Electronic Visit Verification Offers Proof of Care Delivered at the Point of Care
Home healthcare agencies regularly take the right steps to ensure they prevent the occurrence of fraud by documenting patient care, coding and billing accurately and working to improve patient outcomes. One technology, Electronic Visit Verification (EVV), helps agencies in all three of those areas. Agencies that don’t use EVV leave themselves wide open to risk of fraudulent claims submission, billing for false care visits and disrupting cash flow by spending too much time on paperwork and less time on patient-focused care.
Home health agencies can help protect themselves from fraudulent activities by requiring their clinicians to document every step of the patient care process including: date, time and location of each home visit. An EVV app accessible through mobile devices such as tablets and Smartphones puts these compliance capabilities conveniently in the hand of the clinician and helps agencies document proof of care. The data is also integrated with home healthcare management software for streamlined charting, billing, employee payroll and claims submission purposes.
In the U.S., medical fraud costs tens of billions of dollars. To combat healthcare fraud, the U.S. Department of Health & Human Services (HHS) and the U.S. Department of Justice formed a joint project called Health Care Fraud Prevention and Enforcement Action (HEAT). Project HEAT, through the use of Strike Force Teams, has been highly successful in bringing healthcare fraud cases and prosecuting them quickly and effectively.
HHS reported that in October 2012, Medicare Strike Force operations in seven cities led to charges against 91 healthcare individuals for their alleged participation in Medicare fraud schemes involving approximately $432 million in false billing.
Recently, the Office of the Inspector General announced the owner of a Miami home health care company pleaded guilty in connection with a $13 million Medicare fraud scheme that involved paying kickbacks and bribes to Medicare beneficiaries, doctors’ offices, medical clinics and others in exchange for patient referrals and fraudulent prescriptions to support fraudulent billings to Medicare.
Yet Medicare fraud doesn’t only happen in the nation’s largest cities. The Ohio newspaper The Columbus Dispatch reported that Columbus has the most Medicare-certified home health agencies per person among the 50 largest metro areas in the country and that HHS found that 18 percent of agencies across the state of Ohio had questionable billing, twice the national average.
EVV helps protect home health agencies from risk of fraud by verifying that services were actually received for which claims are submitted. Risks agencies face by NOT using EVV include:
- Risk: employees falsifying patient visits that never occurred.
Solution: EVV tracking and monitoring of employees. GPS, cellular and Wi-Fi technology records the date, time and location of home care visits when the clinician performs a check in and check out for the visit, using a mobile app. Patient signatures are collected on the mobile devices as additional proof that the care was provided at the point of care. The EVV feature is only available if a clinician checks-in at the immediate vicinity of the patient’s residence. If discrepancies arise in the records, the problem can be addressed proactively.
Remember: agencies that submit false patient data– whether knowingly or unknowingly — are at risk for task force investigations, fines and, ultimately, prison time. At the least, agencies may find payments delayed due to audits or investigations, causing a disruption in cash flow.
- Risk: Inefficient, inaccurate charting of patient information.
Solution: An EVV app that allows patient charting in real-time and is automatically synched up with a robust home healthcare management software solution.
- Risk: Less favorable patient outcomes by spending more time on paperwork and the less time on patient care.
Solution: A streamlined, automated system for all documentation, billing, HIPPA and other regulatory compliance requirements through mobile applications and interoperable systems for effective communication, reporting, claims submissions, payroll and more.
The benefits for home healthcare agencies for using EVV are evident. Agencies that wish to remain compliant and run as efficiently as possible need to adopt EVV and integrate mobile technology into their business. EVV prevents the conditions that lead to improper payments and provide an effective response to an audit, if one occurs. An EVV system is best combined with effective policies and procedures as well as a comprehensive, integrated home health software solution. Using this technology, home health agencies can be more profitable and can do what they do best: provide patient care at home.
