A significant update from the Texas Health and Human Services Commission (HHSC) is set to impact how Electronic Visit Verification (EVV) claims are handled. Starting December 1, 2023, there are new submission processes that Texas providers need to be aware of.
Key Update:
From December 1, 2023, all program providers are required to submit their HHSC EVV claims to the Texas Medicaid & Healthcare Partnership (TMHP). You can do this through Cubhub automatically as an approved PSO. For the full details, you can view this TMHP notice.
What This Means for Providers
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Claims Rejection by MCOs: Managed Care Organizations (MCOs) will reject any HHSC managed care claims with EVV services dated on or after December 1, 2023. These claims must be resubmitted to TMHP for proper EVV claims matching.
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Billing Combination Changes: New billing combinations and modifiers have been introduced for different types of service locations, including in-home and out-of-home settings. You can view the new billing combinations in the Long-term Care Bill Code Crosswalks.
Next Steps for Providers
Be aware that from January 1, 2024, EVV claims without an EVV visit match will be denied. It's crucial to thoroughly understand and integrate these updates into your operations. Ensure your team is trained and your billing systems are updated to align with the new requirements, including the use of specific billing combinations and modifiers for different service settings. Stay proactive in monitoring your EVV data to avoid claim denials and utilize resources like Cubhub for streamlined, real-time tracking and management of your EVV submissions.
Simplify EVV with Cubhub
Claims submitted with Cubhub are automatically sent to TMHP, so you don’t have to do any extra work. All claims submitted can be tracked in real-time to easily resolve any issues and ensure claims are not denied.
We're committed to staying ahead of state-mandated changes, ensuring that your business can focus on what truly matters — providing exceptional care to your clients.
Contact us today to learn more about how Cubhub can streamline EVV for your business. For more information about EVV in your state, email info@cubhub.io.