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Sunshine Health Announces EVV Policy, Procedure Changes

Date: 03/13/24

Fort Lauderdale, Florida

As part of Sunshine Health’s ongoing effort to drive Electronic Visit Verification (EVV) compliance, we will discontinue the use of the Quick Visit Entry module for providers utilizing the HHAeXchange Free EVV Portal. Providers who must confirm a visit manually can do so through the member’s Calendar Page and Call Dashboard.

Sunshine Health will sunset the Quick Visit Entry module under the phases outlined below. Please review and ensure your agency has trained each caregiver and implemented the free EVV tools available prior to these dates. Providers can utilize the HHAeXchange support center to obtain job aids and training videos for the HHAeXchange mobile app and IVR lines.

  • Phase 1: Effective April 1, 2024, Sunshine Health will no longer offer Quick Visit Entry though the HHAeXchange Free Portal for providers with less than 25 percent EVV compliance. The measurement of less than 25 percent EVV compliance will be based on a historical look back period. The look back period will include January 1, 2024, to March 31, 2024.
  • Phase 2: Effective June 1, 2024, Sunshine Health will no longer offer Quick Visit Entry though the HHAeXchange Free Portal for providers with less than 50 percent EVV compliance. The measurement of less than 50 percent EVV compliance will be based on a historical look back period. The look back period will include April 1, 2024, to May 31, 2024.
  • Phase 3: Effective August 1, 2024, Sunshine Health will no longer offer Quick Visit Entry though the HHAeXchange Free Portal offering.

If you require additional training to use the free EVV tools, please use the self-help tools within the HHAeXchange Support Center, which can be accessed through the Client Support Portal. Contact HHAeXchange support at support@hhaexchange.com.

Reducing EVV Exceptions, Complying with State, Federal Guidelines

The 21st Century Cures Act requires providers delivering home health, Private Duty Nursing (PDN) and personal care services to validate services and submit claims through a compliant Electronic Visit Verification (EVV) system.

The Florida Agency for Health Care Administration (AHCA) and the Department of Health (DOH) have emphasized reducing exceptions pertaining to the use of EVV. This includes manual edits/adjustments to visits that were electronically verified. The process also involves closely monitoring the reimbursement of Managed Care Organizations (MCOs) for visits that were electronically verified.

Sunshine Health has taken significant steps towards fully complying with the 21st Century Cures Act and we want to ensure providers also fully comply with the guidelines.

Beginning June 1, Sunshine Health will deny any EVV claims not electronically verified. To prevent any reimbursement delays, we encourage all providers to reduce and eliminate EVV exceptions, including visit times that are manually adjusted. All visit files from your Electronic Data Interchange (EDI) vendor should be provided to HHAeXchange at least once a week for EDI providers who use a third-party EVV vendor. Florida’s EVV guidelines are available online.

Questions?

If you have any questions, please call Sunshine Health Provider Services at 1-844-477-8313 or visit the Secure Provider Portal. Our Provider Engagement staff are also here to help answer questions. Visit the Find Your Administrator tool to confirm the individual supporting your specialty and region. We encourage you stay up to date on Sunshine Health provider notices by reviewing and bookmarking Provider News.

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