Provider Information for Electronic Visit Verification

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The Kentucky Department for Medicaid Services (DMS) is in the process of implementing electronic visit verification or EVV. Beginning no later than January 1, 2021, providers delivering in-home services to 1915(c) Home and Community Based Services waiver participants must use EVV to record information about their visits. DMS is asking providers to fill out the form below to give us needed information and to help us ensure important EVV updates reach all affected providers. If you have questions about EVV communications, please email MedicaidPublicComment@ky.gov.

Agency name *

Name of individual(s) DMS should contact regarding EVV *

Address *

Phone number *

Email address *

For Traditional Providers: How many in-home care workers does your agency have?

For PDS Providers: How many waiver participants do you have who use PDS?

For PDS Providers: What is the average number of PDS employees per waiver participant?

For all providers: Does your agency plan to use the Tellus EVV application? *

Yes.

No. Our agency already uses EVV.

No. Our agency plans to choose its own EVV vendor.

Not sure yet.

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