HHAeXchange EVV - General FAQs

See below for a list of general HHAeXchange Electronic Visit Verification (EVV) Frequently Asked Questions (FAQs):

1. I am getting an error: "There is no active contract for this visit" on sending visits to HHAeXchange.
2. I am getting an error: "Patient not found in HHAeXchange" on sending client/visit data.
3. I set up a new insurance account which bills through HHAeXchange. Billing is not submitting to the HHAeXchange. 
4. I am getting the following error code 398 on sending visits to HHAeXchange: "Payer is not configured for EDI Billing Rates. Please contact EDI Support to configure payer for EDI."
5. I am getting an error: "Visit cannot be greater than 25 hours."
6. I am getting an error: "Member is not found based on Qualifier value" on sending visits to HHAeXchange.
7. I am getting an error: "_root_ - Missing required fields: ['VisitEndTime', 'VisitStartTime']."
8. How do I view failed EVV exports to see what the failure/rejection is for?
9. I am getting the following pre-validation errors for certain visits on sending the EVV data: "root - None - VisitEditReasonCode is required if VisitStartTime doesn't match" or "root - None - VisitEditActionTaken is required if VisitStartTime and EVVStartTime doesn't match".

General FAQs:

Pre-Validation versus Post-Validation Errors

There are two types of errors you will notice when you download the Visit_Responses.csv file within the EVV (Electronic Visit Verification) export folder:

1. Pre-Validation Error
2. Post-Validation Error

Pre-validation errors are internal errors generated by AlayaCare to account for errors that may be potentially flagged by the aggregator. Pre-validation errors do not have an error code associated with them in the visit responses file.

Example of a pre-validation error: No error code

Post-validation errors are the errors that come directly from HHAeXchange and have an error code. These are errors that are received back in response to the export file that has been sent from AlayaCare.

Example of a post-validation error: Error code present

1. I am getting an error: "There is no active contract for this visit" on sending visits to HHAeXchange.

Typically, this error means that the Start of Care date in HHAeXchange is later than the visit date we are trying to send from AlayaCare or the client is discharged. Verify that the payer associated with the visit is correct.

You need to contact the payor/MCO to identify the reason for this error. If the error is because of the Start of Care date, then that can be updated from your side within HHAeXchange to ensure that the visits are covered within that period and have the proper authorization.

If the error is occurring due to the client's status, then that would need to be updated by the payer in the aggregator portal, i.e., HHAeXchange, as your agency will not be able to update that information.

2. I am getting an error: "Patient not found in HHAeXchange" on sending client/visit data.

Usually, this post-validation error means that the Member ID added under Client Demographics for these clients in AlayaCare is different from what is available in HHAeXchange or the member/client is not active in HHAeXchange or some other unknown error that needs to be validated by HHAeXchange.

Please validate the Member ID, Date of Birth and Prior Authorization numbers on the Client's Services within AlayaCare to ensure that what you have in AlayaCare matches with what is available in HHAeXchange. If there is a mismatch, you can correct that information in AlayaCare and resent the EVV exports associated with those visits.

If it still does not resolve the issue, we suggest you raise a ticket with HHAeXchange with the details of the clients and visits in question. It is important to note that HHAeXchange may need you to contact the MCO and advise that the Member's placement and authorizations be sent to HHAeXchange. Once the member is loaded into HHAeXchange, you can resubmit the EVV exports from AlayaCare.

Please be advised that only the Medicaid ID should be entered within the Member ID field available within AlayaCare. If a different identifier like an Admission ID is entered within Member ID, it will continue to show the above error.

3. I set up a new insurance account which bills through HHAeXChange. Billing is not submitting to the HHAeXchange. 

This could happen if the EVV (Electronic Visit Verification) Destination System is set as 'None'. Please update the EVV Destination System to HHAeXchange and select the appropriate value in the EVV Destination State.

Also enter the Payer ID and ensure that other fields like Provider Tax ID, Payor Code, Payor Name, Payor electronic transmitter identifier and Provider code are filled out within the payor profile and click 'Save' to complete the payor configuration.

Once this is completed, kindly void the claims you had previously generated for this payor, and this should generate EVV exports for the data to be sent out to HHAeXchange.

4. I am getting the following error code 398 on sending visits to HHAeXchange: "Payer is not configured for EDI Billing Rates. Please contact EDI Support to configure payer for EDI."

Typically, this error code means that a configuration update is required if EDI rates are submitted. The EDI flag is not engaged from HHAeXchange side. Please reach out to HHAeXchange, as they will need to activate the v5 integration from their side to receive the EVV data for this payor.

Please also check to make sure that the Payer ID in AlayaCare matches with the one that is configured on the back end within HHAeXchange.

5. I am getting an error: "Visit cannot be greater than 25 hours."

This error suggests that when the visit was sent from AlayaCare to HHAeXchange as part of the EVV (Electronic Visit Verification) export, the total visit duration was greater than 24 hours.

Please refer to this Zendesk article that walks through the process of adjusting the start and end times on the visit, so that the total duration is under 24 hours.

6. I am getting an error: "Member is not found based on Qualifier value" on sending visits to HHAeXchange.

This error suggests that Medicaid number is either not present within AlayaCare or matches with the information available in HHAeXchange.

To remove this error, make sure that the 'Member ID' available in HHAeXchange is the same value as the 'Member ID' added in client demographics within AlayaCare.

The other information to validate is the First Name and the Last Name of the client record in AlayaCare to ensure it matches the record available in HHAeXchange.

Once this is completed, you can resend the exports from AlayaCare.

7. I am getting an error: "_root_ - Missing required fields: ['VisitEndTime', 'VisitStartTime']."

This pre-validation error means that visits are missing Star and End Times within AlayaCare. Please review these visits and make the necessary corrections.

Please refer to this Zendesk article that walks through the process of adjusting the start and end times on the visit.

Once the start and end times of the visit are adjusted, you can save the visit and resend the EVV (Electronic Visit Verification) export(s) to remove this error.

8. How do I view failed EVV exports to see what the failure/rejection is for?

To review the visits contained within the EVV exports, you will need to follow the below mentioned steps:

1. Navigate to Accounting > Billing > Electronic Billing Summary v2 > EVV Export tab.
2. Click the Download button on an export in a 'Failure' status. This will download a zip file.
3. Open the zip file and you will see a folder for the EVV export along with the ID.
4. On clicking the folder, you will see one or more EVV export files with the format '20230526...', where the date indicates the last time the EVV export was sent from the AlayaCare side.
5. On opening the EVV export file, you will see a file named 'Visit_Responses.csv'. Open this file and you will see the visits that show the success (column D) as "TRUE" are the ones that were sent properly from the AlayaCare side without any error.

The visits that failed will show the success (column D) within the Visit_Responses file as "FALSE", and they will also have an error message in the error description (column O).

We recommend these failed EVV exports be reviewed daily to catch and fix the incorrect data.

9. I am getting the following pre-validation errors for certain visits on sending the EVV data: "root - None - VisitEditReasonCode is required if VisitStartTime doesn't match" or "root - None - VisitEditActionTaken is required if VisitStartTime and EVVStartTime doesn't match".

For any visits when you run into these pre-validation errors, you need to follow the below mentioned steps:

1. Search the visit in the visit verification under "approved and rejected".
2. Unapprove the visit.
3. Run visit verification for the specific time frame / client.
4. Find the visit in violation using the visit ID, then fill in the appropriate reasons and resolutions, then approve the visit.
5. Once this process is complete for all visits on the exports, you can resent the export.

Notes:

• You can troubleshoot the issues explored in this article in your staging environment.
• If the issue is not resolved after going through the steps in this article, please search through other related Zendesk articles or have your super user submit a Zendesk ticket.
• For a full list of FAQs related to Electronic Visit Verification (EVV), check out this section in Zendesk.