According to a report by OIG, nearly 5% of care providers are at potential risk of failing due to compliance and health care fraud in their billing processes. To address this growing concern, providers are increasingly adopting automation along with EVV.

Electronic Visit Verification (EVV) technology has emerged as a game-changer. It enables agencies to remotely monitor caregivers, supports accurate billing and ensures compliance by providing verifiable proof of service.

There is also increased scrutiny on providers’ billing practices to improve compliance, reduce human errors, and mitigate fraud. Agencies are leveraging automation to detect fraud and error to improve the clients’ at home health care experience.

Organizations such as ACFE point to some common patterns across most compliance failures, including incorrect reporting of diagnoses, billing for services not rendered, etc. Mistakes in documentation, even if unintentional, can lead to compliance failures and revenue loss.

Let’s take a look at how this innovative technology is making healthcare safer and more reliable for everyone. In the following sections, we will explore what is home health care fraud, how to prevent it with EVV and its other benefits.

What is Home Health Care Fraud? 

Home health care fraud involves deceitful practices aimed at obtaining unauthorized benefits from insurance providers, government programs, or patients. Both health care fraud and non-compliance can have severe consequences, eroding trust and straining resources within the healthcare ecosystem.

Here are some ways it is carried out- 

• Billing for Services not Rendered

This is the most common type of health care fraud. It occurs when a healthcare provider bills for services that were never actually provided to a patient. This can be done by falsifying medical records, submitting false claims to insurance companies, or providing unnecessary or duplicative services.

• Misrepresenting Dates of Service

Healthcare providers may bills for services that were provided on a different date than what was documented . It is usually done to increase the reimbursement rate for the services or to falsely inflate the number of services provided.

• Misrepresenting Locations of Service

A healthcare provider may bill for services that were provided in a different location than the one that is documented in the patient’s medical record. It is usually done for false reimbursements for the services that were never provided.

Understanding Electronic Visit Verification (EVV) For Home Care

There are numerous ways to prevent home health care fraud with EVV. But first, let’s start with the basics—what is EVV system for home care?

What is EVV for Home Care?

EVV digitally verifies in-home care visits using methods like GPS tracking, geofencing, biometric authentication, and time tracking. It automates the process of recording patient visits, offering real-time validation that services were delivered as scheduled.

EVV software ensures the accuracy of service records by capturing essential details such as the caregiver’s identity, visit time, and location. By incorporating advanced tools like GPS and timestamps, EVV not only verifies the legitimacy of care provided but also facilitates accurate billing while ensuring compliance with regulatory standards.

Key Benefits of EVV Software:

1. Accurate Billing: With detailed and verified records, billing becomes more precise, leading to fewer errors and disputes.
   
2. Regulatory Compliance: EVV helps providers adhere to state and federal mandates, ensuring that all care documentation meets required standards.
   
3. Operational Efficiency: Automating visit tracking streamlines administrative tasks, saving time for both caregivers and management teams.
   
4. Improved Accountability: By offering real-time tracking and proof of service, EVV enhances trust and transparency between care providers, patients, and payers.
   

Implementing an EVV system not only supports compliance and billing accuracy but also strengthens the overall quality of care through increased accountability and efficiency.

How To Avoid Home Health Care Fraud With EVV?

Using an EVV system for home care is a significant leap forward in preventing fraud and promoting accountability. Unlike the outdated method of manually recording and verifying visits, EVV provides a reliable and efficient way to ensure that care is delivered as intended. It builds trust by verifying that the right actions are being taken while ensuring compliance with essential regulations.

• Addressing Billing for Services: EVV app enables attendants to collect digital signatures and notes during each visit, providing proof of service in real time.
  

• Ensuring Accurate Dates of Service: Mobile time and attendance apps, combined with plans-of-care forms, ensure accurate data logging at the time of service, reducing errors in claims submission.
  
• Enhancing Location Accuracy and Timely Care Delivery: Mobile apps can geotag activities and create alerts for scheduled events, enhancing location accuracy and ensuring timely care delivery.
  
• Easy-to-Generate Attendance Logs: Smartphone apps, Text, and IVR can generate accurate attendance logs, billing reports, and audit files, improving compliance with State and Federal requirements and preventing fraud.
  
• Reduce paper form records: EVV can help to reduce paper form usage by digitizing the process of verifying visits. This can make it more difficult for fraudsters to alter or destroy records.
  
• Increase transparency: EVV can increase transparency by providing real-time data on the delivery of care. This can make it easier for regulators and law enforcement to identify and investigate potential cases of fraud.
  
• Protect patient privacy: EVV can protect patient privacy by encrypting data and restricting access to authorized personnel. This can help to prevent fraudsters from accessing sensitive patient information.
  

Conclusion

In a healthcare landscape plagued by fraud and non-compliance, the integration of EVV has been a significant step forward. By leveraging mobile technology, organizations can prevent health care fraud, ensure compliance, and ultimately enhance patient care and trust. Staying vigilant against unethical medical billing practices is crucial for the integrity of the healthcare industry.

The best EVV system for home care is one that streamlines your unique business requirements, and helps you achieve all of these goals- GPS tracking, geofencing, and time tracking to verify that care visits are being conducted as scheduled and that the services being provided are accurate. It should also generate real-time reports and analytics that can be used to identify and investigate potential cases of fraud. Here are the things to consider while choosing EVV software.

In addition to preventing fraud, EVV app can also help organizations improve compliance with state and federal regulations. The software’s automated workflows can help to reduce the risk of human error and ensure that providers comply with the law.