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[]
["EVV Alternate Vendor Review Tool"]
["Devices"]
["Question",null,"Answer","Risk"]
[1,"Does the alternate vendor offer at least two (2) different types of visit verification devices (mobile application, fixed visit device, telephony, etc.)?",null,{"$f":"_xlfn.IFS(C5=\"Yes\",\"No Risk\",C5=\"No\",\"Risk\",C5=\"N/A\",\"Risk\",C5=\"\",\" \")","v":" "}," "]
[2,"Does the alternate vendor offer at least one (1) device to use in areas with limited, intermittent or no landline, cell, or internet service?",null,{"$f":"_xlfn.IFS(C6=\"Yes\",\"No Risk\",C6=\"No\",\"Risk\",C6=\"N/A\",\"Risk\",C5=\"\",\" \")","v":" "}]
["Paper Timesheets"]
["Question",null,"Answer","Risk"]
[3,"Does the EVV system allow you to enter paper timesheet information when the use of paper timesheets is allowable?",null,{"$f":"_xlfn.IFS(C9=\"Yes\",\"No Risk\",C9=\"No\",\"Risk\",C9=\"N/A\",\"Risk\",C9=\"\",\" \")","v":" "}]
[4,"Does the alternate vendor offer a device with a paper timesheet that can independently verify the actual date, start and end time of the service?",null,{"$f":"_xlfn.IFS(C10=\"Yes\",\"No Risk\",C10=\"No\",\"Risk\",C10=\"N/A\",\"Risk\",C10=\"\",\" \")","v":" "}]
["Scheduling"]
["Question",null,"Answer","Risk"]
[5,"Does the EVV system have the ability to enter a schedule for each service?",null,{"$f":"_xlfn.IFS(C13=\"Yes\",\"No Risk\",C13=\"No\",\"Risk\",C13=\"N/A\",\"Risk\",C13=\"\",\" \")","v":" "}]
[6,"Does the EVV system allow you to reschedule visits?",null,{"$f":"_xlfn.IFS(C14=\"Yes\",\"No Risk\",C14=\"No\",\"Risk\",C14=\"N/A\",\"Risk\",C14=\"\",\" \")","v":" "}]
[7,"Does the EVV system track which visits are rescheduled? ",null,{"$f":"_xlfn.IFS(C15=\"Yes\",\"No Risk\",C15=\"No\",\"Risk\",C15=\"N/A\",\"Risk\",C15=\"\",\" \")","v":" "}]
[8,"Does the EVV system stop schedules from being canceled/changed after the scheduled start time?",null,{"$f":"_xlfn.IFS(C16=\"Yes\",\"No Risk\",C16=\"No\",\"Risk\",C16=\"N/A\",\"Risk\",C16=\"\",\" \")","v":" "}]
[9,"Does the EVV system allow live-in caregivers to provide services without a schedule if your agency allows it?",null,{"$f":"_xlfn.IFS(C17=\"Yes\",\"No Risk\",C17=\"No\",\"Risk\",C17=\"N/A\",\"Risk\",C17=\"\",\" \")","v":" "}]
[10,"If the EVV system allows caregivers to change schedules directly, is the agency able to approve schedules prior to the visit OR conduct post reviews on a sampling of schedules for all caregivers?",null,{"$f":"_xlfn.IFS(C18=\"Yes\",\"No Risk\",C18=\"No\",\"Risk\",C18=\"N/A\",\"Risk\",C18=\"\",\" \")","v":" "}]
["Member Verification"]
["Question",null,"Answer","Risk"]
[11,"Does the EVV system have a way to capture member verification at the point of care?",null,{"$f":"_xlfn.IFS(C21=\"Yes\",\"No Risk\",C21=\"No\",\"Risk\",C21=\"N/A\",\"Risk\",C21=\"\",\" \")","v":" "}]
[12,"Does the EVV system have a way to capture member verification after the point of care?",null,{"$f":"_xlfn.IFS(C22=\"Yes\",\"No Risk\",C22=\"No\",\"Risk\",C22=\"N/A\",\"Risk\",C22=\"\",\" \")","v":" "}]
[13,"Does the EVV system allow a designee to verify service delivery for a member?",null,{"$f":"_xlfn.IFS(C23=\"Yes\",\"No Risk\",C23=\"No\",\"Risk\",C23=\"N/A\",\"Risk\",C23=\"\",\" \")","v":" "}]
[14,"Does the EVV system have a way for you to authenticate the member verification (i.e. view the signature, listen to a voice recording)?",null,{"$f":"_xlfn.IFS(C24=\"Yes\",\"No Risk\",C24=\"No\",\"Risk\",C24=\"N/A\",\"Risk\",C24=\"\",\" \")","v":" "}]
["Location"]
["Question",null,"Answer","Risk"]
[15,"Does the EVV system capture and record the location of the visit (at the start and end of the visit)?",null,{"$f":"_xlfn.IFS(C27=\"Yes\",\"No Risk\",C27=\"No\",\"Risk\",C27=\"N/A\",\"Risk\",C27=\"\",\" \")","v":" "}," "]
[16,"Does the EVV system enable GPS tracking while the DCW is on the clock?   If so, does the EVV system either allow that to be disabled per member preference or allow for the use of an alternate device that doesn't track?",null,{"$f":"_xlfn.IFS(C28=\"Yes\",\"Possible Risk\",C28=\"No\",\"No Risk\",C28=\"N/A\",\"Risk\",C28=\"\",\" \")","v":" "}]
["Contingency Plan"]
["Question",null,"Answer","Risk"]
[17,"Are you able to enter the member's contingency plan preferences by service in the EVV system?",null,{"$f":"_xlfn.IFS(C31=\"Yes\",\"No Risk\",C31=\"No\",\"Risk\",C31=\"N/A\",\"Risk\",C31=\"\",\" \")","v":" "}]
[18,"Are you able to make changes to the member's contingency plan for a specific visit in the EVV system based on the member's preference?",null,{"$f":"_xlfn.IFS(C32=\"Yes\",\"No Risk\",C32=\"No\",\"Risk\",C32=\"N/A\",\"Risk\",C32=\"\",\" \")","v":" "}]
[19,"Does the EVV system only use the contingency plan defaults when the member has chosen not to provide a preference?",null,{"$f":"_xlfn.IFS(C33=\"Yes\",\"No Risk\",C33=\"No\",\"Risk\",C33=\"N/A\",\"Risk\",C33=\"\",\" \")","v":" "}]
["Visit Maintenance",null,null,null," "]
["Question",null,"Answer","Risk"," "]
[20,"Does the EVV system allow caregivers to perform visit maintenance?",null,{"$f":"_xlfn.IFS(C36=\"Yes\",\"Possible Risk\",C36=\"No\",\"No Risk\",C36=\"N/A\",\"Risk\",C36=\"\",\" \")","v":" "}]
[21,"Does the EVV vendor send data to the aggregator frequently enough so that it does not impede your ability to bill for services?",null,{"$f":"_xlfn.IFS(C37=\"Yes\",\"No Risk\",C37=\"No\",\"Risk\",C37=\"N/A\",\"Risk\",C37=\"\",\" \")","v":" "}]
[22,"Does the EVV system maintain an appropriate audit trail of all visit transactions including:\n1. The person entering the information.\n2. The names and AHCCCS Provider IDs of both the rendering service provider agency and group biller (if applicable)\n3. The AHCCCS ID number of the member receiving services\n4. The date and time of the visit,\nThe reason for the manual verification\n6. The date and time of the manual verification and\n7. The names of the member/designee and the name and system generate ID of the DCW who validated the visit. Member/designee verification is required when visit data is edited",null,null,{"$f":"_xlfn.IFS(C38=\"Yes\",\"No Risk\",C38=\"No\",\"Risk\",C38=\"N/A\",\"Risk\",C38=\"\",\" \")","v":" "}]
["Scenario: DCW lives with the member so a schedule is not required.  ",null,null,null," "]
[23,"For this scenario, does the EVV system flag the visit with the “Unscheduled Visit” exception? ",null,{"$f":"_xlfn.IFS(C40=\"Yes\",\"No Risk\",C40=\"No\",\"Risk\",C40=\"N/A\",\"Risk\",C40=\"\",\" \")","v":" "}]
[24,"Are you able to enter the reason code \"LiveIn/Onsite Caregiver\" in the EVV system?",null,{"$f":"_xlfn.IFS(C41=\"Yes\",\"No Risk\",C41=\"No\",\"Risk\",C41=\"N/A\",\"Risk\",C41=\"\",\" \")","v":" "}]
["Scenario: DCW forgets to clock in."]
[25,"For this scenario, does the EVV system flag the visit with the “Visits Without In Calls\" exception? ",null,{"$f":"_xlfn.IFS(C43=\"Yes\",\"No Risk\",C43=\"No\",\"Risk\",C43=\"N/A\",\"Risk\",C43=\"\",\" \")","v":" "}]
[26,"Are you able to manually edit the visit to add the clock in time?",null,{"$f":"_xlfn.IFS(C44=\"Yes\",\"No Risk\",C44=\"No\",\"Risk\",C44=\"N/A\",\"Risk\",C44=\"\",\" \")","v":" "}]
[27,"Are you able to enter the reason code \"Caregiver Error\" in the EVV system?",null,{"$f":"_xlfn.IFS(C45=\"Yes\",\"No Risk\",C45=\"No\",\"Risk\",C45=\"N/A\",\"Risk\",C45=\"\",\" \")","v":" "}]
[28,"Are you able to enter a memo stating \"Entered manual date and time after confirming with the [member/designee’s name] via [Communication Method] on XX/XX and [caregiver name] via [Communication Method] on XX/XX.\" (Communication method = verbal, email or portal)? ",null,{"$f":"_xlfn.IFS(C46=\"Yes\",\"No Risk\",C46=\"No\",\"Risk\",C46=\"N/A\",\"Risk\",C46=\"\",\" \")","v":" "}]
["Scenario: DCW cancels and the agency can't provide a relief caregiver to meet the member’s contingency plan."]
[29,"For this scenario, does the EVV system flag the visit with the “No Show” exception? ",null,{"$f":"_xlfn.IFS(C48=\"Yes\",\"No Risk\",C48=\"No\",\"Risk\",C48=\"N/A\",\"Risk\",C48=\"\",\" \")","v":" "}]
[30,"Are you able to enter the reason code \"Caregiver No Show\" in the EVV system?",null,{"$f":"_xlfn.IFS(C49=\"Yes\",\"No Risk\",C49=\"No\",\"Risk\",C49=\"N/A\",\"Risk\",C49=\"\",\" \")","v":" "}]
[31,"Are you able to enter the appropriate resolution code \"Reschedule within 2, 24 or 48 hours; Next Scheduled Visit; or Non-Paid Caregiver\" in the EVV system?",null,{"$f":"_xlfn.IFS(C50=\"Yes\",\"No Risk\",C50=\"No\",\"Risk\",C50=\"N/A\",\"Risk\",C50=\"\",\" \")","v":" "}]
["Scenario: Guardian/Designee was not home when the service ended to verify service delivery.",null,null,null," "]
[32,"For this scenario, does the EVV system flag the visit with the “Client Signature Exception, or Service Verification Exception” exception? ",null,{"$f":"_xlfn.IFS(C52=\"Yes\",\"No Risk\",C52=\"No\",\"Risk\",C52=\"N/A\",\"Risk\",C52=\"\",\" \")","v":" "}]
[33,"Are you able to enter the reason code \"Member/Designee Unable to Verify\" in the EVV system?",null,{"$f":"_xlfn.IFS(C53=\"Yes\",\"No Risk\",C53=\"No\",\"Risk\",C53=\"N/A\",\"Risk\",C53=\"\",\" \")","v":" "}]
[34,"Are you able to enter a memo stating \"Confirmed date/time of service delivery with the [member/designee’s name] via [Communication Method] on XX/XX.\" (Communication method = verbal, email or portal)? ",null,{"$f":"_xlfn.IFS(C54=\"Yes\",\"No Risk\",C54=\"No\",\"Risk\",C54=\"N/A\",\"Risk\",C54=\"\",\" \")","v":" "}]
["Scenario: The member can’t verify service delivery and the guardian is the paid caregiver. There is no one else to verify service delivery."]
[35,"For this scenario, does the EVV system flag the visit with the “Client Signature Exception, or Service Verification Exception” exception? ",null,{"$f":"_xlfn.IFS(C56=\"Yes\",\"No Risk\",C56=\"No\",\"Risk\",C56=\"N/A\",\"Risk\",C56=\"\",\" \")","v":" "}]
[36,"Are you able to enter the reason code \"Member/Designee Unable to Verify\" in the EVV system?",null,{"$f":"_xlfn.IFS(C57=\"Yes\",\"No Risk\",C57=\"No\",\"Risk\",C57=\"N/A\",\"Risk\",C57=\"\",\" \")","v":" "}]
[37,"Are you able to enter the appropriate resolution code \"Designee Attestation on File\" in the EVV system?",null,{"$f":"_xlfn.IFS(C58=\"Yes\",\"No Risk\",C58=\"No\",\"Risk\",C58=\"N/A\",\"Risk\",C58=\"\",\" \")","v":" "}]
["Scenario: DCW and member decide on a schedule change, but don’t tell the agency."]
[38,"For this scenario, does the EVV system flag the visit with the “No Show” exception? ",null,{"$f":"_xlfn.IFS(C60=\"Yes\",\"No Risk\",C60=\"No\",\"Risk\",C60=\"N/A\",\"Risk\",C60=\"\",\" \")","v":" "}]
[39,"Are you able to enter the reason code \"Member Preference\" in the EVV system?",null,{"$f":"_xlfn.IFS(C61=\"Yes\",\"No Risk\",C61=\"No\",\"Risk\",C61=\"N/A\",\"Risk\",C61=\"\",\" \")","v":" "}]
["Scenario: DCW forgets to clock in until after starting work."]
[40,"For this scenario, does the EVV system flag the visit with the \"Late In Call” exception? ",null,{"$f":"_xlfn.IFS(C63=\"Yes\",\"No Risk\",C63=\"No\",\"Risk\",C63=\"N/A\",\"Risk\",C63=\"\",\" \")","v":" "}]
[41,"Are you able to manually edit the visit to add the clock in time?",null,{"$f":"_xlfn.IFS(C64=\"Yes\",\"No Risk\",C64=\"No\",\"Risk\",C64=\"N/A\",\"Risk\",C64=\"\",\" \")","v":" "}]
[42,"Are you able to enter the reason code \"Caregiver Error\" in the EVV system?",null,{"$f":"_xlfn.IFS(C65=\"Yes\",\"No Risk\",C65=\"No\",\"Risk\",C65=\"N/A\",\"Risk\",C65=\"\",\" \")","v":" "}]
[43,"Are you able to enter a memo stating \"Entered manual date and time after confirming with the [member/designee’s name] via [Communication Method] on XX/XX and [caregiver name] via [Communication Method] on XX/XX.\" (Communication method = verbal, email or portal)? ",null,{"$f":"_xlfn.IFS(C66=\"Yes\",\"No Risk\",C66=\"No\",\"Risk\",C66=\"N/A\",\"Risk\",C66=\"\",\" \")","v":" "}]
["Security"]
["Question",null,"Answer","Risk"]
[44,"Has the alternate vendor provided you with information on how the system complies with Requirement #13 outlined in the AHCCCS Provider Participation Agreement? ",null,{"$f":"_xlfn.IFS(C69=\"Yes\",\"No Risk\",C69=\"No\",\"Risk\",C69=\"N/A\",\"Risk\",C69=\"\",\" \")","v":" "}]