Your Billing Integration Options with Agency Workforce Management

Could a typo cost you thousands of dollars? When it comes to Medicaid audits, yes. If your organization manually enters data into a billing system, it is not only wasting time but also making itself vulnerable to costly errors.

But data entry is not the only option. Billing integration software ensures billing accuracy and speeds up the billing process by importing time and attendance records directly to your billing software. The software automates calculations, tracks state requirements, and gives your billing system all the information it needs for compliance. It also lets you off the hook for hours of data entry.

Integrate with Your Billing Software

Providers have significantly more options to manage payroll and billing with Agency Workforce Management than with any other software vendor. Agency Workforce Management provides revenue cycle management for many billing systems, including:

  • Amber Clinic
  • Annkissam
  • EZClaim
  • Fund E-Z
  • HSys
  • Millin
  • OnTarget
  • PrecisionCare

Direct exports are also available to a number of state systems and EVV data aggregators.

Additionally, Agency Workforce Management can import data from EHR providers such as Therap and Foothold to reconcile billing with time and attendance. This works with attendance records from Agency Workforce Management or records imported from any other time and attendance system such as ADP or Kronos.


Don’t Forget About Payroll Integration

Which payroll service do you use? No matter what it is, it will integrate with our software. Agency Workforce Management can speak to any existing payroll system, period. This means that the same advantages of billing integration – like time savings and error avoidance – can apply to your payroll process, too.

Who Approves Alternative EVV Systems?

Providers who supposedly have the freedom to choose alternative EVV vendors over state systems are starting to wonder whether the process is actually feasible.

Some states have chosen a “hybrid” implementation model, in which providers may use the free state-contracted system or another system that meets requirements. This solution serves to mollify providers who are unhappy with the state system, but some of those providers find it nearly impossible to get an alternative system approved.

Ohio EVV UpdatesOhio, for example, has a contract with Sandata to provide a state-wide EVV solution beginning January 2018. The state claims providers can use their own vendor instead of Sandata. However, providers who start that process are connected with a Sandata representative. The state offers an “EVV Provider Hotline” which directs to Sandata. Emails to receive replies from Sandata. In other words, Sandata has the ultimate power to approve or deny competing vendors.

Texas EVV UpdatesThe situation in Texas is similar. DataLogic Vesta, which operates the statewide system, must approve any alternative EVV system that providers want to use. Will DataLogic Vesta’s profits suffer if it approves alternative vendors? If so, will the company let any other vendor take away its customers without an extremely burdensome process?

Lack of Clarity in Some States

Many other states do not clarify which organization or agency approves alternative vendors. In Louisiana, Florida, Indiana, and Nebraska, alternative EVV systems must integrate with the statewide system. It is not yet clear how straightforward the integration requirements are.

Colorado EVV UpdatesThe difficulty in predicting problems providers might face is that each state implements EVV in a different way, even if it uses the same vendor as another state. Colorado, like Ohio, has a contract with Sandata for a statewide EVV system, but that doesn’t necessarily mean the situation is identical. Colorado says providers are free to use any EVV system they choose, as long as it meets federal guidelines and is capable of communicating with Sandata through a data aggregator. The state does not specify whether Sandata needs to approve the alternate system.

Good Examples of Provider Choice

Virginia EVV UpdatesA few states appear to have a relatively easy approval process. Virginia declared that “Virginia Medicaid does not and will not approve EVV vendor systems…it is the responsibility of the provider to ensure that it meets Virginia Medicaid’s requirements.”

Missouri EVV UpdatesMissouri says it will obtain “a vendor neutral aggregator system to compile all data” from providers’ various EVV systems. The aggregator system “will allow the state to maintain quality oversight while providing flexibility in vendor selection.”

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Has your organization chosen to use an alternative vendor? What was your experience? Let us know in the comments!

Louisiana Providers Shoulder Unnecessary Costs

Louisiana providers are struggling with the costs of the state’s EVV requirement. Although the 21st Century Cures Act allows telephony to verify visits, Louisiana declared that providers must use mobile devices with GPS functionality. And, whether they use the state system or an alternative one, providers must bear the cost of the technology themselves.

Some providers, especially those with many employees, expressed apprehension about the massive cost of the mobile devices. On March 23, 2018, the Department of Health answered these concerns saying: “The state is providing the EVV system free of charge to providers. It is set up to be accessed from a device with internet access (smart phone, tablet, or computer). A provider agency who decides to provide the device for login should consider getting one device per participant, not per DSW.”

The state has not taken any further steps on the matter. Providers that do not spend what is necessary to comply with the EVV mandate may receive Medicaid reimbursements.

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Do you think states should ban telephony for EVV? Should providers bear the cost of the mobile devices or should they ask employees to use their own?

The True Cost of State-Mandated Systems

As organizations and associations debate the various EVV implementation models, provider choice is strongly preferred across the board by providers who don’t want to get stuck with a limited and out-dated state system. Nevertheless, some states procure a state-mandated system without allowing alternative vendors. The only benefit for agencies in this model is that the system is free. But as it turns out, even that isn’t quite true.

State-mandated systems carry many hidden costs. The top three, according to agency feedback, are devices, inefficiency, and redundancy.

The Cost of Devices

Louisiana EVV UpdatesSome states choose to put the cost of devices on the provider. Louisiana providers have no choice but to use the statewide system, which itself is free but requires mobile devices to function. Providers must bear the cost of the mobile devices themselves. And not just the devices, but also the data plans to operate them.

To manage this requirement, some providers use a BYOD (bring your own device) policy. However, a Louisiana provider told MITC: “We are losing seasoned staff who are very good at their jobs because they cannot afford the device and data plan required. Instead of being able to focus on the service provided they feel overwhelmed.”

The Cost of Inefficiency

According to reports from providers, most of the state-mandated systems are inefficient. They rarely have strong reporting capabilities, lack payroll integration, comprehensive training, or even documentation capture. They don’t integrate with other workforce management tools like scheduling software. These shortcomings raise the likelihood of errors like under- or over-billing.

The Cost of Redundancy

A lot of providers manage multiple programs – some are required to use EVV and others are not. When providers have a state-mandated system for some of its programs, they must use another system for their other programs. This causes an immense load of redundant data entry. Payroll, in particular, is a nightmare!

Most providers prefer to use the same software vendor across all programs. When states allow providers to choose an EVV vendor, they can often use their existing software or find something that works for the entire agency. But when states mandate a vendor, a lot of providers are stuck using two systems. As a result, they have to pay more overtime or hire people to complete all the extra work.

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If your organization uses a state-mandated system, tell us your experiences! Do you have to provide mobile devices and data plans? What other hidden costs have you encountered?

Nevada Yet to Decide Whether Providers Can Continue Using Current EVV Systems

Nevada announced it will mandate a single system for all Nevada providers. However, the state has not decided whether providers who currently use EVV systems may continue to use them instead of the statewide system.

Nevada Medicaid says providers will be able to use the state’s system free of charge. However, many state-mandated systems incur unforeseen expenses upon providers.

The RFP opened to EVV vendors on May 30, 2018. The anticipated contract start date is August 14, 2018.

Virginia Announces Provider Choice Model

Virginia has not finalized its EVV requirements, but it has announced that all providers must choose and implement an EVV system that works for them by January 1, 2019. The chosen system must comply with Virginia Medicaid’s reporting requirements:

  • The system must verify the attendant onsite with GPS or caller-ID
  • The system must maintain records for 6 years

Virginia Medicaid will have several system edits/audits (as detailed in the FAQ):

  • Standard edit processes such as member and provider eligibility
  • Verifying the claim or encounter is supported by and consistent with EVV data
  • Verifying the claim is supported by and consistent with a service authorization
  • Pricing the claim using the appropriate rate for the procedure code submitted
  • Checking for duplicate or overlapping service

Providers will have 60-90 days after the implementation deadline to test and refine the solution.

Why Provider Choice is the Best Choice

So far, the provider choice model (or the open vendor model) is the most successful EVV implementation model country wide. It allows providers to choose the EVV system that best meets their needs and it is minimally disruptive. For the many providers who manage programs that do not require EVV as well as programs that do, the provider choice model enables them to use the same workforce management software across all programs.

However, a few states continue to opt for state-mandated systems. Louisiana, for instance, implemented this model twice only to fail both times. Louisiana finally came around to the reality that every provider has different needs, but not without causing huge disruptions during those first two implementation attempts.

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What are your thoughts on the provider choice/open vendor models? Do you agree that provider choice is the best choice?

North Dakota Wraps Up Stakeholder Meetings

North Dakota held three public meetings for providers to submit input on the upcoming EVV implementation. The last meeting occurred June 5, 2018 – the state has not made any announcements since then.

In February 2017, North Dakota solicited information from potential EVV contract bidders. CMS indicated that North Dakota has chosen the open vendor model, but this information is not confirmed on the state’s websites.

Texas Temporarily Drops EVV Compliance Level

Due to the recent shakeup when Texas chose not to renew its contract with one of the two statewide EVV vendors, the state has temporarily dropped its EVV compliance level. Texas had a 90-percent minimum EVV Compliance Plan score for providers, but has decreased the requirement to 75-percent while providers are transitioning.

DHS states: “Effective June 1, 2018, all provider visits between March 1, 2018 and Nov. 30, 2018 must meet the minimum EVV Compliance Plan Score of 75-percent. The 90-percent minimum EVV Compliance Plan score will resume beginning with visits on Dec. 1, 2018.”

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Texas providers: Has the transition to one vendor affected your agency operations?

Time Theft: An Agency’s Secret Payroll Expense

When most people hear about company theft, they picture an employee smuggling monitors home or padding expense reports. Most people do not think about the often subtle act of time theft. Perpetrators may consider it a harmless way to maximize time off the clock, but it can severely hurt an organization in the long run.

What is Time Theft?

An employee commits time theft by accepting pay for time not worked. They can do this either by working the payroll rounding rules or by fudging timesheets. For example, if Elise is paid in 15-minute increments, she could clock in 7 minutes late and clock out 7 minutes early without receiving a penalty. Employees who fill out paper timesheets have even more opportunities to record false hours.

A little stolen time, which is not a big deal, turns into a big deal over time. If Elise continues her habit of stealing 7 minutes on both ends of the day for 5 days, she will have over an hour of stolen time. In the course of a year (assuming she works 5 days a week), that adds up to about 60 hours. With a $15/hour pay rate, the total value of her stolen time will hit approximately $900. If Elise is not the only employee to do this – if perhaps 30 employees do the same thing – the stolen time value skyrockets to $27,000.

Wondering if you need to worry about time theft in your organization? Well, time theft is more widespread than you may think. The American Society of Employers estimates 20% of every dollar earned by a US company is lost to employee time theft. Furthermore, the American Payroll Association says 75% of companies lose money from buddy punching, the most widespread form of time theft.

Factors that Encourage Time Theft

Agencies can inadvertently encourage time theft in several ways. These three factors are not the only causes of time theft, but they are the most prevalent.

Paper timesheets

Paper timesheets provide no security. It is incredibly easy for employees to write fraudulent times. Even if they do not intentionally steal time, they may not realize how much they round and how quickly it adds up.

Poor employee engagement

Unengaged employees are not interested in their work or the good of the company. If presented with the opportunity to work less without suffering wage loss, their disinterest in the company may fuel their temptation to take the opportunity.

Poor scheduling 

If an employee is overworked, has too little time between shifts to take a proper break, or is scheduled when unavailable, the employee is more likely to show up late for work or take extended breaks. This type of time theft is not always malicious – overtired employees may just have a hard time staying on schedule.

How to Prevent Time Theft

If you realize that your agency enables time theft, you can take several simple steps to reverse the error.


Biometric devices, such as fingerprint readers, eliminate all kinds of fraud. Buddy punching is impossible,  unless someone has detachable fingers, and so is lying since biometrics record the exact punch time. Fingerprint readers can also operate without an internet connection, so employees cannot make excuses about poor connectivity for missing an attendance record.

Management alerts

Automated alerts help managers detect time theft at the earliest signs. An effective time and attendance solution will notify managers when an employee clocks in late, clocks out early, or takes too long of a break. Since a few of these instances are permissible, an effective solution will also run reports on attendance records over time so managers can see whether certain employees have more offenses than others.

Engagement efforts

Re-engaging disinterested employees will do wonders for time and attendance compliance. If you suspect time theft in your agency, provide contexts to evaluate employee engagement. Maybe your employees don’t understand the larger purpose of their work, so they are looking for ways to get out early. Or maybe they don’t have enough paid time off, so they feel burnt out. The results of an employee engagement survey might reveal the underlying reasons for time theft at your agency.

Effective scheduling


A scheduling solution should have more functionality than pen and paper. It should filter available employees by availability, preferences, and hours so managers don’t overload one person while another begs for more work. Good scheduling software will also ensure employees have enough break time between shifts and sufficient travel time between locations.


Time theft is a nearly-invisible cost on your agency’s payroll that can hinder organizational growth and employee morale. But solutions do exist to help your agency spot time theft and stop it at the source. A productivity increase of 20% is worth the effort!