Electronic Visit Verification (EVV)

Electronic Visit Verification (EVV) is a computer-based system that electronically documents and verifies service delivery information, such as date, time, service type and location, for certain Medicaid service visits.  Texas Health and Human Services Commission (HHSC) determines when a program provider, Financial Management Services Agencies (FMSA) or Consumer Directed Services (CDS) employer must use EVV based on the services delivered. EVV is required for all programs and services listed in the Programs and Services Required to Use EVV .

Electronic Visit Verification (EVV) Provider Webinar Sessions

Blue Cross and Blue Shield of Texas (BCBSTX) Medicaid hosts 30-minute webinar sessions to learn more about Electronic Visits Verifications (EVV) system and process. Registration is required for webinar,  refer to our Provider Training Webinar page.

Important Contact Information

Blue Cross and Blue Shield of Texas (BCBSTX) Contact Information:

  • For EVV questions, call Provider Customer Service at 1-877-784-6802 or email the EVV Mailbox at BCBSTX_EVV_Questions@bcbstx.com
  • For Service Coordination needs, call 1-877-301-4394 (TTY 7-1-1)
  • Information on how to submit a Complaint or Appeal

For EVV Visit Maintenance Unlock Request (VMUR) :

Health and Human Services EVV Contact Information:

TMHP EVV Contact Information:

Vendor Contact Information:

Website: Texas EVV Vendor Information Center

EVV System Information: HHAeXchange EVV

Customer Support:

Other Information:

 

EVV Compliance Oversight Reviews Section

EVV Compliance Oversight Review is currently under revision. Review Section 10000 EVV Compliance Reviews from the EVV Policy Handbook for more information.

State Fiscal Year (SFY) 2024

Usage Score Compliance - State Fiscal Year 2024

EEVVVV Compliance Oversight Usage Reviews

Quarter 1 (Q1)

Quarter 2 (Q2)

Quarter 3 (Q3)

Quarter 4 (Q4)

EVV Compliance Oversight Usage Reviews Qtr 1      

EVV Usage score of 80% or above

1

 

 

 

EVV Usage score of 100%

20

 

 

 

EVV Usage score of 80% below

10

 

 

 

 

Most Common Reasons for Denial

State Fiscal Year 2024 - EVV Relevant Claims

State Fiscal Year 2024

Most Common Reasons

Quarter 1

  •  Duplicate Claims
  • EVV03 - Dates of Service Mismatch
  • EVV06 - Units Mismatch
  • EVV02 - Medicaid ID Mismatch
  • EVV05 - Service Mismatch

 

Quarter 2

  • Duplicate claims
  • Not a Covered Benefit/Service
  • Submit to Primary Insurance
  • EVV03 - Dates of Service Mismatch
  • EVV02 - Medicaid ID Mismatch

 

Most Common Reasons for Recoupment

Each quarter, this section is updated with the top reasons of recoupment for EVV-relevant claims.

BCBSTX has not had any recoupments of EVV - relevant claims in State Fiscal Year 2024.

Span Billing Guidelines

BCBSTX allows for EVV claims to be submitted with a span date. If a provider chooses to submit a claim with a span date, the provider must ensure that:

  • Each date within the span has one or more matching EVV visit transactions.
  • The total units on the EVV claim must match the combined total units of the matched EVV visit transactions.