UnitedHealthcare Community Plan of Arizona is compliant with Section 1903 of the Social Security Act (42 U.S.C. 1396b), also known as the 21st Century Cures Act, and the requirements set forth by AHCCCS; the Arizona State Medicaid program. This consists of the implementation of Electronic Visit Verification (EVV) for non-skilled in-home services (attendant care, personal care, homemaker, habilitation, respite) and in-home skilled nursing services (home health) as of January 1, 2021. For updated EVV information, please review the material below or visit https://www.azahcccs.gov/AHCCCS/Initiatives/EVV/.
As of January 1, 2023, EVV Hard Edits began for non-skilled in-home services (attendant care, personal care, homemaker, habilitation, respite) and for in-home skilled nursing services (home health). Please use the UnitedHealthcare Community Plan of Arizona Electronic Visit Verification Hard Edit Interactive Guide to learn more about complying with EVV requirements to prevent unnecessary claim denials. We encourage you to review this resource with your organization. For questions, please refer to the Resources section at the end of the guide for additional contact information. Find more information under the Electronic Visit Verification (EVV) section of this UnitedHealthcare Community Plan of Arizona website.
EVV Contingency Planning FAQ – Provider agencies are expected to reschedule a visit based upon the member’s contingency plan preferences. Adherence to a member’s contingency plan is recorded in the EVV system as the Resolution Code for when a visit is missed or late. More information on how to clear the missed or late visit exceptions is available in the Visit Maintenance and Documentation FAQ
The AHCCCS Service Confirmation Portal is required to be used by providers when providing an EVV service that does not require prior authorization by a health plan. If a service subject to EVV already requires prior authorization by a health plan, there is no change to that health plan’s process, providers are advised to continue to follow the specific prior authorization requirements and processes for the health plan. If a service subject to EVV does not require prior authorization by the health plan, providers will use the AHCCCS Service Confirmation Portal to notify the health plan of their intention to provide a new service or continue providing an existing service. NOTE: If you are contracted to provide the same service for multiple health plans, you may have to adhere to different requirements and processes depending on the prior authorization requirements for each health plan.
UnitedHealthcare Community Plan of Arizona would like to encourage our provider community utilizing EVV to have a policy in place outlining their process for following all of the provider requirements, as specified in AMPM 540. A policy may be essential in the future for potential review and auditing purposes.