EVV exception monitoring for Pennsylvania home care agencies
EVV exceptions, reviewed daily.
Every visit paid by Pennsylvania Medicaid has to be verified electronically. We review missed clock-ins and clock-outs, location mismatches and unverified visits every day, follow up with caregivers and prepare what your team needs to approve corrections before billing.
Who it is for.
For agencies that find EVV problems at billing, or that are close to the 15% manual-edit line. Your agency approves every correction; we find the exceptions early and do the follow-up.
Agencies near the 15% manual-edit line
Daily review keeps exceptions from piling up over the quarter.
Agencies that find exceptions at billing
Exceptions are reviewed the same day, while the caregiver still remembers the visit.
Agencies billing CHC through HHAeXchange
We work in HHAeXchange, where CHC plans see your visit records and prebilling holds.
03 · EVV Monitoring
What we cover.
- Daily review of exceptions: missed clock-ins and clock-outs, location mismatches, unverified visits
- Follow-up with caregivers, the same day
- Corrections prepared for your team's approval, with the reason documented
- A weekly report of your manual-edit rate
How it works.
- 01
Review every day
Missed clock-ins and clock-outs, location mismatches and unverified visits, reviewed daily.
- 02
Follow up the same day
Caregivers are contacted while the visit is fresh.
- 03
Prepare the correction
Corrections are prepared for your team's review and approval in your EVV system, with the reason documented.
- 04
Report weekly
A weekly report of your manual-edit rate by program, with recurring exceptions that may need review.
What your agency receives.
Everything we do is written down and handed to your team, so you always know what happened and what is still open.
Request a consultationA daily exception list with status
Caregivers with repeated exceptions, flagged for your team
A weekly manual-edit rate by program
A list of what is resolved and what still needs review
Why it matters in Pennsylvania
Claims without a matching verified visit are denied. Since January 2025, the Department of Human Services expects at least 85% of visits to be verified without manual edits. Since January 2026, providers above 15% receive alerts (from DHS for fee-for-service, from the MCO for managed care), and two quarters in a row can lead to a corrective action plan. Corrections are recorded in the appropriate EVV system, with supporting documentation.
Where our role ends
We don't change visit records on our own. Every correction goes through the people and the rules your agency sets.
Questions agencies ask us.
Straight answers about how this works in Pennsylvania.
Since January 1, 2025, the Department of Human Services expects at least 85% of visits in each program to be verified without a manual edit, measured each federal fiscal quarter.
Since January 2026, providers above 15% receive alerts: DHS issues them for fee-for-service, and managed care providers are followed up by their MCO. Two quarters in a row above the line can lead to a corrective action plan.
Generally, yes. Under DHS guidance, changes made after the visit count as manual edits. Some plans publish specific exceptions, such as PA Health & Wellness for qualifying midnight-shift corrections, so check your plan's current instructions.
No. Your agency controls changes to visit records. We document the issue and prepare the correction for your team to review and approve.
Yes. Use our free EVV score check to compare your manual-edit rate with the 85% threshold.
Related guides.
EVVPennsylvania's 85% EVV Standard: What the 2026 Alerts MeanAgencies whose EVV manual edits pass 15% now get alerts. What the 85% standard measures, what follows two quarters over, and how to stay under it.Read the guide 
EVVSandata and HHAeXchange in PA: Who Does WhatIn Pennsylvania, HHAeXchange and Sandata do different jobs. Where visits are captured, corrected, held and denied, and who to contact for each.Read the guide Other services
After-Hours & On-Call CoverageAfter-hours calls, call-outs and escalation.
SchedulingAvailability, schedule changes and open shifts.
Hours & Authorization UtilizationAuthorized, scheduled and delivered hours.
DCW Candidate ScreeningFirst-round screening, organized notes.
Supervisory Visit MonitoringDue dates, completed visits and follow-up.
EVV exceptions, before billing.
Tell us which EVV system you use and how your team handles exceptions today.