Netsmart Electronic Visit Verification (EVV)



In December 2016, the 21st Century Cures Act was enacted into law by the 114th United States Congress. Section 212006 of the Cures Act requires all states to implement the use of Electronic Visit Verification (EVV) for Medicaid-funded personal care and home health services that require an in-home and community visit. EVV is a technology solution that electronically verifies the utilization and delivery of care services.

On January 1, 2021, Highmark Wholecare (formerly Gateway Health) implemented Netsmart EVV to electronically verify the utilization and delivery of care services for its Medicaid members.

How does Netsmart EVV work?

Netsmart EVV solution is an easy-to-use, web and mobile-based solution. It will provide you with a comprehensive set of tools to easily manage your visit schedules, care plans and claims processing. Using mobile technology, Netsmart captures the time and location that those services are delivered — ensuring your patients receive the medically necessary services and support they need. With EVV, you can easily schedule, monitor and verify visits as well as submit timely and accurate claims for processing.

 

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This information is issued on behalf of Highmark Wholecare, coverage by Gateway Health Plan, which is an independent licensee of the Blue Cross Blue Shield Association. Highmark Wholecare serves a Medicaid plan to Blue Shield members in 13 counties in central Pennsylvania, as well as, to Blue Cross Blue Shield members in 27 counties in western Pennsylvania. Highmark Wholecare serves Medicare Dual Special Needs plans (D-SNP) to Blue Shield members in 14 counties in northeastern Pennsylvania, 12 counties in central Pennsylvania, 5 counties in southeastern Pennsylvania, and to Blue Cross Blue Shield members in 27 counties in western Pennsylvania.

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