States: EVV Services and CMS Compliance

Sandata State Solutions: Make Your Medicaid Program More Efficient, Accountable, and Compliant

Far too much of your team’s time is spent on tedious manual processes and monitoring program integrity. Validating provider claims against EVV data before payment is another headache – as is assigning the right providers to care for your members. Sandata’s State Payer solutions do away with these frustrations – which is why more states trust Sandata over other providers to ensure transparency and make better decisions. Our end-to-end solutions automate the flow of data from order to billing, facilitate timely delivery of care, and ensure you only pay for care that is actually delivered.

Time-Saving. Transparent. Transformative.

Increased Efficiency

We eliminate the need for manual processes, decrease the time to first provider visits, and allow real-time communication between all stakeholders.

Greater Visibility

We aggregate program data into a single environment, improving oversight, compliance, and reporting. Our robust data and analytics give you the visibility you need to improve oversight and accountability. At the same time, you can make better-informed financial decisions and improve patient care.

Easier Compliance

We support end-to-end Electronic Visit Verification (EVV), including data aggregation and claims validation, enabling compliance with the 21st Century Cures Act. We understand what project success requires – and guarantee a successful implementation and CMS certification.

An Open-Model, Flexible, and Compliant Solution

Sandata invented EVV over 40 years ago, and we’ve had more successful implementations than anyone in the industry. We chose to be an open model solution, giving our customers the advantages of interoperability with third parties, seamless integrations with other systems, the flexibility to customize and extend systems based on needs, and the scalability to adapt to changes in technology and organizational requirements over time. The result is a fully compliant EVV program that allows you to better serve your neediest populations with efficiency and accountability.

Visit Capture EVV

Our EVV solutions easily capture all Cures Act compliance data elements and support collecting tasks, member verification, group visits, multiple languages, and service location input.

  • Offers multiple EVV technologies to ensure real-time home and community-based visit data and verification is always available and captured at the point of care

EVV Portals

  • Allow states to view and make corrections to visits while requiring all visits to meet program rules and include a full audit history

Aggregator Portal

  • Minimizes friction by allowing providers to use EVV and billing systems of their choice while ensuring all program data meets the payer’s rules

Supporting Services

Claims Validation

The most important requirement for Claims Validation, meaning confirming there is EVV data for a paid claim, is to determine the specific “‘rules”’ to match EVV visit and claims data. Sandata has successfully led 58 payers in seven sStates through this claims validation process and knows from experience the questions to ask and potential problem areas to avoid.

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Fraud, Waste & Abuse Analytics

It’s crucial for homecare providers to be vigilant, implement robust compliance programs, and collaborate with regulatory bodies to ensure the integrity of homecare services and prevent Fraud, Waste & Abuse (FWA). Sandata FWA Business Intelligence-powered analytics and dashboards are tailored for state stakeholders working in FWA prevention and program integrity activities, helping to transform raw data into actionable insights.

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Business Intelligence & Analytics

Elevate your decision-making at every level with FuseTM BI. Our dashboards offer strategic insights for executives, as well as tactical guidance for decision makers at every level. This ensures a seamless blend of strategic vision and operational efficiency.

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Order Manager

A seamless, easy-to-use application that minimizes manual burden, inefficient processes, compliance risks, and data issues. Order Manager expedites the distribution of member cases to improve homecare service delivery for your members. Accessed via a web-based, HIPAA-compliant portal, the automated process enables real-time, secure communication with your provider network.

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Why State Payers Choose Sandata

“Implementing the Sandata platform was a significantly lower technical lift and much less costly than building this capability ourselves. And their open model reduced our provider abrasion.”

Related Resources


EVV™ Beyond Compliance

The Electronic Visit Verification (EVV™) mandate has taken effect in most parts of the United States – did you know that EVV can be part of a larger strategy to operate your agency more efficiently? Sandata can get you on the right track to understand why compliance matters, but also, how using EVV to your advantage can help your agency in the long term.


How to Ensure EVV Compliance: Using Technology to Comply with the 21st Century Cures Act

It is no secret that Electronic Visit Verification (EVV) software offers home care and I/DD agencies a powerful tool to manage patient care. It’s also known—and all too often learned the hard way—that the benefits of EVV don’t get fully or even adequately realized if field staff have trouble using it.


Prepare Your Agency for Increased Profitability with Value-Based Care and EVV™

Learn how to position your home care agency to enter into the value-based care models more effectively and set your agency up for more profitability, increased efficiency, and exceptional care.

Contact Us

Let’s get the conversation started about how we can help you ensure higher quality, more efficient, and compliant homecare services for your members.

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