Where to Submit Corrected Claims for EVV Claim Denials
Date: 08/11/20
In order for Electronic Visit Verification (EVV) matching to be performed for STAR Kids, STAR Health and STAR+PLUS member claims, corrected claims must be sent to Texas Medicaid & Healthcare Partnership (TMHP). For EVV claims with dates of service on or after September 1, 2019 that include any of the denial codes listed below, please submit the corrected claims to TMHP*.
EVV Denial Codes | |
|---|---|
EX1i | EVV02 NO EVV VISIT MATCH FOR MEDICAID ID BILLED |
EX1J | EVV03 NO EVV VISIT MATCH FOR MEDICAID ID AND DATE OF SERVICE BILLED |
EX1n | EVV04 NO EVV VISIT MATCH FOR MEDICAID ID AND NPI/API FOR DOS BILLED |
EX1O | EVV05 NO EVV VIST MATCH FOR MEDICAID ID AND HCPCS/MODS FOR DOS BILLED |
EX1P | EVV06 UNITS BILLED DOES NOT MATCH TOTAL EVV VISIT UNITS |
*Note: As a reminder, Consumer Directed Services (CDS) employers/Financial Management Services Agencies (FMSAs) are not required to use EVV at this time.
To review the process for submitting corrected claims to TMHP, please review Preparing to Submit Electronic Visit Verification (EVV) Claims to Texas Medicaid & Healthcare Partnership (TMHP) (PDF).
Additional Information
- More information on EVV matching can be found in the EVV Provider Training located on Superior HealthPlan’s Texas Medicaid & Health Insurance Provider Resources webpage.
- To contact your selected EVV vendor, please use the contact information below:
DataLogic Software, Inc. (Vesta)
Phone: 1-844-880-2400
Email: Info@vestaevv.com
First Data Government Solutions (AuthentiCare)
Phone: 1-877-829-2002
Email: AuthentiCareTXSupport@firstdata.com
Contact Information
For any additional EVV-related information or questions, please use the following contacts:
- For EVV policy questions, please email Electronic_Visit_Verification@hhsc.state.tx.us
- For EVV vendor and portal questions, please email EVV@TMHP.com.
- For additional EVV-related contacts, review the HHS EVV Contact Information Guide (PDF)
For any other questions, please contact Superior’s Provider Services department at 1-877-391-5921.