HHAeXchange Electronic Visit Verification (EVV) Aggregation Transaction Manager Rule Holds and Resolutions

The HHAX EVV Aggregation Transaction Manager (Admin > EVV Aggregation Transaction Manager) allows providers to manage visits (related to the linked payer placements) that have been approved or rejected by the Texas Medicaid and Healthcare Partnership (TMHP) EVV Aggregator. The TMHP EVV Aggregator is a centralized database maintained and operated by TMHP that collects, validates, and stores statewide EVV visit transaction data transmitted by the HHAeXchange system.

This document contains hold reasons found in the HHAeXchange EVV Aggregation Transaction Manager, and the recommended actions to take for successfully addressing in the HHAX system. These instructions are specific to the HHAX system.

• For questions, contact HHAX Support in the Client Support Portal. Select the State EVV Aggregation option.

• For additional guidance with identifying and correcting an EVV visit transaction rejection received from the EVV Aggregator, refer to the TMHP EVV Visit Transaction Rejection Guide located on tmhp.com.

Important for all EVV Visits: After the steps listed in the How to Resolve section have been completed, all EVV visits must be resubmitted for validation by the TMHP EVV Aggregator. To resubmit an EVV visit to the TMHP EVV Aggregator, locate the EVV visit transaction in the HHAeXchange EVV Aggregation Transaction Manager, click the Actions button then select Validate and Submit to Aggregator.

HHAX Hold Reason(s)	HHAX Rule Check(s)	How to Resolve
Consumer Directed Services Employer First Name is too long. Consumer Directed Services Employer First Name is missing.	Populates for consumer directed services (CDS) Healthcare Common Procedure Coding System (HCPCS) codes. Consumer Directed Services Employer First Name cannot exceed 50 characters. This field cannot be empty for a CDS visit.	Go to Patient > Search Patient to locate and select the Patient. If the Patient is the Consumer Directed Services (CDS) Employer, go to the Profile page, click the Edit button, and update the First Name field. Save. If the Patient has a different CDS Employer, go to the General page, click the Edit button, and update the CDS Employer of Record field. Save.
Consumer Directed Services Employer Last Name is too long. Consumer Directed Services Employer Last Name is missing.	Consumer Directed Services Employer Last Name cannot exceed 50 characters. This field cannot be empty for a CDS visit.	Go to Patient > Search Patient to locate and select the Patient. If the Patient is the Consumer Directed Services (CDS) Employer, go to the Profile page, click the Edit button, and update the Last Name field. Save. If the Patient has a different CDS Employer, go to the General page, click the Edit button, and update the CDS Employer of Record field. Save.
Employee ID is missing.	Cannot be empty.	Go to Caregiver > Search Caregiver to locate and select the Caregiver. On the Profile page, click the Edit button and update the Employee ID field. The Employee ID is an identifier assigned to the Caregiver by his or her employer for HR and payroll purposes. Click Save.
EVV Call In Address Type has incorrect value. EVV Call Out Address Type has incorrect value.	EVV Call In/Out Address Type must be one of the following: • Patient Home • Community • Family Home • Neighbor Home Cannot be empty	Go to Patient > Search Patient to locate and select the Patient. On the Profile page, click the Edit button. Verify that the member address is assigned an Address Type and save. If a phone number is assigned in the member’s profile, verify that the member Phone Location is selected. If a member is configured for Alternative Device EVV, ensure that the member home address is selected on the General page, FOB Location field. Doing the above corrects the hold moving forward, but past visits need to be corrected by locating the visit in the member’s calendar, clicking the Visit Info tab, and clicking the Edit button for Clock Out.
EVV Call In Phone is not in correct format for IVR method. EVV Call In Phone is missing for landline (IVR) Method.	EVV Phone is not a 10-digit number for the landline method (IVR method). Cannot be empty	Go to Patient > Search Patient to locate and select the Patient. On the Profile page, click the Edit button and update the Home Phone field. Save.
EVV Call In Phone is changed for resubmission. EVV Call Out Phone is changed for resubmission.	EVV Phone has changed for an updated visit resubmission.	EVV Call In and Call Out cannot be modified after an EVV transaction has been approved. Re-link the original Call In/Out for the visit.
EVV Call In Time has changed for resubmission. EVV Call Out Time is changed for resubmission.	Actual Call In/Out Time cannot be changed for an updated visit resubmission.	Go to Patient > Search Patient to locate and select the Patient. On the Profile page, click the Edit button and update the Home Phone field. Save.
EVV Visit Call In LATITUDE is changed for resubmission. EVV Visit Call Out LATITUDE is changed for resubmission. EVV Visit Call In LONGITUDE is changed for resubmission. EVV Visit Call Out LONGITUDE is changed for resubmission.	EVV Visit Call In/Out Latitude cannot be changed for an updated visit resubmission. EVV Visit Call In/Out Longitude cannot be changed for an updated visit resubmission.	EVV Call In and Call Out cannot be modified after an EVV transaction has been approved. Re-link the original Call In/Out for the visit. Go to Patient > Search Patient to locate and select the Patient. On the Profile page, click the Edit button. Verify that the member address is assigned an Address Type and save. If a phone number is assigned in the member’s profile, verify that the member Phone Location is selected. If a member is configured for Alternative Device EVV, , ensure that the member home address is selected on the General page, FOB Location field. Doing the above corrects the hold moving forward, but past visits need to be corrected by locating the visit in the member’s calendar, clicking the Visit Info tab, and clicking the Edit button for Clock In.
EVV Hours changed for resubmission.	Actual Hours cannot be changed for a visit resubmission.
EVV Service Delivery Address, City, State, or Zip Code In is missing. EVV Service Delivery Address, City, State, or Zip Code Out is missing.	EVV Service Delivery Address In/Out cannot exceed 50 characters. One or more of the EVV Service Delivery In/Out fields are missing. EVV Service Delivery Location is not listed below: • Patient Home • Community • Family Home • Neighbor Home Cannot be empty
EVV Service Delivery Address In is too long. EVV Service Delivery Address (or City, State, Zip Code) In is missing.	EVV Service Delivery Address In cannot exceed 50 characters. One or more of the EVV Service Delivery In fields are missing. Cannot be empty	Go to Patient > Search Patient to locate and select the Patient. On the Profile page, click the Edit button and update the Address fields. Verify that the member Phone Location is selected. If a member is configured for Alternative Device EVV, ensure that the member home address is selected on the General page, FOB Location field. Doing the above corrects the hold moving forward but past visits need to be corrected by locating the visit in the member’s calendar, clicking the Visit Info tab, and clicking the Edit button for Clock In.
LTC Contract Number is missing due to no matching LTC Authorization retrieved from the FFS Authorization web service	Long-Term Care (LTC) Contract Number, also known as LTC Provider Number, is required for LTC EVV visits. The following must match between the EVV Visit and authorization: TIN NPI Service Code Service Group Auth Start/End Date	Verify member LTC eligibility. If the member is active with LTC, service code and service group on the EVV visit must match LTC authorization from the web service.
Medicaid ID is not in correct format. Medicaid ID is missing.	Medicaid ID must be 9 digits. Cannot be empty	Go to Patient > Search Patient to locate and select the Patient. On the Profile page, click the Edit button and update the Medicaid Number field. Save.
Patient’s Date of Birth missing.	Patient’s Date of Birth cannot be empty.	Go to Patient > Search Patient to locate and select the Patient. On the Profile page, click the Edit button and update the Date of Birth field. Save.
Patient First Name is not in correct format. Patient First Name is missing.	Patient First Name cannot exceed 50 characters. Cannot be empty	Go to Patient > Search Patient to locate and select the Patient. On the Profile page, click the Edit button and update the First Name field. Save.
Patient Last Name is not in correct format. Patient Last Name is missing.	Patient Last Name cannot exceed 50 characters. Cannot be empty	Go to Patient > Search Patient to locate and select the Patient. On the Profile page, click the Edit button and update the Last Name field. Save.
Patient Primary Phone is not in correct format.	Patient Primary Phone must be 10 digits. Cannot be empty	Go to Patient > Search Patient to locate and select the Patient. On the Profile page, click the Edit button and update the Home Phone field. Save.
Patient Secondary Phone is not in correct format.	Patient Secondary Phone must be 10 digits. Cannot be empty	Go to Patient > Search Patient to locate and select the Patient. On the Profile page, click the Edit button and update the Phone 2 field. Save.
Patient Tertiary Phone is not in correct format.	Patient Tertiary Phone must be 10 digits. Cannot be empty	Go to Patient > Search Patient to locate and select the Patient. On the Profile page, click the Edit button and update the Phone 3 field. Save.
Payer Patient Plan Code is missing.	Cannot be missing when member payer is MCO: ET, AGP, BCB, CFC, CHS, CKC, CMC, DRC, MOL, SHP, TXC, UHC, CHC, SET, EP1, PRK, SCW, FCR Cannot be empty.	Go to Patient > Payers/Insurance. Review the member payer placement for any errors. Add a new payer placement if eligibility changed for the member. Correcting the payer placement will prevent holds moving forward. To resolve the visits on hold, go to Patient > Calendar > Visit > Bill Info. Select Plan Code and Save. Repeat for each affected visit.
Provider API has incorrect format. Provider NPI or Provider API is missing.	If only the Atypical Provider Identifier (API) is populated, it must have 10 characters. Provider National Provider Identifier (NPI) or Provider API cannot be empty at the same time.	Go to Admin > Office Setup > Search Office to locate and select the office. On the Edit Office page, update the API field and save.
Provider Legal Name is too long. Provider Legal Name is missing.	Provider Legal Name cannot exceed 50 characters. Cannot be empty.	Go to Admin > Office Setup > Search Office to locate and select the office. On the Edit Office page, update the Office Name field and save.
Provider NPI has incorrect format. Provider NPI or Provider API is missing.	If only the NPI is populated, it must have 10 characters. Provider NPI or Provider API cannot be empty at the same time. Cannot be empty	Go to Admin > Office Setup > Search Office to locate and select the office. On the Edit Office page, update the NPI No. field and save.
Provider TIN has incorrect format. Provider TIN is missing.	Provider Taxpayer Identification Number (TIN) is not a 9-digit number. Provider TIN cannot be empty.	Go to Admin > Office Setup > Search Office to locate and select the office. On the Edit Office page, update the Tax ID field and save.
Caregiver First Name is too long. Caregiver First Name is missing.	Caregiver First Name cannot exceed 50 characters. Cannot be empty	Go to Caregiver > Search Service Provider to locate and select the Caregiver. On the Profile page, click the Edit button and update the First Name field. Save.
Caregiver Last Name is too long. Caregiver Last Name is missing.	Caregiver Last Name cannot exceed 50 characters. Cannot be empty	Go to Caregiver > Search Service Provider to locate and select the Caregiver. On the Profile page, click the Edit button and update the Last Name field. Save.
Caregiver Social Security Visa Passport is not in correct format. Caregiver Social Security Visa Passport is missing.	Caregiver Social Security Visa Passport must be last 4 numbers from SSN followed Caregiver last name (max. 50 characters). Cannot be empty.	Go to Caregiver > Search Service Provider to locate and select the Caregiver. On the Profile page, click the Edit button and update the Social Security Number field. Save.
Visit Date is earlier than 4/1/2015.	Actual Visit Date must be later than 4/1/2015.	Visits prior to 4/1/2015 cannot be created in HHAX. Visit must be deleted.

HHAX Hold Reason(s)

HHAX Rule Check(s)

How to Resolve

Consumer Directed Services Employer First Name is too long.

Consumer Directed Services Employer First Name is missing.

Populates for consumer directed services (CDS)

Healthcare Common Procedure Coding System

(HCPCS) codes.

Consumer Directed Services Employer First Name

cannot exceed 50 characters.

This field cannot be empty for a CDS visit.

Go to Patient > Search Patient to locate and select the Patient.

If the Patient is the Consumer Directed Services (CDS) Employer, go to the Profile page, click the Edit button, and update the First Name field. Save.

If the Patient has a different CDS Employer, go to the General page, click the Edit button, and update the CDS Employer of Record field. Save.

Consumer Directed Services Employer Last Name is too long.

Consumer Directed Services Employer Last Name is missing.

Consumer Directed Services Employer Last Name cannot exceed 50 characters.

This field cannot be empty for a CDS visit.

Go to Patient > Search Patient to locate and select the Patient.

If the Patient is the Consumer Directed Services (CDS) Employer, go to the Profile page, click the Edit button, and update the Last Name field. Save.

If the Patient has a different CDS Employer, go to the General page, click the Edit button, and update the CDS Employer of Record field. Save.

Employee ID is missing.

Cannot be empty.

Go to Caregiver > Search Caregiver to locate and select the Caregiver. On the Profile page, click the Edit button and update the Employee ID field.

The Employee ID is an identifier assigned to the Caregiver by his or her employer for HR and payroll purposes. Click Save.

EVV Call In Address Type has incorrect value.

EVV Call Out Address Type has incorrect value.

EVV Call In/Out Address Type must be one of the following:

• Patient Home

• Community

• Family Home

• Neighbor Home

Cannot be empty

Go to Patient > Search Patient to locate and select the Patient. On the Profile page, click the Edit button. Verify that the member address is assigned an Address Type and save.

If a phone number is assigned in the member’s profile, verify that the member Phone Location is selected.

If a member is configured for Alternative Device EVV, ensure that the member home address is selected on the General page, FOB Location field.

Doing the above corrects the hold moving forward, but past visits need to be corrected by locating the visit in the member’s calendar, clicking the Visit Info tab, and clicking the Edit button for Clock Out.

EVV Call In Phone is not in correct format for IVR method.

EVV Call In Phone is missing for landline (IVR) Method.

EVV Phone is not a 10-digit number for the landline method (IVR method).

Cannot be empty

Go to Patient > Search Patient to locate and select the Patient.

On the Profile page, click the Edit button and update the Home Phone field. Save.

EVV Call In Phone is changed for resubmission.

EVV Call Out Phone is changed for resubmission.

EVV Phone has changed for an updated visit resubmission.

EVV Call In and Call Out cannot be modified after an EVV transaction has been approved. Re-link the original Call In/Out for the visit.

EVV Call In Time has changed for resubmission.

EVV Call Out Time is changed for resubmission.

Actual Call In/Out Time cannot be changed for an updated visit resubmission.

Go to Patient > Search Patient to locate and select the Patient. On the Profile page, click the Edit button and update the Home Phone field. Save.

EVV Visit Call In LATITUDE is changed for resubmission.

EVV Visit Call Out LATITUDE is changed for resubmission.

EVV Visit Call In LONGITUDE is changed for resubmission.

EVV Visit Call Out LONGITUDE is changed for resubmission.

EVV Visit Call In/Out Latitude cannot be changed for an updated visit resubmission.

EVV Visit Call In/Out Longitude cannot be changed for an updated visit resubmission.

EVV Call In and Call Out cannot be modified after an EVV transaction has been approved. Re-link the original Call In/Out for the visit.

Go to Patient > Search Patient to locate and select the Patient. On the Profile page, click the Edit button. Verify that the member address is assigned an Address Type and save.

If a phone number is assigned in the member’s profile, verify that the member Phone Location is selected.

If a member is configured for Alternative Device EVV, , ensure that the member home address is selected on the General page, FOB Location field.

EVV Hours changed for resubmission.

Actual Hours cannot be changed for a visit resubmission.

EVV Service Delivery Address, City, State, or Zip Code In is missing.

EVV Service Delivery Address, City, State, or Zip Code Out is missing.

EVV Service Delivery Address In/Out cannot exceed 50 characters.

One or more of the EVV Service Delivery In/Out fields are missing.

EVV Service Delivery Location is not listed below:

• Patient Home

• Community

• Family Home

• Neighbor Home

Cannot be empty

EVV Service Delivery Address In is too long.

EVV Service Delivery Address (or City, State, Zip Code) In is missing.

EVV Service Delivery Address In cannot exceed 50 characters.

One or more of the EVV Service Delivery In fields are missing.

Cannot be empty

Go to Patient > Search Patient to locate and select the Patient. On the Profile page, click the Edit button and update the Address fields.

Verify that the member Phone Location is selected.

If a member is configured for Alternative Device EVV, ensure that the member home address is selected on the General page, FOB Location field.

Doing the above corrects the hold moving forward but past visits need to be corrected by locating the visit in the member’s calendar, clicking the Visit

Info tab, and clicking the Edit button for Clock In.

LTC Contract Number is missing due to no matching

LTC Authorization retrieved from the FFS Authorization web service

Long-Term Care (LTC) Contract Number, also known as LTC Provider Number, is required for LTC EVV visits. The following must match between the EVV Visit and authorization:

TIN
NPI
Service Code
Service Group

Auth Start/End Date

Verify member LTC eligibility. If the member is active with LTC, service code and service group on the EVV visit must match LTC authorization from the web service.

Medicaid ID is not in correct format.

Medicaid ID is missing.

Medicaid ID must be 9 digits.

Cannot be empty

Go to Patient > Search Patient to locate and select the Patient. On the Profile page, click the Edit button and update the Medicaid Number field. Save.

Patient’s Date of Birth missing.

Patient’s Date of Birth cannot be empty.

Go to Patient > Search Patient to locate and select the Patient. On the Profile page, click the Edit button and update the Date of Birth field. Save.

Patient First Name is not in correct format.

Patient First Name is missing.

Patient First Name cannot exceed 50 characters.

Cannot be empty

Go to Patient > Search Patient to locate and select the Patient. On the Profile page, click the Edit button and update the First Name field. Save.

Patient Last Name is not in correct format.

Patient Last Name is missing.

Patient Last Name cannot exceed 50 characters.

Cannot be empty

Go to Patient > Search Patient to locate and select the Patient. On the Profile page, click the Edit button and update the Last Name field. Save.

Patient Primary Phone is not in correct format.

Patient Primary Phone must be 10 digits.

Cannot be empty

Go to Patient > Search Patient to locate and select the Patient. On the Profile page, click the Edit button and update the Home Phone field. Save.

Patient Secondary Phone is not in correct format.

Patient Secondary Phone must be 10 digits.

Cannot be empty

Go to Patient > Search Patient to locate and select the Patient. On the Profile page, click the Edit button and update the Phone 2 field. Save.

Patient Tertiary Phone is not in correct format.

Patient Tertiary Phone must be 10 digits.

Cannot be empty

Go to Patient > Search Patient to locate and select the Patient. On the Profile page, click the Edit button and update the Phone 3 field. Save.

Payer Patient Plan Code is missing.

Cannot be missing when member payer is MCO: ET, AGP, BCB, CFC, CHS, CKC, CMC, DRC, MOL, SHP, TXC, UHC, CHC, SET, EP1, PRK, SCW, FCR

Cannot be empty.

Go to Patient > Payers/Insurance. Review the member payer placement for any errors. Add a new payer placement if eligibility changed for the member. Correcting the payer placement will prevent holds moving forward.

To resolve the visits on hold, go to Patient > Calendar > Visit > Bill Info. Select Plan Code and Save. Repeat for each affected visit.

Provider API has incorrect format.

Provider NPI or Provider API is missing.

If only the Atypical Provider Identifier (API) is populated, it must have 10 characters. Provider National Provider Identifier (NPI) or Provider API cannot be empty at the same time.

Go to Admin > Office Setup > Search Office to locate and select the office. On the Edit Office page, update the API field and save.

Provider Legal Name is too long.

Provider Legal Name is missing.

Provider Legal Name cannot exceed 50 characters.

Cannot be empty.

Go to Admin > Office Setup > Search Office to locate and select the office. On the Edit Office page, update the Office Name field and save.

Provider NPI has incorrect format.

Provider NPI or Provider API is missing.

If only the NPI is populated, it must have 10 characters.

Provider NPI or Provider API cannot be empty at the same time.

Cannot be empty

Go to Admin > Office Setup > Search Office to locate and select the office. On the Edit Office page, update the NPI No. field and save.

Provider TIN has incorrect format.

Provider TIN is missing.

Provider Taxpayer Identification Number (TIN) is not a 9-digit number.

Provider TIN cannot be empty.

Go to Admin > Office Setup > Search Office to locate and select the office. On the Edit Office page, update the Tax ID field and save.

Caregiver First Name is too long.

Caregiver First Name is missing.

Caregiver First Name cannot exceed 50 characters.

Cannot be empty

Go to Caregiver > Search Service Provider to locate and select the Caregiver. On the Profile page, click the Edit button and update the First Name field. Save.

Caregiver Last Name is too long.

Caregiver Last Name is missing.

Caregiver Last Name cannot exceed 50 characters.

Cannot be empty

Go to Caregiver > Search Service Provider to locate and select the Caregiver. On the Profile page, click the Edit button and update the Last Name field. Save.

Caregiver Social Security Visa Passport is not in correct format.

Caregiver Social Security Visa Passport is missing.

Caregiver Social Security Visa Passport must be last 4 numbers from SSN followed Caregiver last name (max. 50 characters).

Cannot be empty.

Go to Caregiver > Search Service Provider to locate and select the Caregiver. On the Profile page, click the Edit button and update the Social Security Number field. Save.

Visit Date is earlier than 4/1/2015.

Actual Visit Date must be later than 4/1/2015.

Visits prior to 4/1/2015 cannot be created in HHAX. Visit must be deleted.