Enhancements to EVV, EDI, Client Authorizations, and the Agency Portal

Import client authorizations using excel file

We’ve added a new Import Auth feature that allows agencies to upload multiple client authorizations at once using an Excel file, instead of entering them one by one in each client profile.

Previously, authorizations had to be added manually for each client, which was time-consuming and increased the chance of errors.

With this improvement:

A new Import Authorizations option is now available under Standard Data Migration.

Selecting Import Authorizations opens a dedicated screen where users can:

• Upload an Excel file (mandatory)
• Download a sample file
• Cancel or upload the file

The sample file shows:

• Mandatory fields highlighted in red
• Optional fields filled with example data
• Users can successfully import authorizations by following this sample file format.

Data Validation During Import

The system validates imported data in three clear levels to ensure accuracy:

Level 1 – Office & Client Validation

The system checks Office Name and Client details (Last Name, First Name or Full Name).

Validation works if either:

• Client Full Name is provided (with Medicaid ID), or
• Client First Name + Last Name (with Medicaid ID) is provided.
• An error is shown only if both options are missing or incorrect.

Level 2 – Client & Payer Validation

The system checks the Client–Payer combination using:

• Client Name
• Payer Name
• Payer’s Member ID
• Payer linking must already exist in the system.

Level 3 – Service & Authorization Validation

The system validates:

• Service Type
• Bill Type
• Authorization Start and End Dates
• If the same service, bill type, and date range already exist, a conflict of error is displayed.
• Different services with overlapping dates are allowed.

Error Handling & Messaging

Errors are displayed immediately after the import, following the existing import behavior.

Error messages:

• Clearly show the row number (starting from Row 2)
• Reference to the exact Excel column (Column A, B, etc.)
• Display each error on a separate line if multiple issues exist in one row

Mandatory field errors clearly mention:

• Field name
• Row number
• Column location
• Character length limits are enforced, and clear messages are shown if limits are exceeded.
• The authorization date of conflicts is clearly highlighted with the affected row number.

Import Rules & Save Options

Only new authorizations are imported.

Existing authorizations are not updated.

If conflicts are found, the system will display the set of errors.

After a successful import, users see a review screen with options to:

• Save
• Cancel
• Save & Sync
• Save & Sync works the same way as the existing manual authorization workflow.

Consistency with Existing Functionality

• All existing Standard Data Migration behaviors remain unchanged.
• Please Note: The Update Header option remains disabled for this import to prevent errors and potential data loss. Since authorizations are directly tied to billing, this option has been intentionally disabled to ensure accurate and reliable data import.
• Modifier fields are split into four separate columns in the import file and are accurately mapped to the authorization.
• Error pop-ups, row highlighting, and horizontal scrolling continue to work as they do today.

This update significantly reduces manual effort, improves data accuracy, and helps agencies import client authorizations faster and more reliably, while keeping all existing workflows as it is intact.

EVV & aggregator enhancements

Multi‑State EVV Configuration for Therap

Agency can now configure multiple states for the Therap EVV aggregator:

• Added multi‑state selection for Therap under the EVV Configuration screen (Aggregator → Office → State/Province).
• Posting workflow and existing settings for Therap remain unchanged.
• Behavior is now aligned with other aggregators such as Tellus, Sandata, HHAeXchange, AuthentiCare, etc.

What changed

• Agencies can now configure multiple states for the Therap EVV aggregator (like Sandata, Tellus, Authenticare, etc.).

Added Value

• Easier setup for multi‑state agencies using Therap.
• Consistent configuration experience across major EVV aggregators.

State‑specific sandata updates

Massachusetts – Sandata EVV Guideline Updates

Massachusetts Sandata configuration has been updated per the latest guidelines:

• Replaced references from “EOEA” to “AGE”.
• Added service code T1022 (“RESTRICTED FOR HH ONLY RN Specialized services in patient home”).
• Updated Bypass Reasons and added a new bypass reason (effective 10/22/2025).
• Updated Payer/Program/Service mappings, including new SCO and One Care payers and ASAP payers.
• Clarified Minimum Visit Duration rules and ClientIdentifier field expectations.
• Marked ClientIdentifierOnCall as not required.
• Added new service codes for SDABI and SDMFP programs.
• Re‑ordered the Procedure Code table for easier search.

Reference: https://sandata.zendesk.com/hc/en-us/article_attachments/46329616923411

Added Value

• These changes reflect the latest MA Sandata requirements.
• Designed to reduce claim/visit rejections related to outdated service codes or identifiers.

Delaware – sandata EVV updates

We have aligned Delaware Sandata configuration with the latest vendor specifications:

• Added missing services and modifiers requested by DE.
• Updated program mapping from DSHP to DSHPP where applicable.
• Updated service code G1056 → G0156 for DSHP – HHO Home Health Aide.
• Applied required Payer/Program/Service changes.

References:

• Delaware (DE DHSS) Vendor Solutions Specifications v.1.12
• https://sandata.zendesk.com/hc/en-us/article_attachments/44957294350227

Added Value

• Better alignment with Delaware DHSS requirements.
• Intended to minimize rejections due to incorrect program/service mappings.

Payer‑specific EDI enhancements

North Carolina – CareBridge Service Code Update

For North Carolina CareBridge:

• Service code G0158 revenue code mapping updated to include 0434 in addition to 0430.
• This is reflected in the AuthRef field logic per CareBridge documentation.

Reference: North Carolina

Added Value

• Updated to mirror CareBridge NC guidance.
• Reduces billing issues tied to incorrect revenue code mapping for G0158.

Arizona DDD – WellSky 837P Integration

We introduced support for WellSky 837P formatting for Arizona DDD:

• The new WellSky profile/clearinghouse can be configured under Billing Information.
• Set up screens and fields mirror existing clearinghouse profiles for a consistent user experience.
• Generated 837P files are aligned to the WellSky AZ DDD Companion Guide requirements.

Reference:
https://des.az.gov/sites/default/files/media/WellSky_AZ_DDD_Edition_837P_Companion_Guide_v10.pdf

Added Value

• Agencies billing AZ DDD through WellSky can now generate compliant 837P files directly from CareSmartz360.
• Simplifies setup by using a familiar clearinghouse configuration flow.

Virginia – DMAS 837 P & I Integration

Added integration support for DMAS payer 837 formats:

• New DMAS profile/clearinghouse available under Billing Information.
• EDI generation process and configuration steps remain consistent with existing 837 P/I workflows.
• Generated files are structured per the DMAS companion guide (as provided).

Added Value

• Agencies billing through Virginia DMAS can configure DMAS as a clearinghouse and generate compliant EDI files.
• Reduces the need for manual file formatting or external tools.

Blue Cross NC – PWK Segment Support in 837

Enhanced 837 EDI files for Blue Cross – North Carolina to support attachments:

• Added PWK segment and Attachment Control Number at the claim level (2300 loop).
• Supports required fields such as Report Type Code, Report Transmission Code, and related control numbers, in line with Blue Cross NC expectations.
• Ensures better alignment with standard 837 Professional/Institutional implementations while keeping existing claim data intact.

Added Value

• Better alignment with Blue Cross NC expectations for claims with attachments.
• Help prevent rejections where a PWK segment is required.