Why did my claim deny for EVV?
Georgia denies personal care claims that do not carry EVV visit data. The claim must go through the state EVV system with six data points: who got care, who gave it, the service, the place, the date, and start and end times. Fix the visit in EVV, then resubmit.
Since October 1, 2021, Georgia Medicaid has denied EVV-required personal care claims that arrive without EVV information. EVV means electronic visit verification, the check-in and check-out record of each visit.
The state system captures six things: who receives the service, who gives it, the type of service, the location, the date, and the start and end times.
If a claim denied, try this:
- Open the visit in the state EVV system and look for a missing check-in or check-out.
- Make sure the client, worker and service match what was authorized.
- If the caregiver forgot to clock in or out, an administrator can fix the visit with a reason code. The system keeps an audit trail.
- If care happened at a different address, record the real address with a reason code.
- Resubmit the claim through the state EVV system. EVV claims can no longer go through the GAMMIS web portal.
A visit that happens before the authorization is approved still needs EVV data. The claim goes to GAMMIS once the authorization is approved.
Check the codes and modifiers too. Each service type has its own set.
How CareBravo® helps
A rejected EVV record comes back explained in plain words, and a caregiver who forgot to clock in answers one question; the office confirms the time.
Sources
- Electronic Visit Verification (EVV): Provider-related FAQs · Georgia DCH
- Georgia Electronic Visit Verification (EVV) · Georgia DCH
Reviewed by Beth Bledsoe, Care Business Advisor®, 28 Oct 2026. Rules change. Confirm with your state Medicaid agency before you act.
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