AHCA Behavior Analysis FAQ’s
AHCA BA EVV Frequently Asked Questions
The Florida Agency for Health Care Administration (AHCA) has contracted with Tellus to implement the AHCA Electronic Visit Verification (EVV) program for behavior analysis (BA) services for certain regions . Below are some frequently asked questions you can use as a reference when needed.
What is Electronic Visit Verification (EVV)?
Electronic Visit Verification is the process by which providers schedule visits, check in and check out of service delivery, and submit Medicaid claims for payment. EVV is being increasingly used across the country for a variety of health care services to safeguard the integrity of funding, reduce paperwork burden, and standardize the collection of data.
Who has to use the EVV system?
Electronic Visit Verification is being rolled out as a pilot for recipients with a residential address in Regions 9, 10, and 11, for all behavior analysis services, except assessments and reassessments.
How long will the pilot last?
There is no end date.
Is there a cost to use the EVV service?
May I use a different EVV system?
Yes, providers may use a different EVV system. Providers should contact Tellus (the Agency’s contracted vendor) at: email@example.com to ensure your system is compatible with the Tellus EVV system. The Agency does not reimburse for other systems.
What is the main function of the EVV system?
The EVV system collects data to assist providers in creating claims for submission to the Florida Medicaid Management Information System (MMIS). The data collected includes the rendering provider information, recipient information, location of service delivery, procedure codes for the services delivered, and tasks and notes when applicable. This information is matched against information submitted to obtain prior authorization. This allows the system to identify that the right services are delivered to the right recipients at the right times and locations. Altogether this approach helps to ensure recipients receive the approved services and reduces abhorrent billing practices.
Will there be a grace period for using the EVV system until providers are ready?
No. Providers delivering services (referenced above) to Medicaid recipients in the pilot area must schedule and bill for services delivered beginning December 1, 2019 through August 1, 2020, using the EVV system. Beginning December 1, 2019 through August 1, 2020, the Agency will initiate a soft-launch of the EVV system with a mandatory launch date no earlier than August 1, 2020.
Do I still need to get a Prior Authorization (PA) for the recipients I serve, and is that process changing?
A PA must still be requested from the Agency’s Quality Improvement Organization (eQHealth) before services are scheduled and rendered.
How do I get paid for services delivered to eligible Medicaid recipients?
You will bill for services delivered through Tellus’ EVV system, but you will continue to get paid the same way as you do today.
When will training be available?
Webinar training for EVV Orientation began May 15, 2019. Training will be delivered in a topic specific approach. All training sessions will be posted on the firstname.lastname@example.org website. Providers will be able to link to a registration for their desired sessions.
Who should go to training?
All providers that are new to BA EVV should review the training available (posted at email@example.com) to determine who from their organization should attend.
How can I register for training?
Training sessions are posted to firstname.lastname@example.org with links to training registration.
Can I attend more than one session?
Yes. However, for ease of access, all training presentations and materials will be available for review at email@example.com.
What is a Global Positioning System (GPS)?
A Global Positioning System is an accurate worldwide navigational and surveying program based on the reception of signals from an array of orbiting satellites.
Does the GPS tracking follow my location?
No. The GPS identifies the location of the rendering provider at the time of check in and then again at check out of service delivery only.
What if I do not have cell phone access or there is no Wi-Fi connectivity when I should check in and check out?
If the visit appears on your schedule for the day, you can start and end the visit as you normally would. The Tellus EVV mobile application uses GPS technology to record the start and end location. It does not require cellular or Wi-Fi connectivity. If the visit does not appear on your schedule for the day, your administrator will need to start and end the visit on the Tellus EVV Administrator Console and provide a reason for the manual entry of the visit. To ensure visits appear on your schedule, log in to the Tellus EVV mobile application while you have cellular or Wi-Fi connectivity, so your schedule can sync to the system.
Can I see a recipient without having a PA?
No. The visit to the recipient needs to be scheduled prior to the delivery of services. This requires that an approved PA is already obtained.
What if I need to make changes to a PA?
You will follow the same process that you do today through eQHealth.
Can a schedule be changed?
Yes. It is best to make changes before delivering serves; however, if that is not possible the Administrator may enter corrected information after the service is completed.
Can a service be scheduled to start and stop in different locations?
What if the rendering provider forgets to check in or check out?
The Administrator can assist with entering the correct information into the EVV system so that the visit can be billed.
What services are required to be billed in the EVV system?
The following behavior analysis services (procedure codes) are required to be billed in the EVV system: H2012 BA, H2014 BA, H2014 BA GK, and H2019 BA
Is there a limit to the number of system administrators per group provider/clinic?
Will providers still be able to submit claims via the provide web portal’s Direct Data Entry after August 1, 2020?
How soon do we get the claim information/status after claims are submitted through Tellus?
The Tellus system submits claims nightly, and the status of the claims is available in the MMIS within approximately 24 hours. Tellus receives claims status updates every Monday, and the Tellus EVV system reflects that claim status as soon as it is received. Claims will continue to be paid on the same cycle as they are today.