12/18/2025
This communication is directed to both Electronic Visit Verification (EVV) Vendors and Provider Agencies required to participate in EVV for the services they provide to Banner Medicaid Members.
This communication contains important reminders regarding compliance with EVV that require action on behalf of provider agencies and EVV vendors. Compliance with these requirements is being monitored by AHCCCS and the MCOs. Provider agencies and EVV vendors can expect to receive communication in the coming weeks if data demonstrates potential non-compliance with requirements.
Information for Provider Agencies
Live in Caregiver
- The data must be sent for all live-in caregiver relationships that were active beginning 10/01/25. Thereafter, the data must be sent within 30 days of a change (i.e. a start or end to a relationship).
- If your EVV system does not yet have this functionality, they are jeopardizing your compliance with EVV. The live in caregiver data requirements are specifically outlined in the AHCCCS Medical Policy Manual, 1240-A.
- To be considered compliant, you must 1) enter this information into your EVV system and 2) only use the “other” category to define a relationship between the member and the caregiver as a last resort. You are not compliant with the requirements if you are using the “other” category as the rule versus the exception.
- The live-in caregiver requirements is in the process of being incorporated into the quality monitoring performed by the MCOs on an annual basis.
- Other information on the live in caregiver XREF may be found in the EVV 2.0 FAQ.
Unverified and Unpaid Visits
You need to check to see if you have any visits, prior to 10/01, that are not in a verified/processed state. Visits in an approved/incomplete status, are not payable. In order to get paid for those visits, these visits will need to be addressed.
- If you didn’t switch EVV vendors, you just need to address visits the way you always have to get them to a verified state.
- If you did switch EVV vendors, you may need to enter a manual visit for any visits that occurred before 10/01 that are not in a verified/processed state. When entering in a manual visit, you need to follow the documentation standards in the Visit Maintenance and Documentation FAQ. Please follow up with your EVV vendors to learn about how to enter a manual visit.
You can use the “Visit Listing” Aggregator report to identify visits that are not in a verified state (visits in approved or incomplete status). Details on the reports can be found in the EVV Aggregator Provider User Manual.
The following are ways that you can help us better support you.
- Please try and submit a ticket to the HelpDesk for one issue. If multiple issues are being reported on one ticket, it can make it difficult to assign the ticket for review and resolution especially when each issue requires a different SME’s attention.
- Make sure you are submitting a ticket to the right HelpDesk.
- The EVV Service Now Registration Manual outlines which helpdesk to use depending upon your step in the registration process to gain access to the aggregator. Once you have access to the aggregator and have issues or questions related to the actual use of the aggregator, you should use the AHCCCS Solutions Center Helpdesk. Please refer to the AHCCCS Solutions Center User Manual for instructions on how to access, submit and monitor support tickets.
Information for EVV Vendors
Duplicate Visits
EVV vendors must follow the following directions to mitigate the receipt of duplicate visits by the AHCCCS Aggregator. If duplicate visits are present, this will disrupt the claims validation process and jeopardize provider payments.
- When updating a visit, send all the required visit data including the data that is being updated for the same visit other ID. Do not just send the updated information.
AHCCCS already has a temporary fix in place to mark visits previously sent with the same VisitOtherID in “omit” status and maintaining the most recent update.
- Only send back updated records that previously had errors. Do not send all the records in the payload, only those with errors.
AHCCCS already has a permanent fix in place to allow the acceptance of records without errors from the payload.
- Do not send multiple transmissions for the same visit with different VisitOtherIds.
AHCCCS is working on a temporary fix to keep the latest record in verified status and mark the others as “omit” status to mitigate claims payment issues for providers.
- Do not send visit data for visits that were in verified status prior to 10/01/25 with another vendor.
AHCCCS is working on a temporary fix to mark these visits as “omit” status.
Live in Caregiver Compliance
- The XREF must be sent for all live-in caregiver relationships that were active beginning 10/01/25. Thereafter, the XREF must be sent within 30 days of a change (i.e. a start or end to a relationship).
- If your EVV system does not yet have this functionality, you are jeopardizing the compliance of your contracted providers.
- Please help your providers comply with the requirements by reminding them that they should 1) enter this information into your EVV system and 2) only use the “other” category to define the relationship between the member and the caregiver as a last resort. Providers are not compliant with the requirements if they are using the “other” category as the rule versus the exception.
- Other information on the live in caregiver XREF may be found in the EVV 2.0 FAQ.
Outstanding Unpaid Visits
There are still a number of providers who have unresolved visits (visits not in a verified/processed status) prior to the 10/01 transition. The historical data is available in the aggregator and providers can utilize the aggregator look up functions and reports to identify those visits. Without resolution, those visits will not pass EVV claims validation and will not be payable.
Communication has gone out directed to providers to highlight this issue and provide guidance on how they can identify these visits. They will, however, need direction from their EVV vendors on how to either resolve the visit or how to enter a manual visit in the event they were using a different EVV vendor prior to 10/01 than they use now.
The EVV 2.0 FAQ has information on how to address these outstanding visits.
Visits that require manual entry must comply with the documentation standards outlined in the Visit Maintenance and Documentation FAQ.
The following are ways that you can help us better support you.
- Please try and submit a ticket to the HelpDesk for one issue. If multiple issues are being reported on one ticket, it can make it difficult to assign the ticket for review and resolution especially when each issue requires a different SME’s attention.
- All EVV vendor inquiries and questions should be directed to the AHCCCS Solutions Center Helpdesk. Please refer to the AHCCCS Solutions Center User Manual for instructions on how to access, submit and monitor support tickets.