ACTION REQUIRED

EVV Required for NC Home Health Claims Starting October 1, 2025

Dear Home Health Provider,

Effective October 1, 2025, Standard Plans and Tailored Plans will return to a Hard Launch for Electronic Visit Verification (EVV) of Home Health Services. To ensure timely payment, EVV data must be submitted to HHAeXchange for all applicable claims. 

Who is Affected?

Home Health Providers with taxonomy 251E00000X who are contracted with the following NC health plans: 

• Alliance
• Partners
• Trillium
• Vaya
• AmeriHealth Caritas NC
• Carolina Complete Health
• WellCare NC
• UnitedHealthcare NC
  

Please note: If you are a provider that also performs Personal Care Services, that process is not changing. The above only applies to how you remain compliant for Home Health Services. 

Immediate Action Required

If you are using a third-party EVV vendor and have not yet integrated with HHAeXchange, please begin the integration process immediately. 

Helpful Resources

• HomeCare Provider Integration Visit Import Guide v5
• EDI Export Interface Guide v5
• EDI Code Table Guide v5
  
• V5 Flat File Common Import Rejections

Billing Option for Home Health Providers

Option 1: Bill Through HHAeXchange

1. Ensure visit data from your EVV vendor successfully imports into HHAeXchange.
2. Regularly review and resolve Prebilling and Billing Review holds.
3. Monitor claim status to ensure successful export. 

Option 2: Direct Billing to Health Plan

1. Submit 837 claims directly to the health plan.
2. Import EVV data to HHAeXchange.
3. Work with your vendor to monitor and resolve visit import failures. 
4. Ensure service code and revenue code on the visit file match the 837 claim.
5. Health plans will pend claims for up to 14 days to allow time for EVV submission. 
6. Claims will be denied if EVV data is missing or codes do not match. 

Please open a ticket with HHAeXchange support for any integration or system-related issue. 

Best, 

The HHAeXchange Team

North Carolina Information Hub

 Visit the Info Hub for more details →