EVV, Caregiver Visits & Timekeeping

Limitations

Live-in exemptions and exact vendor workflows are published by DMAS. Eden will not describe internal security controls or vendor credentials. Eden educational resources are not a substitute for official Medicaid, waiver, or health-plan determinations. Rules vary by program, assessment, authorization, and plan. Confirm current details with DMAS, your MCO, and Eden intake.

Important definitions

Short definitions used on this page. Program manuals may phrase lists slightly differently.

• EVV: Electronic Visit Verification — a federal and Virginia requirement to record visit facts such as member, service, caregiver, date, location, and start/end time for many personal care, respite, and companion visits.

Plain-English summary

Why electronic visit verification exists, which visit facts are recorded, clock-in/out expectations, and what this page will not disclose about internal security.

Why EVV exists

Federal 21st Century Cures Act rules require EVV for Medicaid personal care. Virginia also applies EVV to consumer-directed personal care, respite, and companion.

Required visit elements

Typical required facts include the member, service, caregiver, date, location, start time, and end time.

Clock in and clock out

Caregivers clock in when the visit starts and clock out when it ends, using the method the program requires. Missed verification may need a documented correction.

EVV vs overtime

A 2021 DMAS bulletin addresses live-in caregiver EVV exemption and consumer-directed attendant overtime. That is a Medicaid CD payment rule, not Eden's private employment overtime policy.

Eligibility and applicability

Program rules, assessments, and payer authorization decide what can start. Medicaid enrollment, waiver enrollment, service eligibility, service authorization, and authorized hours are not the same status.

Assessment and documentation

Depending on the program and service, an assessment and supporting documentation may be required. A nurse does not automatically visit first for every request.

Authorization and approval

When authorization is required, the payer or MCO reviews the requested service and hours. Outcomes can include approval, partial approval, a request for more information, or denial. Eden does not approve the benefit.

Hours and limits

Requested, assessed, authorized, scheduled, and EVV-verified hours can all differ. This site does not invent a universal hour number.

How services can interact

Personal care, respite, companion, adult day, and transportation follow separate rules. A plan may authorize one, more than one, or none.

Family caregiver implications

A parent or spouse is not automatically a paid caregiver. Virginia LRI rules apply only in defined relationships and only when the current official policy and authorization allow it.

Agency-directed vs consumer-directed

Agency-directed: a licensed agency is the employer. Consumer-directed: the member or representative is the employer of record, with services-facilitator support where the waiver allows. Eden's typical public role is agency-directed care.

Insurance and MCO implications

Managed-care members usually follow their plan's authorization and appeal process. Fee-for-service members follow DMAS processes. A plan existing on the official roster does not mean Eden is in-network.