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Illinois Information Center

Provider Enrollment Form

WELCOME TO HHAEXCHANGE

Illinois has partnered with HHAeXchange to help Illinois providers become compliant with state and federal Electronic Visit Verification (EVV) requirements and ensure a simplified, user-friendly, and seamless experience.

Under Section 12006(a) of the 21st Century Cures Act, states are required to implement EVV for all Medicaid personal care services and home health care services that require an in-home visit by a provider. The EVV system must verify the type of service performed, along with the date, time, and location of the service, as well as the individual receiving and the individual providing the service.

Illinois has decided to use an open system or “Open Vendor Model.” The implementation of an “Open Vendor Model” allows providers to use the state’s selected EVV system, HHAeXchange, at no cost, or an alternate EVV system of their choosing that directly integrates with the state’s EVV system, HHAeXchange. The HHAeXchange system includes data collection, data aggregation, and a pre-billing module to support Illinois’ Department of Healthcare & Family Services and its providers. HHAeXchange will support Illinois HFS by consolidating all visit data, regardless of the EVV tools used.

In 2023, Illinois HFS began the implementation with HHAeXchange for aggregation of EVV data. The implementation has been staggered to allow adequate time for training and adoption by impacted stakeholders.

  • As of September 1, 2023, Illinois Division of Developmental Disabilities, Personal Support Worker (PSW) services have gone live with EVV.
  • As of December 31, 2023, Home Health services billed to Illinois Medicaid (HFS) and the Managed Care Organizations (MCOs), Division of Developmental Disabilities, and Division of Specialized Care for Children has gone live with EVV.
  • Illinois Department on Aging (i.e., Community Care Program/CCP) and Division of Rehabilitation Services (i.e., Home Services Program/HSP) agency-based providers have not gone live with aggregation of data to HHAeXchange. Agencies are not yet permitted to use the State-sponsored EVV system through HHAeXchange for these programs.

Illinois State Payers and Managed Care Organizations Currently in Scope

  • Illinois Department of Human Services – Division of Developmental Disabilities (DDD)
  • UIC Division of Specialized Care for Children (DSCC)
  • Illinois Department of Healthcare & Family Services (HFS)/Illinois Medicaid
  • Aetna Better Health of Illinois HCI
  • Aetna MMAI
  • Illinois Blue Cross Blue Shield HCI & MMAI
  • CountyCare Health Plan Illinois HCI
  • Meridian Health Plan HCI & MMAI
  • Molina Healthcare IL HCI & MMAI
  • Humana IL MMAI

HHAeXchange is offered at no cost to the providers. However, we understand that providers may need to expend time and resources to implement a change this large in order to achieve compliance in partnership and cooperation with Illinois (IL). Here’s a look at some of the benefits you will get if you choose the no-cost HHAeXchange EVV Portal.

EVV

  • Participant Management
  • Mobile Application in Multiple Languages
  • Telephone Lines in English and Spanish
  • EVV options focused on Self-Direction
  • Clock-In / Clock-Out Exception Dashboard
  • Submission / Aggregation of EVV Data

Compliance

  • Plan of Care Adherence
  • Visit Confirmation Compliance
  • Visit Reporting

Purpose-Built for Self-Direction

  • Participant or employer review and approval of time worked

 

Choose the Best Option for Your Agency

Your provider agency plays a vital role in the success of the state’s EVV program. As part of your participation with Illinois Medicaid, you have two options to ensure EVV compliance. Please review your options and then fill out the Illinois Provider Enrollment Survey to make your selection. This survey will create your HHAeXchange portal. Every agency who provides in scope EVV services for Medicaid customers is required to have a portal!

  • Option 1 – Use the free version of HHAeXchange for EVV data entry.  This option may be particularly appealing for agencies currently without an EVV Solution.
  • Option 2 – Use a third-party EVV vendor for EVV data entry.  This option may be particularly appealing for agencies currently using another 3rd Party EVV Solution since agencies can use their existing EVV system and import visit data into the HHAeXchange EVV Portal using Electronic Data Interchange (EDI).

Your Monthly EVV Compliance Report

The Know Your Numbers Q&A session held on November 8 provided insight into the EVV Compliance Report and how it supports transparency and accountability across the EVV process. If you missed the webinar or would like a refresher, please review the deck below.

Recording| Slide Deck

To help you navigate the report, we’ve prepared a detailed article that walks you through the compliance reporting details step-by-step. It is available on the HHAeXchange Knowledge Base.

Click the links below to review EVV Policies for provider agencies by program:

Monthly Reporting:

An EVV compliance report will be generated on the 15th of each month for EVV data from the previous month, as well as “year-to-date” information.  The report will be sent via email to all admin users for agencies providing services for the payers listed below.

  • Illinois Department of Human Services – Division of Developmental Disabilities (DDD)
  • UIC Division of Specialized Care for Children (DSCC)
  • Illinois Department of Healthcare & Family Services (HFS)/Illinois Medicaid
  • Aetna Better Health of Illinois HCI
  • Aetna MMAI
  • Illinois Blue Cross Blue Shield HCI & MMAI
  • CountyCare Health Plan Illinois HCI
  • Meridian Health Plan HCI & MMAI
  • Molina Healthcare IL HCI & MMAI
  • Humana IL MMAI

Please note: DRS and DOA services are not in scope for EVV at this time.

 Frequently Asked Questions (FAQ)

In an effort to simplify EVV Compliance Reporting,  questions from provider agencies and answers from Subject Matter Experts are presented below.  This information should help you to understand these reports and know how to use them.

Question Answer
What will happen when you find paid claims that have visits that don’t have EVV data in HHAX? For EVV in scope services, paid claims comparison is in the initial stages. Any policies related to paid claims matching thresholds and impact to provider agencies will be communicated once effective.
When is HFS going to start matching claims data with EVV data collected? HHAeXchange is working with HFS, DSCC, and DDD to develop reporting on paid claims comparisons to EVV data.
So far we have not been able to set up schedules using your portal. The support team said it is because IDOA and MCO authorizations are not loaded into your system. So what do we do from here to be in compliance? There is no statewide EVV aggregation compliance for IDOA currently as IDOA and DRS are not in scope or live with HHAeXchange at this time. There is no definitive ETA for when IDOA and DRS will go live with HHAeXchange. Providers billing IDOA, DRS, or the MCOs for services provided to IDOA or DRS customers should continue following current EVV policies and billing practices until further notice. Questions regarding IDOA EVV policy may be submitted to [email protected]. Questions regarding DRS EVV policy may be submitted to [email protected].
Any idea on when claims denials will start? Providers will be notified through updated policy if/when a State payer elects to implement claims denials for EVV non-compliance. Please refer to the respective State payer (DSCC, DDD, or HFS) for current EVV policy.
Comment from IL Dept. on Aging: For IDOA, providers who have questions specific to EVV for your IDOA customers, please email [email protected].
So IDOA and MCO is not in the scope of this presentation as of yet? There is no statewide EVV aggregation compliance for IDOA currently as IDOA and DRS are not in scope or live with HHAeXchange at this time. There is no definitive ETA for when IDOA and DRS will go live with HHAeXchange. Providers billing IDOA, DRS, or the MCOs for services provided to IDOA or DRS customers should continue following current EVV policies and billing practices until further notice. Questions regarding IDOA EVV policy may be submitted to [email protected]. Questions regarding DRS EVV policy may be submitted to [email protected].
How much time does the staff have to clock in and out from the scheduled time? Is there a grace period? (ie. scheduled at 7am, but clocks in at 7:03am) Schedules are not required for in-scope EVV services. If there is no schedule in the system, your clock in and clock out becomes the ‘schedule’ and visit time.
How does the tolerance rate of 500 feet work if it is a community visit? This topic was covered during the July 3, 2023, Illinois EVV Townhall webinar. Please see slide 28 of the presentation at this link. Community Visits are not considered exceptions.
If the patient’s parent wants the nurse to work with them in a different location, e.g., the parent goes on vacation and wants the staff to follow them, can the staff clock in and out in a different location if the client is with them? Please speak with the respective State payer (HFS, DDD, or DSCC) regarding policy pertaining to service provision outside of the home.
What is the option for a client who does not have a home phone and the staff member does not have a cell phone that is able to download the app? Please submit this question to the respective State payer for guidance (DDD, DSCC, HFS).
I know that IDOA and DRS are not going live, but what about the MCO’s? Homemaker services (S5130) are currently not in scope. If you’re serving a CCP or HSP customer under IDOA or DRS, whether you’re billing IDOA, DRS, or an MCO, HHAX is not available for EVV and not required for EVV at this time.
IDOA CCP and DRS waiver programs are NOT live with HHA and no ETA for when that will happen – correct? Correct. There is NO ETA at this time. More info to come.
What is the deadline in integrating? The expectation is to be currently integrated for services in scope. Please refer to HFS’ EVV website (link) for implementation timelines.
What is the rule for manual clock in and out if caregiver has network issue or app is not working; will it be acceptable under compliance? For providers using the HHAeXchange mobile application, utilizing the offline mode of the mobile application will not impact compliance. If using a 3rd party vendor, please confirm this functionality with your vendor.
Which programs are live with HHAeXchange and will appear on the EVV Compliance Report? The following programs are live and comprise what appears on the EVV Compliance Report: Illinois Department of Human Services (IDHS)-Division of Developmental Disabilities (DDD) for Personal Support Worker (PSW) and Home Health Care Services (HHCS), Illinois Department of Healthcare & Family Services (HFS) for HHCS, and Division of Specialized Care for Children (DSCC) for HHCS.
Which providers will receive the EVV Compliance Report? All linked providers will receive the EVV Compliance Report. This includes both providers who use HHAeXchange as their EVV system as well as those using an Alternate EVV Vendor.
Who will receive the email with the EVV Compliance Report? All active users in HHAeXchange with an “Admin” role will receive the report via email.
When is the report generated? The report is generated and e-mailed to users on the 15th of each month.
What data is contained on the report each month? The report contains visit data for dates of service from the previous month, which have been entered or edited up until the 15th of the following month (when the report is generated). For example, the report sent on December 15, 2024 contains visits with dates of service 11/1/24-11/30/24.
What is the threshold for EVV Compliance? IDHS-DDD, DSCC, and HFS provider agencies who do not achieve 75% overall EVV visit compliance by October 31, 2025, will receive Corrective Action Plans that if not implemented, will ultimately result in a referral to HFS OIG.
What is considered an exception for EVV? “There are seven exception categories:

  1. No EVV Call In
  2. No EVV Call Out
  3. No EVV Call In and No EVV Call Out
  4. TEMP Caregiver assigned to visit
  5. No GPS Coordinates when EVV Type is Mobile
  6. No Caller ID when EVV Type is Telephony (IVR)
  7. Manual Edit (EVV Call In and EVV Call Out do not match Visit Start Time and Visit End Time)
How is EVV Compliance Calculated? “The calculation is as follows:

(Total Visits for the Time Period – Total Visits for the Time Period with an Exception)/ Total Visits for the Time Period”

If my caregiver’s clock in and out are different from the schedule, does that affect compliance? No schedules are required for in scope EVV services, and the EVV Compliance calculation does not consider Schedule times. If the caregiver clock in and out are different than the schedule, it will not impact your compliance.
If my caregiver has network issues or the app is not working, how does that impact EVV and compliance?
Schedules are not required for in scope EVV services, and the EVV Compliance calculation does not consider Schedule times. If the caregiver clock in and out are different than the schedule, it will not impact your compliance.
If EVV is performed in the Community, does this count against EVV Compliance? Among the programs live for HHAeXchange, only IDHS-DDD PSWs are allowed to log EVV visits in the community when service is performed in the community. GPS coordinates in the community will not negatively impact compliance for IDHS-DDD PSWs. Please ensure the PSW is properly denoting “Community” when using the HHAeXchange mobile app, or that your EVV vendor is indicating visits done in the Community using the integration.

Training Opportunities

HHAeXchange University (Learning Management System/LMS):

HHAeXchange University is the new Learning Management System (LMS) for software mastery. This user-friendly, self-paced platform is designed to help you learn the HHAeXchange portal and Electronic Visit Verification (EVV) in less time. Getting started is easy—register on the LMS Sign Up page using your name, email, chosen password, and six-digit customer ID. No need to share credentials—anyone from your agency can create their own login. Once registered, explore personalized learning plans and start your journey today. Your foundational training takes just 2-3 hours, putting essential tools and knowledge at your fingertips!

 

Upcoming & Previously Recorded Illinois Specific Training Sessions

Training Session Date Links
Illinois Alternate EVV Lunch & Learn May 19, 2025 Recording | Slide Deck 

 

Boost Your Compliance with Reporting April 29, 2025 Recording | Slide Deck

 

EVV Best Practices Webinar April 17, 2025 Recording | Slide Deck

 

 

Upcoming Webinars

Please click here for Additional Training Webinars.

Link to Key Information Document

Click here to review the detailed FAQ 2.0 document in regard to the Illinois Implementation.

Key Dates

Date Event
October 1, 2025                          75% Compliance Required
April 1, 2025 50% Compliance Required
October 1, 2024 EVV Compliance Policies Released
September 1, 2024 Caregiver Full SSN Required

 

 

 

Electronic Data Interchange (EDI) Process

The EVV integration timeline is dependent on the 3rd party agency management system and other factors. While in the configuration process, you do not need to do anything further for EVV or data aggregation, aside from responding to your 3rd party vendor’s or HHAX’s requests for EDI linking. As long as EVV data is being captured in the 3rd party vendor’s system, it will be transferred over for aggregation retroactively once EVV aggregation linking is completed.

EDI Overview (Integrating with a 3rd Party Agency Management System)

Note, this process applies specifically to providers that chose Option 2, found on the “Get Started Now!” tab above.

Thank you for working with HHAeXchange on the Electronic Data Interchange (EDI) project for your agency. Below you will find information about the general requirements and steps to successfully integrate your 3rd Party Agency Management System with HHAeXchange. EDI providers will be required to comply with both the business requirements and technical specifications listed below. Upon review of the documents below, please follow the steps in the Getting Started Checklist for Illinois State-Sponsored Alternate EVV Providers

Please review and follow the steps below

  1. Business Requirements Link
  2. Technical Specification Document
  3. Authorization Specification (Optional)

Importing Caregivers into HHAeXchange 

(Note: This action is not required for agency providers using an EDI Import file to integrate with their 3rd Party Agency Management System).

To assist organizations with a large census of Caregivers, HHAeXchange has created a Caregiver Bulk Import tool to expedite the entry process. CLICK HERE to access the Caregiver Bulk Import Process Guide,which provides instructions for how to:

  • Access and Save the Caregiver Import Template
  • Prepare the Caregiver Import File for your Agency
  • Follow Instructions for the EDI Team to Receive your File. Go to hhaexchange.com/supportrequest. From the support portal page, please click on Provider EDI Integrations and submit a Caregiver Import request.

Training Opportunities for EDI Providers

“EDI Onboarding Webinar for Illinois Home Health”

Recording | Slides

“EDI Onboarding Webinar for Illinois DDD Personal Care”

Recording | Slides

The below in scope services are the only services currently live with the HHAeXchange State-Sponsored EVV Tools and Aggregation.

Personal Care Services (PCS):

Individuals receiving personal support in the home through Illinois’ Home and Community Based Services (HCBS) waivers, This consists of services supporting Activities of Daily Living (ADLs), such as bathing, dressing, grooming, and meal preparation.

Illinois Department of Human Services (DHS) – Division of Developmental Disabilities (DDD) Personal Care Services:

Service Code Service Description
T1019 Personal Support
T1019:TU Personal Support (Overtime)
T2034 Personal Support (Crisis Funding)
T2034:TU Personal Support (Crisis Funding Overtime)

Home Health Care Services (HHCS)

Individuals receiving home health services through the Medicaid State Plan, the Nursing and Personal Care Services (NPCS) program, or authorized under a waiver, including the Medically Fragile Technology Dependent (MFTD) Waiver

Illinois Department of Healthcare and Family Services (HFS) – Medicaid State Plan Home Health, including both Fee-For-Service (FFS) and the Managed Care Organizations (MCO)

Service Code Description
T1020 In-home shift nursing for Nursing and Personal Care Services in all counties; child age 0 through 20 – CNA
T1003 In-home shift nursing for Nursing and Personal Care Services in all counties; child age 0 through 20 – LPN
T1002 In-home shift nursing for Nursing and Personal Care Services in all counties; child age 0 through 20 – RN
G0153 Speech therapy visit
G0153:U2 Speech therapy evaluation
G0152 Occupational therapy visit or occupational therapy assistant visit
G0152:U2 Occupational therapy evaluation or occupational therapy assistant evaluation
G0151 Physical therapy visit or physical therapy assistant visit
G0151:U2 Physical therapy evaluation or physical therapy assistant evaluation
G0156 Home health aide visit
G0300 Intermittent skilled nursing visit – LPN
G0299 Intermittent skilled nursing visit – RN
G0299:U2 Intermittent skilled nursing assessment visit – RN

Illinois Department of Human Services (DHS) – Division of Developmental Disabilities (DDD)

Service Code Description
T1003 Nursing LPN – Agency Provider
T1002 Nursing RN – Agency Provider
G0153 Speech Therapy Visit
G0152 Occupational Therapy Visit or Occupational Therapy Assistant Visit
G0151 Physical Therapy Visit or Physical Therapy Assistant Visit
T2034:TU Personal Support (Crisis Funding)

Illinois Department of Human Services (DHS) – Division of Specialized Care for Children (DSCC)—NPCS and MFTD

Service Code Description
S5150 Respite Nursing (MFTD waiver, CNA providing service)
T1002 Nursing RN – Agency Provider (MFTD waiver)
T1002:CR Nursing RN – Agency Provider Parents (Overtime)
T1002:TT Nursing RN – Agency Provider (Multiple Patients)
T1002:TU Nursing RN – Agency Provider (Overtime)
T1002:TT:TU Nursing RN – Agency Provider (Multiple Patients, Overtime)
T1002:TT:U7 Nursing RN – Agency Provider Parent (Multiple Patients)
T1002:TU:U7 Nursing RN – Agency Provider Parent (Overtime)
T1002:TT:TU:U7 Nursing RN – Agency Provider Parent (Multiple Patients, Overtime)
T1002:U7 Nursing RN – Agency Provider (MFTD waiver-Family Member)
T1003 Nursing LPN – Agency Provider (MFTD waiver)
T1003:CR Nursing LPN – Agency Provider Parents (Overtime)
T1003:TT Nursing LPN – Agency Provider (Multiple Patients)
T1003:TU Nursing LPN – Agency Provider (Overtime)
T1003:TT:TU Nursing LPN – Agency Provider (Multiple Patients, Overtime)
T1003:TT:U7 Nursing LPN – Agency Provider Parent (Multiple Patients)
T1003:TU:U7 Nursing LPN – Agency Provider Parent (Overtime)
T1003:TT:TU:U7 Nursing LPN – Agency Provider Parent (Multiple Patients, Overtime)
T1003:U7 Nursing LPN – Agency Provider (MFTD waiver-Family Member)
T1004 Home Health Aide Services – Agency Provider
T1004:TU Home Health Aide Services – Agency Provider (MFTD waiver)
T1005:TE Respite Nursing – LPN
T1005:TD Respite Nursing – RN
T1005:TE:TT Respite Nursing (MFTD waiver, LPN, RN providing service)
T1005:TD:TT Respite Nursing (MFTD waiver, LPN, RN providing service)

 

  • IL Department of Healthcare and Family Services is currently holding recurring Townhall meetings for all in scope provider agencies

All providers can use our Client Support Portal to find answers to questions and create support requests or reach out to HHAeXchange at [email protected].

If you need to contact someone directly for DHS’ Division of Rehabilitation Services (DRS), please email [email protected].

If you need to contact someone directly for UIC-DSCC, please email [email protected].

If you need to contact someone directly for Department on Aging, please email [email protected]

If you need to contact someone directly from DHS-DDD, please email [email protected].

If you need to contact a representative of HFS regarding State Plan Home Health services billed to Illinois Medicaid or the MCOs, please email [email protected].

 HHAeXchange Illinois EVV Helpline: (833)961-7429