Form preview

Get the free Electronic Visit Verification

Get Form
Electronic Visit Verification Provider Compliance Plan This applies to STAR+PLUS, UnitedHealthcareConnected (Medicare Medicaid Plan), and STAR KIDS (STAR KIDS effective 11/1/2016). The following services
We are not affiliated with any brand or entity on this form

Get, Create, Make and Sign electronic visit verification

Edit
Edit your electronic visit verification form online
Type text, complete fillable fields, insert images, highlight or blackout data for discretion, add comments, and more.
Add
Add your legally-binding signature
Draw or type your signature, upload a signature image, or capture it with your digital camera.
Share
Share your form instantly
Email, fax, or share your electronic visit verification form via URL. You can also download, print, or export forms to your preferred cloud storage service.

How to edit electronic visit verification online

9.5
Ease of Setup
pdfFiller User Ratings on G2
9.0
Ease of Use
pdfFiller User Ratings on G2
To use the services of a skilled PDF editor, follow these steps:
1
Log in. Click Start Free Trial and create a profile if necessary.
2
Simply add a document. Select Add New from your Dashboard and import a file into the system by uploading it from your device or importing it via the cloud, online, or internal mail. Then click Begin editing.
3
Edit electronic visit verification. Rearrange and rotate pages, insert new and alter existing texts, add new objects, and take advantage of other helpful tools. Click Done to apply changes and return to your Dashboard. Go to the Documents tab to access merging, splitting, locking, or unlocking functions.
4
Save your file. Choose it from the list of records. Then, shift the pointer to the right toolbar and select one of the several exporting methods: save it in multiple formats, download it as a PDF, email it, or save it to the cloud.
pdfFiller makes dealing with documents a breeze. Create an account to find out!

Uncompromising security for your PDF editing and eSignature needs

Your private information is safe with pdfFiller. We employ end-to-end encryption, secure cloud storage, and advanced access control to protect your documents and maintain regulatory compliance.
GDPR
AICPA SOC 2
PCI
HIPAA
CCPA
FDA

How to fill out electronic visit verification

Illustration

How to fill out electronic visit verification:

01
Gather necessary information: Before filling out the electronic visit verification, make sure you have all the required information at hand. This may include the date and time of the visit, the client or patient's name, the service provided, and any additional details required for documentation.
02
Access the electronic platform: Depending on the system being used, access the electronic platform or software designated for electronic visit verification. This may be a mobile app, a website, or a specific software program. Ensure you have the necessary login credentials to access the system.
03
Enter visit details: Once logged in, locate the section or form for entering visit details. This may be labeled as "Enter Visit Information" or something similar. Follow the prompts and provide accurate information about the visit. This may include the start and end time of the visit, the tasks performed, any specific milestones or goals achieved, and any notes or comments related to the visit.
04
Verify client or patient details: Double-check the client or patient details entered, ensuring their name and identification correspond correctly with the visit. This is crucial for accurate documentation and billing purposes.
05
Review and submit: Before submitting the electronic visit verification, review all the entered information for accuracy and completeness. Make any necessary adjustments or additions if required. Once satisfied, submit the form or visit details according to the instructions provided by the system.
06
Confirmation and documentation: After submission, you may receive a confirmation message or notification indicating that the electronic visit verification has been successfully recorded or saved. Take note of this confirmation and ensure that a copy or record of the verification is securely stored for future reference or audit purposes.

Who needs electronic visit verification:

01
Home healthcare providers: Electronic visit verification is necessary for home healthcare providers who offer services like nursing care, therapy, personal care, or companionship to patients or clients in their own residences.
02
Medicaid beneficiaries: Electronic visit verification is often required for Medicaid beneficiaries who receive home healthcare services funded by Medicaid. It helps ensure accurate billing and accountability for the services rendered.
03
State and federal regulations: Some states and federal programs mandate the use of electronic visit verification as a means to prevent fraud, track service delivery, and ensure the quality and appropriateness of care provided to eligible individuals.
04
Caregivers and agencies: Caregivers, both independent and those working under agencies, may be required to use electronic visit verification to record and document their visits, ensuring accurate tracking of services and compliance with regulations and contracts.
Fill form : Try Risk Free
Users Most Likely To Recommend - Summer 2025
Grid Leader in Small-Business - Summer 2025
High Performer - Summer 2025
Regional Leader - Summer 2025
Easiest To Do Business With - Summer 2025
Best Meets Requirements- Summer 2025
Rate the form
4.0
Satisfied
40 Votes

For pdfFiller’s FAQs

Below is a list of the most common customer questions. If you can’t find an answer to your question, please don’t hesitate to reach out to us.

The premium pdfFiller subscription gives you access to over 25M fillable templates that you can download, fill out, print, and sign. The library has state-specific electronic visit verification and other forms. Find the template you need and change it using powerful tools.
With pdfFiller, it's easy to make changes. Open your electronic visit verification in the editor, which is very easy to use and understand. When you go there, you'll be able to black out and change text, write and erase, add images, draw lines, arrows, and more. You can also add sticky notes and text boxes.
You can do so easily with pdfFiller’s applications for iOS and Android devices, which can be found at the Apple Store and Google Play Store, respectively. Alternatively, you can get the app on our web page: https://edit-pdf-ios-android.pdffiller.com/. Install the application, log in, and start editing electronic visit verification right away.
Electronic visit verification (EVV) is a system used to electronically verify when a caregiver visits a recipient to provide them with assistance with activities of daily living.
Providers of Medicaid-funded personal care services are required to file electronic visit verification.
Electronic visit verification can be filled out using a mobile app or a web-based portal provided by the state Medicaid agency.
The purpose of electronic visit verification is to ensure that the services billed to Medicaid are actually provided and to improve accountability in the personal care services industry.
Information such as the date, time, and duration of the visit, the services provided, the caregiver's identity, and the recipient's identity must be reported on electronic visit verification.
Fill out your electronic visit verification online with pdfFiller!

pdfFiller is an end-to-end solution for managing, creating, and editing documents and forms in the cloud. Save time and hassle by preparing your tax forms online.

Get started now
Form preview
If you believe that this page should be taken down, please follow our DMCA take down process here .
This form may include fields for payment information. Data entered in these fields is not covered by PCI DSS compliance.