Anyone involved in home healthcare is aware of the fraudulent activity that plagues the industry. It seems as if there are always news headlines of someone in the healthcare industry committing Medicare/Medicaid fraud. Some cases are intentional, while others are the unfortunate result of relying on paper documents. In-home healthcare, fraudulent activity not only puts an agency’s future at risk, but it negatively impacts the patient that needs and deserves the care they are authorized to receive.
Some agencies look for it solely as a risk mitigation strategy to protect their agency from fraudulent claim allegations. Others look for operational cost savings by automating time and attendance tracking. A select few are interested in understanding how an EVV system can help improve the quality of care the agency provides. The real “ah-ha” moment comes when an agency understands that all these things are possible with the right EVV solution.
EVV as a Risk Mitigation Tool
This is perhaps the most obvious and expected benefit of an EVV system. If you’re associated with a paper-based agency, you receive a paper document, the client has signed off that it’s accurate, and you submit for billing. More and more agencies are reporting that auditors are challenging the accuracy of the times logged on paper, as well as the patient signature.
An electronic system is accurate to the minute. Times are generated from the point of care, and auditor concerns are eliminated. As a compliance tool, an EVV system can validate who, where, and when services are delivered. Instead of relying on paper that can easily be falsified, the integrity of the data can’t be compromised. Further, any quality EVV system maintains a detailed audit trail of who, what, and when any changes were made. Times are accurate, the agency can be assured that the caregiver was present, and there is never a concern of a lost or misplaced time-card.
Finally, in markets where EVV systems aren’t mandated, many agencies use EVV as a differentiating and value-added feature when selling to payers and referral sources.
EVV Creates Operational Efficiencies & ROI
When linked with an agency management scheduling system, the EVV system validates visits in real-time. Deviations from the proper schedule can be identified and addressed immediately, eliminating the wait on paper documents to arrive in the office before schedule adjustments can be made. For visits occurring as planned, validation and approval can be automated. The visit can be marked ready for billing and payroll within seconds of the call being received by the EVV system without manual intervention from internal agency staff.
In addition to the decrease in administrative expenses required to manage the time-card approval process, other ROI opportunities are generated from:
- Reduction of unknown missed visits
- Reduced mileage costs
- Decreased paper costs (helps save on printing, mailing, scanning, and storing)
- Preparation for an audit – the EVV system can produce a specific client or employee time-card; re-purposing staff to focus on revenue generating activities such as referral source outreach calls, working to fill open shifts, etc.
EVV Improves the Quality of Care the Agency Delivers
Perhaps the least expected benefit of an EVV system is how it can improve the quality of care being delivered.
- Missed visits – Allows the agency to communicate more effectively with the client, and often back-fill what might otherwise result in a missed shift.
- Task entry at the point of care – An electronic system can then compare the tasks entered against the plan of care to ensure the patient is receiving the right services.
- Adherence to Schedule – By logging the specific in and out times, you can ensure the patient is receiving the full value of their authorized hours.
- Client visit verification – Allows a client to “approve” or “deny” hours and/or services entered by the caregiver at the point of service.
In summary, there is a growing trend among home healthcare payers encouraging, and even requiring, EVV system use. Providers must realize that embracing EVV system capabilities can yield huge benefits in operational efficiencies, the quality of care delivered, and agency protection from fraud allegations.