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EVV Billing FAQ - NC
Q: How do I resolve 'Shift Overlapping' errors in the HHA Exchange portal under Prebilling?
A: OnTarget allows a 7 minute overlap based on NC billing and payroll rules. However, EVV requirements do not allow caregiver's shifts to overlap. According to HHA, the NC LME/MCO payers have requested the shifts not overlap as well. This means the shifts will need to be edited within HHA by adjusting the start or end time of the visit based on the other caregiver's start or end time.
Q: How do I resolve the following HHA status error: Caregivers can only be assigned to secondary offices which share same Payroll, Duty List and Time zone configuration as their Primary Office?
A: Per HHA, they resolved this issue the week of 7/27/2021, and reprocessed claims. If you continue to get this error, please reach out to HHA Exchange via their Client Support Portal.
Q: How do I resolve the following HHA status error: Can not schedule visit when there is no any active contract?
A: Per HHA, go to the Client in HHA portal and verify the start date under Vendor Information>Service Start Date is not after the date of service submitted. If the date needs to be changed, please contact the MCO to have this updated. If this is not the issue contact HHA via Thier Client support Portal.
Q: How do I resolve the following HHA status error: Caregiver profile found with matching SSN and different Alt Caregiver Code?
A: Caregiver codes are maintained in the HHA portal. If you get this error, please reach out to HHA Exchange via their Client Support Portal.
Q: EVV Billing: How do I resolve an issue with missing 3rd party invoice number in HHA?
A: The invoice number is sent by OnTarget in the HHA file in column AV of the file under Invoice Number. For a copy of the file, go to Reports/Published Documents/HHA Responses then search for the payer name and check the daily files for the ‘Visit’ file you need, click on the file to download. Contact HHA Exchange via their Client Support Portal.
Q: How do I resolve a ‘Patient not Found’ import status error from HHA Exchange?
A: Please verify all client data in HHA Exchange matches the data in OnTarget (Medicaid Number, Date of Birth, Service Start Date). If needed, update the information in OnTarget and rebill the claim. If the data in HHA is incorrect. contact the MCO to have data updated:
- Alliance: providerEVV@alliancehealthplan.org
- Eastpointe: support@eastpointe.net
- Partners: evvsupport@partnersbhm.org
- Sandhills: Submit a ticket to their support center through this link: https://support.sandhillscenter.org/support/login
- Trillium: NetworkServicesSupport@TrilliumNC.org
- Vaya: provider.info@vayahealth.com
Q: How can I tell if my EVV claims sent to HHA have been paid or denied?
A: Once EVV records have been submitted to HHA, OnTarget downloads the HHA Responses to Reports/Published Documents/HHA Responses as a courtesy-these reports are also available in the agency’s HHA portal. Each agency is responsible for checking those reports for Import Status errors (very last column of each report). Please contact edisupport@hhaexchange.com for any questions on resolving any errors. If the import status states “Success”, HHA should create an 837, and send to the MCO. The 835s will still come from the MCO and post in OnTarget. Please check status of claims in your MCO portals using the claim status reports or payments in OnTarget.
Q: How do I fix duplicate denials for EVV claims with more than one schedule prior to 9/1/2021?
A: If the claims were submitted AND the date of service is prior to the day you went live with HHA, just rebill the claims to the MCO in OnTarget by choosing Rebill Selected. Each payer should be able to handle multiple visits sent over by HHA, but we are aware they were not handling properly prior to 9/1/2021. If the claims were sent after 9/1/2021, please follow up with the MCO. The EVV visits are sent by HHA to the MCO as one invoice and the MCO should be readjudicating these.
Q: What does this mean on our 837 Status: ‘Serial Number 0’ or blank?
A: The EVV submissions prior to December 2021 will not have a serial number because they are not required. 837 files require a serial number, but the EVV files are not actual 837s, just a CSV file.
Q:How do I know when my EVV claims have been sent to HHA for processing?
A: To confirm when EVV files were sent to HHA please go to the 837 status under the Claims menu. The time/date of the response file does not indicate the actual date/time the files were sent, just when OnTarget was updated with this response. The HHA Response files are also available in the HHA portal. Please contact HHA Exchange via their Client Support Portal for any questions re: items in their portal.
Q: How do I fix an HHA Import Status Error of ‘Patient not Found’ when the issue is the client ID number?
A: To fix the client’s Medicaid ID number in OnTarget go to Client/General/Insurance and update the Funding ID to match what is in HHA for the client. Then rebill the claim in OnTarget by selecting the claim, choosing Void Only, then recreate the batch and invoice.
Q: My Alliance EVV claims are denying because the patient or authorization data is incorrect in HHA. Who do I contact?
A: Please contact Alliance at ProviderEVV@alliancehealthplan.org for assistance with incorrect patient or authorization data in HHA Exchange.
Q: My Partners EVV claims are denying because the patient or authorization data is incorrect in HHA. Who do I contact?
A: Please contact Partners at evvsupport@partnersbhm.org for assistance with incorrect patient or authorization data in HHA Exchange.
Q: Are retainer payment services subject to EVV requirements?
A: According to NC DHHS, retainer payments are not subject to EVV; please refer to this link and scroll down in the FAQs: https://medicaid.ncdhhs.gov/providers/programs-and-services/long-term-care/electronic-visit-verification#innovationstraumatic-brain-injury
Q: The MCO states the address, NPI or taxonomy is not correct on the EVV claims sent to them. How do we get this fixed?
A: OnTarget does not send site, NPI or taxonomy information for any EVV claims. HHA stores this data and sends on the 837 they send to the MCO. If they send an incorrect site, taxonomy or NPI on claims, please contact HHA Exchange via their Client Support Portal/RCO Service Desk. HHA should correct the data and resend the file(s) to the MCO. We also recommend contacting the EVV department at the MCO to keep them informed. In some cases, they can assist with resolving the issue.
- Alliance: providerEVV@alliancehealthplan.org
- Eastpointe: support@eastpointe.net
- Partners: evvsupport@partnersbhm.org
- Sandhills: Submit a ticket to their support center through this link: https://support.sandhillscenter.org/support/login
- Trillium: NetworkServicesSupport@TrilliumNC.org
- Vaya: provider.info@vayahealth.com
Q: How do I correct the following Billing Errors: The EVV Start Time is missing for claim “; this claim has at least one schedule record without a corresponding timeclock; The EVV End Time is missing for claim “?
A: Add the timeclock records manually under the Timeclocks desktop. Once they are updated the claims will be submitted to HHA on the next scheduled export. If you are not able to edit the timeclock record manually, please contact support@ontargetclinical.com.
Q: How do I resolve claims held up at HHA under prebilling edits for authorization issues related to service codes “All” in HHA Exchange?
A: Per communications with some MCOS, HHA should not hold claims in prebilling for authorizations that have the service code listed as “All” in HHA. If this is happening, please contact the MCO with examples of EVV visits held up in HHA so they can contact HHA to have them released. Service codes should not be changed in OnTarget OR HHA to get the claims released.
Q: I need to add a new payer for EVV billing, do I have to do anything with HHA?
A: When you contract with a new payer/MCO for EVV required services, even for single case agreements, you will need to alert HHA via email. A previous MCO realignment brought this to light and is one of the major reasons provider payments were being delayed. There is a 3rd party configuration setting needed to be enabled in HHA for each new payer to continue billing EVV claims. When you add a new payer contract for your services, please contact HHA via their client support portal with the request to “enable third party billing for (your Agency Name, Your Agency Tax ID, and payer name). Please forward the FINAL response you receive from HHA that the payer has been configured so we can document on our end. If you are still not receiving payment, please contact HHA Exchange via their Client Support Portal/3rd Party Integration Support immediately to request this configuration.
Q: My EVV claims are not paid or denied in OnTarget, but show 'Success' under the Import status on the HHA Response. Where are my claims?
A: Here are some places in HHA you can check for processing of files, as well as files held up for any reason-please contact edisupport@hhaexchange.com for any questions regarding accessing or understanding these reports:
- Admin/EDI Tool (copies of the HHA Response Reports)
- Admin/File Processing (claims sent to MCO by HHA)
- Billing/Prebilling (claims stuck in HHA)
- Billing/Billing Review
- Billing/Invoice Search/By Batch/Status=Pending (claims stuck in HHA)
- Report/Billing/Invoicing/Batch Summary Report
- Report/Billing/Invoicing/Batch Detail Report
Q: My NC EVV claims were created and submitted to HHA. What are my next steps?
A: Once EVV claims have been submitted to NC HHA Exchange, their team is responsible for creating the 837 file and sending to the MCO. As an agency, there are necessary steps each week to ensure your claims make it to the MCO, both in OnTarget and within your own HHA Exchange portal:
- In OnTarget:
- Go to Billing/Claims/837 Status (bottom right)
- Check for Status of "Accepted" on files with the word 'VISITS' in the name-Accepted means HHA accepted the file. Allow up to 24 hours for a "Submitted" status to update.
- Go to Reports/Published Documents/HHA Responses. Look for the payer and date of the file, scroll to the far right under 'Import Status'. The status of 'Success' means there were no initial rejections. Note that this same information is in the HHA Exchange portal under Admin/EDI Tool.
- In HHA Exchange portal-please contact HHA Exchange via their Client Support Portal for any questions regarding accessing or understanding these reports:
- Admin/EDI Tool (copies of the HHA Response Reports)
- Admin/File Processing (claims sent to MCO by HHA)
- Billing/Prebilling (claims stuck in HHA)
- Billing/Billing Review
- Billing/Invoice Search/By Batch/Status=Pending (claims stuck in HHA). You can also search Billing/Invoice/By Visit to see client visits submitted to MCO-helpful for researching aging.
- Report/Billing/Invoicing/Batch Summary Report
- Report/Billing/Invoicing/Batch Detail Report
Q: How do I resolve North Carolina EVV claims submitted to HHA Exchange that keep denying as duplicate for multiple visits on the same day?
A: Due to a known issue with HHA sending incorrect data for clients with multiple EVV visits on the same day to the NC MCOs/Tailored Plans, these claims/visits should be rebilled directly in HHA Exchange's portal, especially when one visit rejects and the other is pushed through for payment. Here is a step by step compiled by our billing team to help you resolve these partially paid claims: AA Department_Rebilling within HHA portal for adjustments or original claims. Please contact HHA Exchange directly for any questions re: this process.