/EDITED by HSP due to an error made by the IP
    • For example- IP entered incorrect Santrax ID resulting in visits with missing Employee name/Unknown Employee

If non-compliance is determined, the following steps may occur:

  • 1st Non-Compliance within a 6 Month Period, HSP may:
    • verbally remind the Customer that it is his or her responsibility to manage the IP's time.
    • verbally remind the Customer that it is mandatory for IPs to use the EVV timekeeping system and to report exact hours worked. Failure to comply with EVV may result in delayed paychecks and a change in the level of care.
    • review applicable EVV requirements with the Customer.
    • document in a Case Note in WebCM

    Managed Care Cases: HSP staff will send an email notification to the MCO's universal email and will specify that this is the first non-compliance and how it was communicated to the customer. This will also be documented in a Case Note in WebCM.

  • 2nd Non-Compliance within a 6 Month Period, HSP may:
    • verbally and in writing inform the Customer that, if IP continues NOT to comply with EVV, they will be removed from their plan and replaced with agency provider(s).
    • document in a Case Note in WebCM and maintain a copy of the letter in the customer's case file

    Managed Care Cases: HSP staff will send an email notification to the MCO's universal email and will specify that this is the second non-compliance and provide the MCO with a copy of the letter sent to the customer. This will also be documented in a Case Note in WebCM.

  • 3rd Non-Compliance within a 6 Month Period, HSP may:
    • HSP counselor will notify the customer that the Service Plan will be amended by replacing an IP(s) with agency provider(s).

    Managed Care Cases: HSP staff will send an email notification to the MCO's universal email and will specify that this is the third non-compliance and provide the MCO with a copy of the letter sent to the customer; HSP staff will cc DHS.HSPmanagedcare@illinois.gov. This will also be documented in a Case Note in WebCM.