Sandata - CO

Electronic Visit Verification (EVV) / Sandata - CO Registering for Sandata Colorado

To register for Sandata CO:

  1. Navigate to www.colorado.gov/hcpf/evv.
  2. Choose your third-party provider (CentralReach) as your alternative vendor.
  3. When you receive a form, contact CentralReach for “vendor information” details.
  4. Attend the Sandata training prior to submitting Electronic Visit Verification (EVV) data.
  5. Users must also add CentralReach’s free Sandata EVV integration to their account, so we can turn on the integration for you. Please reach out to your Account Manager for assistance.

Electronic Visit Verification (EVV) / Sandata - CO Sandata and CR Mobile Checklist

To utilize Sandata with CR Mobile, users need to complete the following steps:

  1. Contact Sandata (www.colorado.gov/hcpf/evv) to register your request to use CentralReach as your “Provider Choice System” for EVV. Click here to learn how to register for Sandata.
  2. Contact your Account Manager to turn on the CentralReach integration to Sandata EVV.
  3. In CentralReach:
    • Clients’ addresses need to be geolocated.
    • In the “Payors” section of clients’ profiles, set up their Medicaid “Insured ID” under the “Patient” tab.
    • In the organization’s “Accepted Insurances” section, identify the payor as Medicaid (select the “Medicaid” checkbox).
    • Billing Providers need to have their Medicaid ID entered in the “Claim Settings” of their profile. This needs to be completed for each billing provider contact.
      • Please note, the “billing provider” is the entity billing information that is populated in box 33.
    • Employees need to have their SSN and e-mail entered in the “Claim Settings” of their profile.
    • Ensure the appropriate staff have the necessary CR Mobile and billing permissions, including the (Billing > Visit Verification) permission.
  4. In the organization account, navigate to Visit Verification > Credentials to input your Sandata production credentials, which should have been emailed to you from Sandata. 
    • The email should state it contains “Production Credential Information” with a user ID consisting of a mix of alphanumeric characters.
  5. Complete all EVV appointments in CR Mobile. This includes telehealth appointments.
  6. Complete draft timesheets by inputting EVV reason codes, adding session notes, or addressing any other next steps. 
  7. Submit visit verification data in the Billing module.
    • If records are accepted, complete the normal billing process. If records are not accepted, review errors and contact CR support.

Electronic Visit Verification (EVV) / Sandata - CO Secondary Billing to Colorado Medicaid

Organizations that are secondary billing to Colorado with Electronic Visit Verification (EVV) need to complete the following steps:

  1. Service codes need to be set up to capture visit verification information.
  2. Use CR Mobile to complete the appointment and capture EVV information. Finalize draft timesheets, as usual. 
  3. Prior to billing the primary/commercial payor, send the completed visits to Sandata after completion. Complete pre-billing audits and generate the claim for the commercial payor. 

After the ERA is returned from the primary payor, complete the secondary billing workflow. EVV information should be available to Colorado Medicaid to enable reimbursement.

Click here for the CR Mobile and Sandata workflow.

Visit the Colorado EVV website for more information regarding stakeholders and upcoming meetings.

Electronic Visit Verification (EVV) / Sandata - CO Viewing the Status of Visit Verification Data

After the Sandata EVV feature is enabled, users with billing permissions can access the “Visit Verification” section of the Billing module to check the status of visit verification data. Please note, Sandata recommends sending visit information every day. It must be sent prior to submitting a claim to Medicaid.

To view the status of accepted or rejected visit verification data:

  1. Navigate to the Billing module and select Visit Verification
  2. Select a desired date range and add any filters, such as by payor and state, or labels to filter the screen.
  3. Click ALL, PENDING, ACCEPTED, REJECTED, or UNSENT to display the status of billing entries.
    • Unsent: The visit has not been sent to Sandata.
    • Pending: The visit has been sent, but Sandata has not reviewed it.
    • Accepted: The visit is correct. The detail line will display the time it was accepted.
    • Rejected: There is an error/missing information that needs to be corrected. The detail line will contain the information that should be reviewed. For rejected billing entries, make the necessary adjustments and resend to Sandata.
  4. Select the checkbox next to unsent claims and click SEND TO SANDATA in the upper right-hand corner.
  5. Billing entries will show as pending until they are accepted or rejected. Once they are accepted by Sandata, continue the billing process.