GEORGIA: Starting November 1 All EVV-Related Claims Must Include EVV Visit Information

​HCAOA members in Georgia - if you are a provider of Personal Support Services (PSS) or Community Living Supports (CLS) through SOURCE, CCSP, NOW, COMP, ICWP, and / or GAPP, at this point in time, you should have Registered for the State EVV solution and successfully submitted at least one claim per EVV-applicable Medicaid ID.

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Ideally, your agency and aides/caregivers have all completed training and are regularly using your chosen, compliant EVV solution and submitting claims through the State EVV solution, Netsmart Caregiver+.
 
As a new update, the mandatory claims edit for EVV-required services will be extended to November 1, 2021 for all EVV-applicable providers and fiscal intermediaries.
 
DCH acknowledges provider feedback requesting additional time to address the following items:

1. Missing Prior Authorizations
2. Updated Rounding Rules
3. New Rate Adjustments

 
The Georgia Department of Community Health expects missing prior authorizations and rounding rules to be resolved at the end of September and the new rate adjustments to be implemented in early October. This additional month is to allow providers an opportunity to familiarize themselves with the solution and the recent updates.
 
Starting November 1, 2021, all EVV-related claims must include the required EVV visit information and be submitted through the State EVV solution. The only exception will be for those with an outstanding support ticket.
 
Please note:

• This deadline is applicable if you are using a third-party EVV vendor.
• There is training available to you and your aides / caregivers.
• The claims submission deadline is now Thursday at midnight to be in the Friday payment cycle. Providers can no longer wait until Friday noon to submit claims. This submission will occur via the Netsmart solution.
• If a third-party EVV vendor will not be compliant by November 1, 2021, providers using that third-party EVV will also not be compliant. You should speak directly with your third-party EVV vendor about their integration progress. 
• If you have an outstanding support ticket with the Georgia EVV Call Center that is an actual defect preventing you from completing EVV claims submission, that will be taken into consideration. In that case, you will still be allowed to submit claims to GAMMIS until the issue is resolved. This does not apply for issues related to user error or lack of training.
• Submitting a claim does require an aide or caregiver to have completed a visit using your EVV solution of choice.
• As previously noted, Tellus has rebranded to Netsmart. DCH is in the process of updating materials and you may see either name until all documents are updated.
• Case management / support coordination functionality is delayed, and the new date will be communicated upon availability. 

To continue adoption and system usage, complete the provider checklists. These checklists include guides to help you complete training, download the mobile application and even talk to your Medicaid members.
 
Please ensure you, your administrators, and applicable aides and caregivers have completed necessary training. Those training needs and guides are available in both Phase 1 checklists below.
 
Phase 1 Implementation Checklist - Providers Using Tellus EVV

Phase 1 Implementation Checklist - Providers Using a Third-Party EVV Solution
 
Click below to download the PDF Phase 2 (claims) checklist to complete steps for claims submission.
 
Phase 2 (Claims) Implementation Checklist – Providers Using Tellus EVV
 
Phase 2 (Claims) Implementation Checklist – Providers Using a Third-Party EVV Solution