EVV Compliance

The EVV Exception That Sat Unresolved Just Made That Visit Unbillable.

Jackie manually resolves EVV exceptions every week — the GPS that put Monique in the parking lot instead of inside, the clock-out that got forgotten, the visit the system flagged but nobody had time to fix before the billing deadline passed. CareBravo catches exceptions as they occur and resolves them before the billing window closes. Not after.

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What Unmanaged EVV Costs

An Unresolved Exception Is a Visit You Delivered and Can't Bill.

Federal EVV requirements mean every Medicaid visit must be electronically verified — caregiver identity, patient identity, location, start and end time. When the record doesn't match, the claim can't go out clean. Jackie in Georgia uses HHAeXchange because her MCOs require it. Denise uses the same in Texas. Each manages exceptions manually — which means the ones that don't get resolved before the billing deadline become visits that were delivered and cannot be billed. For Tasha, who is choosing her first EVV system: this is why the exception management layer matters as much as the EVV system itself.

How CareBravo Delivers It

Exceptions Caught the Day They Happen. Resolved Before the Billing Window Closes.

CareBravo's EVV compliance function monitors every visit record in real time. When an exception surfaces — GPS drift, a forgotten clock-out, a time discrepancy — it's flagged immediately, not discovered in the billing report three weeks later. The resolution process applies the correct payer-specific rules for your state and MCOs. By the time the billing window arrives, the exceptions that can be resolved are resolved, and the visits that couldn't be verified are identified before they become claim denials rather than after.

What arrives as completed work

EVV exceptions caught as they occur. Payer-specific resolution applied automatically. Billing deadline tracked per visit. Exceptions resolved before the window closes — or flagged as unresolvable before the claim goes out incorrectly.

What your team does instead

Review EVV exception summaries rather than working individual exceptions. Confirm resolution on complex cases. Focus on care delivery while EVV compliance runs in the background.

What connects to this function

EVV connects to scheduling — visits that go unverified are flagged before the next shift is assigned to that caregiver. EVV connects to billing — pre-submission claim review uses EVV status as one of five checks before every claim leaves.

What this looks like at your stage

At 30 patients: manual exception resolution takes hours that Jackie doesn't have. At 90 patients: Denise's MCO requirements make exception management a daily operational function. Pre-launch: EVV setup before the first visit means exceptions are caught from day one, not discovered in the first billing denial report.

100+ agencies. 73% average revenue growth. No added back-office hires. EVV compliance as a managed function is what prevents the billing gaps that come from visits delivered but records unverified. It's a prerequisite for clean claims — and clean claims are what drive revenue recovery.

Questions

What Agency Owners Ask About EVV Compliance

An EVV (Electronic Visit Verification) exception occurs when the electronic record of a home care visit doesn't match expected parameters — the GPS location doesn't match the patient's address, the clock-in time is inconsistent, the caregiver forgot to clock out, or the visit duration is outside the authorized range. Exceptions must be reviewed and resolved before the claim can be submitted. Unresolved exceptions result in claim denials or non-submission.

If EVV records are not compliant, Medicaid will deny the associated claims. Chronic EVV non-compliance can trigger payer audits and in serious cases, affect the agency's Medicaid participation. Most EVV exceptions are correctable if caught quickly — the problem is that exceptions found after the billing deadline cannot be corrected retroactively, making the visit unbillable.

Fixing EVV exceptions requires identifying the specific exception type, accessing the visit record, correcting the discrepancy with appropriate documentation, and resubmitting through the EVV system before the billing deadline. Each payer and state has different rules for acceptable exception resolutions. CareBravo's EVV compliance function catches exceptions as they occur, applies the correct payer-specific resolution, and resolves them before the billing window closes — without requiring manual review of each exception.

EVV system requirements vary by state. Some states mandate a specific state-operated system (such as HHAeXchange in certain states, Tellus/NetSmart in others). Others allow agencies to use any EVV system that meets state specifications. CareBravo integrates with state-mandated EVV systems rather than replacing them — adding the exception management layer on top of whatever system your state and payers require.

Federal law requires EVV for all Medicaid personal care services and Medicaid home health care services. States were required to implement EVV for personal care by January 1, 2020 and for home health by January 1, 2023. Agencies that fail to comply with EVV requirements risk claim denials and Medicaid payment suspensions.

See EVV Compliance Managed — Without the Weekly Exception Reconciliation.

The diagnostic shows how many visits are currently at risk from unresolved EVV exceptions. The first call shows what exception management looks like as completed work for your payer mix.

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How EVV gaps contribute to Compliance Drain → How scheduling connects to EVV compliance → How EVV connects to pre-submission claim review → Choosing your first EVV setup →