This guide outlines the payers in Barnestorm that require EVV, specifies the aggregator to which the visit must be sent, and how the claim should be generated.
Sandata - North Carolina Medicaid Direct
Payer Names: - Medicaid
- Personal Care
- In-Home Care (Adult and Child)
- Medicaid CAP/DA
- CAP/DA In-Home Aide (Respite)
- CAP/Choice In-Home (Respite)
How EVV Visits are Submitted: Completed visits are sent automatically each night.
Billing Claims Information: - Claims must be created in Barnestorm and sent through NCTracks.
- If not set up for SFTP submissions, manually upload claim files via NCTracks > MOVEit or manually key visits.
HHAeXchange - North Carolina Standard Plans, MCOs, LMEs, Tailored Plans
Payer Names: - Standard Plans: 840 PCS ADULT WELLCARE | 870 PCS ADULT AMERIHEALTH | 880 PCS ADULT UNITEDHC | 890 PCS ADULT CAROLINA COMPLETE
- LME: 892 Alliance | 894 Trillium | 896 Vaya | 898 Partners
How EVV Visits are Submitted: Visits must be imported via Billing > HIPAA Transactions > HHAeXchange/CareBridge.
Billing Claims Information: - Configured HHAX contracts auto-send 837 claims for adjudication.
- Otherwise, claims must be manually uploaded to the payer’s portal.
- Vaya requires a testing phase; Trillium needs manual claim submission if not auto-sent.
CareBridge - North Carolina Healthy Blue (BCBS)
Payer Name: 860 PCS ADULT BCBS (861 Child)
How EVV Visits are Submitted: Visits must be imported via Billing > HIPAA Transactions > HHAeXchange/CareBridge.
Billing Claims Information: - CareBridge automatically generates and submits the 837 claim file for adjudication.
- Manual claim generation or submission is not required.
Other - Virginia Medicaid
How EVV Visits are Submitted: Information is sent with the claim generated within Barnestorm.
Billing Claims Information: Claims are generated and sent via Netsmart/Anthem.
Payers Requiring Electronic Visit Verification (EVV)