Electronic Visit Verification

Electronic visit verification (EVV) is a computer-based system that electronically documents and verifies service delivery information for certain Medicaid service visits. EVV helps prevent fraud, waste and abuse, while making sure Medicaid recipients receive care that is authorized for them.

Parkland Community Health Plan complies with all of HHSC’s EVV policies and procedures.

Why is EVV required?

The 21st Century Cures Act (Section 12006), or Cures Act, is a federal law passed in 2016 requiring states to implement EVV for Medicaid personal care services (PCS) and home health care services (HHCS) that require an in-home visit. States that do not implement EVV will receive reduced federal Medicaid funding.

Programs and Services Required to Use EVV

Programs and services required to use EVV are defined in HHSC Texas Administrative Code Section 354.4005, Applicability.

A summary of the personal care services required to use EVV is available on the HHSC EVV webpage.

EVV Policies & Procedures

This section provides EVV policies and procedures specific to Parkland Community Health Plan and HHSC.

HHSC EVV Provider Policy Handbook
EVV Compliance
- Refer to the EVV Policy Handbook section, 11000 EVV Compliance Reviews, for more information.
EVV Quarterly Provider Compliance Review
PCHP Claims and Billing
PCHP Complaints and Appeals
PCHP Provider Portal Login
PCHP Provider Manual

EVV Training & Education

The HHSC EVV Training Policy requires program providers, FMSAs, service providers, CDS employers, and any staff who perform EVV system operations to complete required EVV training before using an EVV vendor system or an EVV proprietary system, and yearly thereafter.

EVV Visit Maintenance Unlock Request

An EVV Visit Maintenance Unlock Request allows a program provider, FMSA, or CDS employer the opportunity to correct data element(s) on an EVV visit transaction(s) after the visit maintenance time frame has expired.

Program providers, FMSAs, and CDS employers must follow the instructions on the EVV Visit Maintenance Unlock Request spreadsheets. Request emails must include a contact name, email address, and phone number. Requests that are not sent securely could result in a Health Insurance Portability and Accountability Act (HIPAA) violation, and the payer will deny the request.

PCHP follows the HHSC EVV Maintenance Unlock Request process: