Please note the following information is not Payer specific.
Q: Why can’t I find a visit in Aggregator?
A: In the ‘Filter Visits By’ dropdown, select ‘All Visits’, with appropriate date range. The results include all visit statuses.
- Confirm the vendor sent the visit with the In/Out date/time in UTC format. The date/time will be converted according to the location of the visit.
- If the visit was not sent with UTC date/time format, a visit update is needed.
- If a visit update was sent, and the In date was changed, the Visit Date remains the value of the originally received In date. Therefore, change the date range searching.
- The claim must be sent with the same Visit date as is in Aggregator.
Q: Why didn’t my Aggregator visit update?
A: The update visit file was rejected.
- All visit updates require the VisitChanges segment.
- Please work with the vendor to check the GET status response and send a corrected file.
Q: Why does my Aggregator visit have an Incomplete status?
A: An Incomplete status indicates there is an exception. On the front display view, there is a dot in the field with the issue.
- A red dot indicates the error must be fixed, with a visit update.
- An orange dot indicates the error can be acknowledged, with a visit update including the appropriate ExceptionAcknowledgement segment.
- Hover over the dot to see the exception, or click anywhere on the visit line to open the Visit Details, and click the Exception tab.
- Work with the vendor to send the appropriate visit update.
Q: Why does my Aggregator visit have an Unauthorized Service exception, but the visit file wasn’t rejected?
A: For specific programs, the client is required to have an authorization, specific to service fields combination, in the specifications/addendum Services appendix. The Aggregator exception will occur when the client is not authorized for the specific service fields combination in the visit.
- The service combination includes the PayerID / PayerProgram / ProcedureCode / Modifier(s) if applies.
- All services and modifiers are case sensitive and must use capital letters.
- Send a visit update, with the specific service fields combination, the client is authorized for.
- Dependent on the program, send an updated client file with the appropriate authorization, or contact the state for the authorization to be sent to Sandata.
- After the authorization has been loaded, send a visit update.
Q: Why does my Aggregator visit have a Short Visit exception?
A: This exception only applies when scheduling is included in the program and occurs when the total duration of the visit is less than the scheduled length of the time expected for the visit.
- ExceptionID 20 must be acknowledged.
- Send a visit update.
Q: Why does my Aggregator visit have a Late In Call exception?
A: This exception only applies when scheduling is included in the program and occurs when the Call In time is later than the Scheduled Start time.
- ExceptionID 18 must be acknowledged.
- Send a visit update.
Q: Why does my Aggregator visit have a Client Verification exception, but the visit file wasn’t rejected?
A: Dependent on the program, the ClientVerifiedTimes, ClientVerifiedTasks, ClientVerifiedService, ClientSignatureAvailable, and ClientVoiceRecording, might be optional segments. Therefore, if they were not received, it will not result in a rejected visit file.
- However, if the program requires, when the field is not sent, sent as null, or sent as false, the appropriate exception must be acknowledged.
- Send a visit update, with the appropriate visit ExceptionAcknowlegement according to the Exceptions appendix.
Q: Why does my Aggregator visit have a Missing Task exception?
A: Specific programs require Tasks, which must be sent in the visits “Tasks” segment.
- Confirm the visit was sent with the “Tasks” segment.
- Confirm the TaskID matches the specifications/addendum Tasks appendix.
- Review appendices to ensure correct codes used. The appendix might include specific ID for a specific ProcedureCode.
- Send visit update.
Q: Why was my claim denied as EVV Visit Not Found?
A: The claim details must match the Aggregator visit details and visit must be in Verified status.
- Review visits in Aggregator for accuracy.
- If the visit is not in Verified status, review the exception and send a visit update, correcting appropriate value or acknowledging the appropriate exception.
- If the visit is in Verified status, but the visit details do not match the claim details, either the claim must be changed or the visit must be updated.
- After the visit is updated, and in Verified status, the claim can be resent.
Q: Why was my claim denied as Units do not match?
A: The claim details must match the Aggregator visit details and visit must be in Verified status.
- Review the visit in Aggregator, to confirm the units match the units claimed.
- If the Aggregator visit has incorrect units, confirm the In and Out times are correct.
- Update the visit or claim accordingly.
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