Provider Relations

Alternative EVV Certification Process

Alternative EVV Certification Process Changes

In response to stakeholder feedback, starting Sept. 15, the Alternate (Alt) EVV Certification process in Ohio will change from requiring each vendor and provider to pass certification to only requiring new vendors to pass certification. With this change, when vendors successfully complete Alt EVV testing with Sandata and their demonstrations with ODM, providers have the option to skip the Sandata testing process and receive production credentials to start sending in visits to the Sandata Aggregator.
Beginning Sept. 15, the Alt EVV Certification process for agency providers whose vendors are already certified in Ohio will adopt the following steps:

This change is a direct result of feedback received from the Alt EVV Stakeholder Small Group. The modification removes several steps currently required by every provider and vendor combination to receive certification. Your feedback challenged Ohio Medicaid to reduce:

Redundancies related to provider/vendor testing.
Administrative burden to providers and vendors.
Confusion in current complex process.
Provider frustration with process and technical requirements.
Time taken away from direct care to the individual.

Below are key things to know with this change:

Every agency provider who intends to use an Alt EVV vendor will continue to initiate the Alt EVV Certification process with Sandata.

Every agency provider who initiates the Alt EVV Certification process will continue to take required training on the Sandata Aggregator and provide a completion training certificate to Sandata.
Providers no longer have to complete the required Demo Request Form. Only vendors will complete the demonstration requirement with ODM – and only if they have not already done so. Providers are encouraged to continue to participate in demonstrations voluntarily if they choose.
Providers are to copy their vendor contacts into their Alt EVV communication with Sandata, so that all parties are aware of progress throughout the certification process.
Provider/vendor-specific testing will still be supported by Sandata if providers chose todo so, even for vendors already certified by Ohio.

Providers using an Alt EVV vendor who haven’t completed Sandata testing, or their ODM demonstration requirement, should follow the steps below:

Additional details will be shared on the ODM website’s Alt EVV webpage closer to Sept. 15. . Providers or vendors may still reach out to the OHAltEVV@sandata.com with any questions regarding Alt EVV, or to work through the certification process. If you have any questions regarding this change, please reach out to the ODM EVV Team at ODMEVV@sandata.com.

EVV

Electronic Visit Verification (EVV)

EVV is an electronic system that verifies key information about the services provided. In accordance with the Cures Act, the system implemented by the Ohio Department of Medicaid (ODM) will record the date of the service, the time the service started and ended, the individual receiving the service, the person providing the service, and the location of the service.

Both agencies and non-agency providers are required to use EVV by ODM rule 5160-1-40 EVV.

EVV training will answer most of your questions. Sign up for training on the ODM website. Participant Directed providers should sign up as a non-agency provider. Sessions are available on-line 24 hours a day. Once you complete training, you will receive your welcome kit via email. The welcome kit contains the username and temporary password you will use to access your Sandata EVV account. The temporary password is valid for 60 days; if you need to reset it, call 1-855-805-3505. If you are a new provider waiting on your Medicaid provider number, you may sign up for training at Sandata learn.

ODM has created quick reference guides that cover many basic EVV tasks. The following topics cover some of the most common tasks and frequently asked questions related to getting started with EVV.

Guidance and FAQs for Providers

EVV Updated Fact Sheet from ODM

Electronic Visit Verification (EVV) Error Resolution Guide

ODA NOTICE 0922815: Beginning Sept. 14, 2022, the EVV validation failed code messages on provider claims are changing to more descriptive language for each EVV exception. The provider’s remittance advice will display the messages contained in the EVV Error Resolution Guide. ODA has created a new EVV Error Resolution Guide to help providers, individuals, and case managers. The EVV Resolution Guide lists each exception, has an exception description, and provides action steps to resolve the exception. Below, is the current exception message in the system printed on an affected provider’s remittance advice and then a list of the updated versions.
Current message: “EVV Validation failed”

Updated message:
“EV001: Provider Medicaid # not found in PIMS”
“EV002: Provider not found in Sandata”
“EV003: Consumer not found in Sandata”
“EV004: Provider & Consumer not found in Sandata”
“EV005: Consumer not found for the provider in Sandata”
“EV006: Verified Service not found in Sandata”
“EV007: Service Date not found in Sandata “
“EV008: Units billed more than in Sandata”

EVV error resolution guide

PROVIDER INFORMATIOn

The Area Agency on Aging 3 is proud to partner with local organizations to ensure a quality provider network is available to assist aging adults with services and supports to remain independent.

Adult Day Service
Assisted Living
Community Transition
Enhanced Community Living
Home Delivered Meals
Home Maintenance and Chore
Homemaker
Home Medical Equipment
Home Modification
Independent Living Assistance
Non-Emergency Medical Transportation
Non-Medical Transportation
Nutrition Consultation
Participant Directed Services (Personal Care Services or Choices Home Care Attendant Services)
Personal Care Service
Personal Emergency Response System
Social Work Counseling
Waiver Nursing

Opportunities for providers are available through both the Medicaid funded and Older Americans Act funded programs.

Additional details are available through the following links:

Provider Rules (Medicaid Funded, Older Americans Act Funded, Background checks)
Medicaid Funded Programs-PASSPORT and Assisted Living Waivers
Older Americans Act (Title III) Funded Programs
Billing

You can also contact our Compliance and Oversight Department at 419-222-7723 for additional information.

These services include:

Provider Information

Commonly Addressed Health and Safety Concerns

PROVIDER RULES

PROVIDER rules

Please pay close attention if you are providing services under multiple funding sources. Although the rules for Medicaid Waiver and Older Americans Act programs often mirror one another, it’s not always the case. It is not recommended that rules be printed and copies maintained for use on a long-term basis as often rules are amended or created. We encourage you to utilize the links below for the most up to date version.

PASSPORT/Assisted Living Waiver

Please follow the steps below to view rules related to services under the PASSPORT and Assisted Living Waiver:

1. Click the link to the Ohio Department of Aging’s website HERE

2. Select 173-39 ODA Provider Certification (for use when providers serve individuals enrolled in waiver programs funded by Medicaid) 3. For program requirements, select requirements for providers to become, and to remain, certified and/or the specific service to view rules.

Older Americans Act (Title III) PROGRAMS

Please follow the steps below to view rules related to services under the Title III Care Coordination Program.

1. Click the link to the Ohio Department of Aging’s website HERE

2. Select 173-3 Older Americans Act (for use when providers serve individuals enrolled in programs not funded by Medicaid) 4. For program requirements, select requirements to include in every AAA-provider agreement and/or the specific service to view rules.

CRIMINAL RECORDS CHECK RULES

Rules with regards to Criminal Background Checks for Direct Care Workers under the PASSPORT and Older Americans Act programs can be found on the Ohio Department of Aging’s website by following the steps listed below:

1. Click on the following link: HERE

2. Select 173-9 Background Checks for Paid Direct-Care Positions

Background Check requirements for Assisted Living Facilities are outlined under the Ohio Administrative Code 3701-13 and regulated by the Ohio Department of Health.

Criminal Background Checks are required by both Medicaid funded and Older Americans Act funded programs. Per the Ohio Administrative Code, only background checks under reason codes 173.27, 173.38, 173.381, 3701.881, 5123.081, 5123.169 meet compliance for programs offered through the PASSPORT waiver and Older Americans Act programs.

Additionally, the return address listed on the results letter must reflect the provider’s business address to meet compliance.

– MEDICAID FUNDED PROGRAMS –

PASSPORT AND ASSISTED LIVING WAIVERS

MEDICAID FUNDED PROGRAMS

INTERESTED IN BECOMING A PASSPORT/ASSISTED LIVING WAIVER PROGRAM PROVIDER?

Please follow the steps below to view rules related to services under the PASSPORT and Assisted Living Waiver:

1. Click the link to the Ohio Department of Aging’s website HERE

2. Select Certified Provider Requirements (for use when providers serve individuals enrolled in waiver programs funded by Medicaid)

3. For program requirements, select requirements for providers to become, and to remain, certified or the specific service to view rules.

Applications to become a Certified Provider for the PASSPORT or Assisted Living Waiver programs may be submitted at any time. Please apply through the Ohio Department of Aging’s Website Portal at the following link: https://aging.ohio.gov/wps/portal/gov/aging/agencies-and-service-providers/certification/

Once you’ve applied online and provided the required documentation, the Ohio Department of Aging will be in contact with the AAA in which your business/organization/residence is located and that AAA will be in contact to schedule a precertification review visit.

If you have questions regarding the certification process, the rules governing these programs, or are already an Ohio PASSPORT Waiver Provider and are looking to expand to Area Agency on Aging 3, please contact our Provider Relations Staff at 419-222-7723.

Participant Directed Services

PARTICIPANT DIRECTED SERVICES

Thank you for your interest in the Participant-Directed Services available through the PASSPORT Waiver Program.

If you have questions regarding the certification process, please contact Area Agency on Aging 3 Provider Relations Staff at 419-222-7723.

OLDER AMERICANS ACT (TITLE III) FUNDED PROGRAMS

OAA TITLE III

INTERESTED IN BECOMING A PROVIDER FOR THE OLDER AMERICANS ACT (TITLE III) PROGRAMS?

Older Americans Act (Title III) PROGRAMS

Please follow the steps below to view rules related to services under the Title III Care Coordination Program.

1. Click the link to the Ohio Department of Aging’s website HERE

2. Select 173-3 Older Americans Act (for use when providers serve individuals enrolled in programs not funded by Medicaid)

3. For program requirements, select requirements to include in every AAA-provider agreement or the specific service to view rules.

Applications to become a Provider of Older Americans Act (Title III) funded programs are completed through a Request for Proposal submitted to the Area Agency on Aging 3 and are completed on an annual and/or bi-annual basis depending on the service. Notice of available Requests for proposal are advertised through legal notice in local newspapers as well as publicized on the AAA3 website.

Please check back regularly for available opportunities.

Completed Requests for Proposals are reviewed with the Agency Needs Assessment Committee, Advisory Board and Board of Directors for final award.

Dining to Improve Socialization and Health (DISH)

Area Agency on Aging 3 partners with local restaurants in our seven-county region to provide a congregate dining project locally referred to as DISH. The purpose of the DISH program is to provide individuals 60 years and older a nutritious meal and an opportunity for socialization by visiting participating restaurants and purchasing their meal through the program. To find out more about your restaurant participating in the program please contact us at 419-222-7723.

BILLING & Email

Billing

DIRECT DATA ENTRY (DDE) BILLING INFORMATION

The Ohio Department of Aging (ODA) has developed a new ONLINE electronic billing process. The Direct Data Entry System (DDE) enables providers to electronically transmit bills and receive correspondence via the Internet. In order to utilize this new data transmission process, your organization will need a computer system with Internet access (preferably high speed).

This system provides the following ONLINE benefits:

1) Ability to track bills

2) Remittance Advice accessibility

3) Will not need to submit hard copy paperwork (i.e. coversheet; invoice entry printout)

4) Simpler billing process

A manual and computer based training (CBT) videos have been developed and made available on this website. Once you have read the manual click here and/or viewed the videos, email Claims@psa3.org This e-mail address is being protected from spambots. You need JavaScript enabled to view it to request your User Name, password, and access to the area. Disclaimer: This software is to be used for Billing Purposes ONLY by contracted PASSPORT, Assisted Living, and Title III Providers. Other use can lead to legal ramifications.

PART 1 - Introduction: Password & Login

PART 2 - Invoice Entry

PART 3 - Invoice Views

PART 4 – Reports

BILLING INFORMATION

Billing and verification information can be found on the Ohio Department of Aging's website here. https://aging.ohio.gov/wps/portal/gov/aging/agencies-and-service-providers/billing-and-verification/

Please contact our Claims Processing Specialist with regards to any questions specific to the following systems, unless you were directly contacted and instructed to do otherwise. Claims Processing Specialist Area Agency on Aging 3

Phone: 567-940-9746