EVV Vendor Solution FAQ – Call Times vs Adjusted Times

Please note the following information is not Payer specific.

Call Times vs Adjusted Times Logic (all states)

• The Calls segment is to represent how the visit originally captured In/Out times, whether via a device or manually. Therefore, it should not be changed.
• Each visit first instance is expected to contain both Calls In and Out, with all appropriate additional fields.
• The Adjusted times should only be used to correct/change previous Call times. The Adjusted times represent the actual visit time(s).
• When a In and/or Out time is corrected in a visit update, the Calls segment is optional, being that the corrected time(s) should only be in the appropriate Adjusted time field(s).
• Adjusted times are treated as manual entries and therefore require the VisitChanges segment. Adjusted times supersede Call times.
• When both Call times and Adjusted times are included, both are used to ensure the actual In time is always before the actual Out time.

BillVisit Logic (all states):

• If BillVisit as false would be sent on the visit first instance, this record is not needed.
• Each visit first instance is expected to have BillVisit as true. If it is later determined the visit is not billable, a visit update must be sent, with BillVisit as false. The visit will be set to Omit status (omit from billing).

VisitChanges segment is required when (all states): 

• CallType is Manual, Adjusted time(s) exist, all visit updates.

Calls Segment Fields Specific to CallType Logic (all states):

• CallType Manual and Other should not include below listed fields. If the below fields are included, they should be sent with null.
• CallType Mobile requires: CallLatitude, CallLongitude, MobileLogin
• CallType Telephony requires: TelephonyPIN, OriginatingPhoneNumber

Calls vs Adjusted scenarios…

#1 – Calls were captured correctly during the visit. This is expected to be the higher percentage of visits.

"AdjInDateTime":null,

"AdjOutDateTime":null,

"CallType": should be however originally captured

"CallDateTime":"2023-02-05T09:00:00Z",

"CallAssignment":"Time In",

"CallDateTime":"2023-02-05T10:00:00Z",

"CallAssignment":"Time Out", 

#2 – Calls were captured during the visit, but the caregiver logged in late and logged out early.

"AdjInDateTime":”2023-02-05T09:00:00Z",

"AdjOutDateTime":”2023-02-05T10:00:00Z",

"CallType": should be however originally captured

"CallDateTime":"2023-02-05T09:10:00Z",

"CallAssignment":"Time In",

"CallDateTime":"2023-02-05T09:50:00Z",

"CallAssignment":"Time Out", 

#3 – Calls were captured before the visit took place. This is inappropriate. Below will result in error ‘Call Out cannot be less than Adjusted In’ or ‘Call Out must be greater than Adjusted In’.

If the visit was first sent with only Calls, it cannot be updated with Adjusted times. Rather, the visit must be updated with BillVisit as false. Then send a new visit, with new/unique VisitOtherID, and actual times as Calls In and Out with CallType Manual.

"AdjInDateTime":”2023-02-05T09:00:00Z",

"AdjOutDateTime":”2023-02-05T10:00:00Z",

"CallType": should be however originally captured

"CallDateTime":"2023-02-05T08:30:00Z",

"CallAssignment":"Time In",

"CallDateTime":"2023-02-05T08:45:00Z",

"CallAssignment":"Time Out", 

#4 – Calls were captured after the visit took place. This is inappropriate. Below will result in error ‘Call In cannot be greater than Adjusted Out’ or ‘Adjusted Out must be greater than Call In’.

If the visit was first sent with only Calls, it cannot be updated with Adjusted times. Rather, the visit must be updated with BillVisit as false. Then send a new visit, with new/unique VisitOtherID, and Calls In and Out with CallType Manual.

"AdjInDateTime":”2023-02-05T09:00:00Z",

"AdjOutDateTime":”2023-02-05T10:00:00Z",

"CallType": should be however originally captured

"CallDateTime":"2023-02-05T10:30:00Z",

"CallAssignment":"Time In",

"CallDateTime":"2023-02-05T10:45:00Z",

"CallAssignment":"Time Out", 

The below grid is included in all user guides, whether included in the specifications/addendum, or a separate document. Other possible scenarios will be accepted or rejected, based on the below grid.

Call In	Call Out	Adjusted In	Adjusted Out	Rule
x	x			Call Out must be > Call In, Otherwise record rejected.
Superseeded by Adj. In	Superseeded by Adj, Out	x	x	Adj Out must be > Adj. In, Otherwise record rejected.
x	Superseeded by Adj, Out		x	Adj. Out must be > Call In, Otherwise record rejected.
Superseeded by Adj. In	x	x		Call Out must be > Adj. In, Otherwise record rejected.