news banner

News

New Electronic Visit Verification Provider Data Validation Process

April 4, 2019

Effective April 1, 2019, the Texas Health and Human Services Commission (HHSC) is implementing an Electronic Visit Verification (EVV) provider data validation process for all contracted providers required to use EVV. This will improve data quality by standardizing EVV data within the Vesta® EVV system, which will help reduce data element errors on visits.

The Vesta® EVV system will be updated to accept certain contracted provider data from the Texas Medicaid & Healthcare Partnership (TMHP). TMHP is the Texas Medicaid claims administrator and is responsible for managing this data validation process. TMHP is also responsible for building and managing the upcoming EVV Aggregator, the EVV claims matching process, and the EVV Portal, which is scheduled for implementation around September 2019.

On or after April 1, 2019:

  • New contracted providers: will be required to enter the National Provider Identifier (NPI)/Atypical Provider Identifier (API) number associated with that payer into the Vesta® system. The Vesta® EVV system will transmit the NPI/API to TMHP, who will validate and return the following provider data to the Vesta® EVV system:

o Texas Provider Identifier (TPI)

o Taxpayer Identification Number (TIN)

o Taxonomy

o Contract Number

o Legal Name

o Address

o City

o State

o Zip Code

  • Existing contracted providers: All National Provider Identifiers (NPI)/Atypical Provider Identifiers (API) currently in the Vesta® EVV system will be validated with Texas Medicaid data at TMHP and the following data will be available in the Vesta® EVV system for confirmation by the provider:

o Texas Provider Identifier (TPI)

o Taxpayer Identification Number (TIN)

o Taxonomy

o Contract Number

o Legal Name

o Address

o City

o State

o Zip Code

If there is a discrepancy or no match, the contracted provider will be alerted to the discrepancy.

Important: Contracted providers should ensure the information is correct before confirming acceptance into the Vesta® EVV system. Contracted providers enrolled with TMHP can update their demographic information, contact information, and addresses using the Provider Information Management System (PIMS) or by fax or mail using the Provider Information Change Form. Contracted providers not enrolled with TMHP should contact their HHSC contract manager or their Managed Care Organization (MCO) to correct inconsistencies.

For questions regarding this alert, please contact HHSC EVV Operations.