EVV Claims Matching Resumes April 1, 2024; Unmatched EVV Claims will Deny for Payment

Date: March 7, 2024

Attention: STAR Kids Providers/Consumer Directed Services employers and FMSA Providers

Effective Date: April 1, 2024

Call to action: Texas Children’s Health Plan (TCHP) would like to let providers know that Texas Health and Human Services Commission (HHSC) implemented a claim matching bypass on February 1, 2024 – for Electronic Visit Verification (EVV) claims with dates of service from January 1 through March 31 – to be paid without a matching EVV visit.

EVV claims matching for all services required to use EVV will begin on April 1, 2024. EVV claims with dates of service of April 1, 2024, and after that do not have an EVV visit match will be denied payment. 

Program providers and FMSAs are encouraged to use the EVV Best Practices to Avoid EVV Claim Mismatches (texas.gov) (PDF) to prevent EVV claim mismatches when submitting EVV claims.

Next steps for providers: Providers are encouraged to share this communication with their staff.

If you have any questions, please email Provider Relations at:providerrelations@texaschildrens.org.

For access to all Provider Alerts,log into:
www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers