Why was my Georgia claim denied for missing EVV information?

The state’s EVV FAQ is blunt: if a claim does not include the required EVV information, the claim will be denied. After October 1, 2021, EVV-required claims cannot be submitted through the GAMMIS web portal. They go through the state EVV solution.

Common reasons a visit does not turn into a clean claim (from DCH’s guides and slides):

1. A missed clock-in or clock-out that nobody fixed.
2. No matching authorization is on file yet. DCH says a visit before approval still needs its EVV data, and the claim goes in after the authorization is approved.
3. The visit is unmatched or still marked "New" after an edit.
4. A rounding difference. Georgia follows standard Medicaid rounding: for 15-minute units, up to 7 minutes rounds down and 8 rounds up.

What DCH says to do:

1. Open the Claims Console and look at unmatched visits and rejected claims.
2. Fix the visit (a manual edit needs a reason code).
3. Confirm "Visit to Claim" shows success for each completed visit.
4. For a paid or partly paid claim, adjust it in the EVV system. A denied claim needs a new, corrected claim.

DCH slides from 2022 also say claims must be in by Thursday midnight to make the Friday payment run. Check that this is still current.