On May 1, 2023 the Wisconsin Department of Health Services (DHS) implemented the hard launch of the Electronic Visit Verification (EVV) system for hands-on cares for the following Service codes:
- T1019 and T1020 – Personal Care services; per 15 minutes and per diem
- S5125 and S5126 – Attendant Care services; per 15 minutes and per diem
Claims will be denied for dates of service on May 1, 2023 and thereafter, if EVV requirements are not followed. Below are a few resources, reminders, and supports to assist impacted providers.
Resources
- New to EVV Flyer: a great introduction to the required system, outlining steps to get started.
- What is EVV Flyer: a brief overview of the system and where to learn more.
- Wisconsin Electronic Visit Verification: a brief video focusing on the basics of EVV.
- EVV Fundamentals: a 30-minute training video about EVV and where to find resources.
- DHS EVV Training Page: a resource page on how to train workers and agency administrators.
- DHS EVV Website: a singular location to access these and all EVV related resources.
- EVV Provider Billing Facts: a resource from Wisconsin Physicians Service (WPS), Inclusa’s Third Party Administrator (TPA) (claims processor), providing guidance to support the claims and billing process.
Important Reminders
EVV Visit Key Needed: Workers are required to check in/out using an EVV system at the start and the end of each visit. Claims without an EVV Visit Key will be denied. The EVV Flyers above provide further details regarding the EVV Visit Key.
No Date Span Billing: Claims for the related services must be submitted separately for each date of service. Claims submitted using date span billing will be denied. The WPS EVV Provider Billing Facts link above provides further details and helpful tips regarding claims and billing.
Date Span Example: A member received services on 14 dates in the month of May. Date span billing is when a date span of 5/1/2023–5/31/2023 is submitted for total units (days) and total charges. Instead, submit each day separately with units and charges on 14 individual claim lines.
Supports
Wisconsin EVV Customer Care is available to provide support throughout the process. Customer Care is accessible by email at vdxc.contactevv@wisconsin.gov or phone at 833-931-2035 Monday–Friday, 7 a.m.–6 p.m. CT.
Inclusa Authorization and Claims Support Team is available to provide support with authorization and claims:
- Supportive Home Care/Personal Care – contact ACS-SHC-SDS-HomeHealth@inclusa.org or 1-888-544-9353, option 7.
- Community Supported Living – contact ACS-Residential-CSL-NH@inclusa.org or 888-544-9353, Option 6.
Inclusa Provider Relations Team is available to provide support with contracting questions. Please contact your local Program Manager, ProviderRelations@inclusa.org, or 877-622-6700, option 2, then option 3.