Home care and home health agencies are in a challenging position. With the requirements of the 21st Century Cures Act and evolving state systems, Electronic Visit Verification (EVV) compliance isn’t optional; it’s mandatory. Non‑compliance can mean denied reimbursements, state sanctions, or even fines. But agencies frequently lack the specialized staff to manage all the moving parts of EVV: data matching, audits, error correction, system updates, staff training, and coordination.
This is why many agencies are now hiring a dedicated EVV Compliance Specialist, sometimes as a full‑time staff member, sometimes as a blended role, and finding that the investment more than pays for itself. In this article, we break down:
- The role and responsibilities of an EVV Compliance Specialist
- Cost vs. benefit comparison: full‑time local hire vs. remote hire via SallySupport
- How that specialist integrates with existing teams
- Best practices and key metrics to track
- Case study examples and data showing the cost of non‑compliance
What Is an EVV Compliance Specialist?
An EVV Compliance Specialist is someone whose primary responsibility is ensuring that all EVV requirements are met consistently. Depending on an agency’s size and state regulations, this might be a full‑time position or a role shared with other administrative duties.
Typical responsibilities include:
Responsibility | What This Looks Like in Practice |
EVV system monitoring and verification | Checking that provider visits are properly logged: correct service type, provider identity, time in/time out, location, initials, or required signatures. Reviewing system reports. |
Error correction & audit response | Identifying mismatches (e.g., visit claimed but not recorded), resolving errors, and responding to auditors or state agencies. |
Documentation & policies | Ensuring staff understand EVV policies; maintaining updated procedure manuals; making sure client records, proof of service, and documentation conform to state and federal standards. |
Training & support | Training caregivers and office staff on how to use EVV tools; holding refreshers when rules or systems change. |
State/county regulation tracking | EVV rules differ state by state; keeping up with updates, state‑specific mandates, penalty thresholds, required data elements, and aggregator/vendor changes. |
Coordination with billing & payroll | Ensuring EVV data matches with billed services; working with payroll or claims staff so that timesheets, claims, and EVV logs reconcile. |
In smaller agencies, or when EVV workload is moderate, this role can be shared or partially blended with general administration, but even then, having someone with clear EVV compliance responsibilities significantly reduces risk.
The Cost / Benefit Comparison: Local Full‑Time Hire vs Remote via SallySupport
One of the biggest objections agencies often have is cost. But when you do the math, including all overhead, hiring a specialist via SallySupport often comes out ahead.
Cost Element | Local Full‑Time Specialist * | Remote Specialist via SallySupport |
Base salary/wages | Depending on region and experience, local EVV compliance roles often pay $20‑25/hour (or more), which is roughly $3,500‑$5,000+/month depending on hours. | Flat $1,700/month for a comparable full‑time VA specializing in EVV compliance. |
Payroll taxes & employer contributions (FICA, Medicare, FUTA, SUTA) | Employers must pay their share of Social Security/Medicare (about 7.65%), plus state & federal unemployment, etc. These can add several hundred dollars monthly. | With SallySupport, those costs are handled by the service provider; the agency pays the flat fee without those additional deductions. |
Workers’ compensation insurance | Required locally; cost varies by state, often a percentage of payroll; may be several hundred to over a thousand dollars/year depending on risk class. | Included in the SallySupport model, the agency does not separately insure the remote VA. |
Benefits / paid time off / health insurance | If offering full‑time status, the costs of benefits can be significant (insurance, paid leave, etc.) | The remote VA model may not require all these benefits, or they are handled by the provider under a different cost structure. |
Training and onboarding costs | Including dedicated time from local staff, software, and potentially a higher cost in learning state‑specific rules or EVV vendor changes. | SallySupport provides an industry crash course, training on HIPAA/PIPEDA, EVV best practices, and often already has VAs with relevant experience. |
Estimated Monthly Cost Comparison
- Local full‑time hire: If paying $22/hour, 40 hours/week, that’s ~$3,520 in wages alone; add employer taxes, insurance, benefits → total cost could easily reach $5,000‑$6,000+ / month.
- Remote via SallySupport: Flat $1,700/month, all inclusive under the VA model.
So agencies can potentially save 60‑70% or more in direct costs by using remote specialist support.
Risks and Costs of EVV Non‑Compliance
It’s not just about what you spend; it’s also about what you lose if EVV isn’t managed well.
Some relevant data:
- Under the 21st Century Cures Act, failure to implement EVV for Personal Care Services (PCS) by Jan 1, 2020, and for Home Health Care Services (HHCS) by Jan 1, 2023, triggers reductions in the Federal Medical Assistance Percentage (FMAP) (i.e., less federal reimbursement for states) if states do not comply.
- In Ohio, a 2024 audit found that only about 44% of PCS and HHCS Medicaid claims had matching EVV data in 2022, meaning the majority of paid claims had missing or mismatched EVV info.
- In New York, audits found billions in services (billings) lacking matching EVV records; for example, one audit reported $14.5 billion in Personal Care and $97.6 million in Home Health Services lacking matching EVV records.
- Non‑compliance may lead to audits, denied claims, refunds, or penalties from state Medicaid authorities. Some states impose escalating fines or make EVV data a condition of payment.
When you add up lost reimbursements + potential fines + increased administrative costs + staff overtime to fix errors, it’s easy to see that a small investment in a dedicated compliance specialist can avoid large losses.
Integration: How the EVV Specialist Fits into Existing Teams
Hiring someone is one thing; making them effective is another. To get full value, you need to integrate them well:
- Define their scope clearly
- Is this person only responsible for EVV compliance?
- Or will they also take on other admin tasks/allocation when the EVV workflow is light?
- Is this person only responsible for EVV compliance?
- Delegation and blended roles
- If full‑time EVV work isn’t enough, assign other tasks: general admin, billing support, scheduling follow‑ups, and caregiver credential tracking.
- If full‑time EVV work isn’t enough, assign other tasks: general admin, billing support, scheduling follow‑ups, and caregiver credential tracking.
- Establish reporting lines
- Who does the EVV Specialist report to? (e.g., Office Manager, Director of Ops)
- How do they coordinate with billing, payroll, and caregiver supervisors?
- Who does the EVV Specialist report to? (e.g., Office Manager, Director of Ops)
- Use of tools and software
- EVV vendor dashboards, audit tools, scheduling integration, and notification systems for missing data.
- Secure document storage, tracking systems for error correction workflows.
- EVV vendor dashboards, audit tools, scheduling integration, and notification systems for missing data.
- Regular meetings and feedback
- Weekly or bi‑weekly check-ins to review EVV compliance reports, error rates, and unresolved issues.
- Monthly summary metrics to leadership.
- Weekly or bi‑weekly check-ins to review EVV compliance reports, error rates, and unresolved issues.
Best Practices for EVV Compliance Specialists
To ensure the role is effective and cost‑efficient, these practices are critical:
- Stay updated on state laws and EVV vendor/aggregator changes. Legislation or system changes can introduce new requirements.
- Use standard checklists for matching EVV records to claims.
- Proactive auditing rather than reactive error correction (i.e., sampling past visits regularly to find errors).
- Train staff early and often (caregivers, schedulers, supervisors) so that EVV data is accurate at the source.
- Focus on data accuracy: timestamps, service codes, provider IDs, client IDs, and location. Small errors often account for big mismatch rates.
- Maintain documentation of corrections, denials, and audits in case of state review or audits.
Key Metrics to Track
A compliance specialist should monitor and report on several metrics. These help assess performance and identify problem areas early:
- EVV match rate, percentage of claimed services that have matching EVV records.
- Error rate/mismatch rate, how often visits are logged but with wrong details (wrong time, service type, location).
- Claims are denied or delayed due to EVV issues, the dollar amount of denied claims, or a lag in reimbursement.
- Volume of corrective tasks, number of mismatches or errors per week/month, and time spent correcting.
- Training incidence: how many staff/caregivers required retraining or refreshers?
- Time to resolution for mismatches or compliance issues.
Tracking these helps show the ROI of the specialist role. Over time, error rates go down, denied claims drop, and staff time is freed for other work.
Case Study(s) / Sample Scenarios
Here are hypothetical but realistic scenarios illustrating how agencies benefit from investing in an EVV Compliance Specialist.
Scenario A: Medium‑Sized Agency in Pennsylvania
- Before hiring a specialist: match rate ~ 70%; monthly denied or delayed claims ~$5,000 due to EVV mismatches; office staff spends ~10 hours/week reconciling logs, correcting claims.
- After hiring a full‑time remote specialist at $1,700/month, the match rate improves to ~ 95%; monthly denied/delayed claims drop to <$500; office staff frees up ~8 hours/week to focus on caregiver support and client satisfaction; savings from fewer denied claims + freed up staff time = ~$3,000/month. Net benefit after paying the specialist: positive ROI.
Scenario B: Small Home Health Agency
- Needs EVV compliance, but doesn’t have enough full‑time volume to justify a local $4,500/month hire. Uses blended role: EVV compliance + other admin work.
- Specialist spends ~60% of time on EVV tasks; the rest on billing prep, credential tracking. Remote rate still ~$1,700/month; much lower than hiring local at full cost. Provides compliance stability, reduces overtime, and reduces mistakes.
How the EVV Compliance Role Can Be Scaled or Blended
Not all agencies need a dedicated full‑time specialist immediately. Possible variations:
- Part‑time EVV Compliance Role: Someone devotes maybe 20‑25 hours/week to EVV tasks; remaining hours for general admin. Good for smaller agencies.
- Remote EVV Coverage Shared Across Agencies: Some providers share specialists across multiple small operations.
- Incremental Hiring: Start with a remote EVV assistant combined with other admin roles; as volume grows, increase EVV responsibilities.
Pricing & SallySupport Offering
Here is how SallySupport’s remote EVV Compliance Hire compares to hiring locally:
- Remote EVV Compliance Hire via SallySupport: $1,700/month flat fee. This includes all training, payroll taxes, workers’ compensation, etc.
- Local Full‑Time EVV Compliance Specialist: $20‑$25+/hour depending on region and experience (US/Canada), plus payroll taxes (FICA, FUTA, SUTA), workers’ compensation insurance, benefits, training costs, and administrative overhead. Total monthly cost is often $5,000‑6,000+.
Why Hiring Dedicated EVV Compliance Support Makes Sense
An EVV Compliance Specialist is more than just a regulatory necessity; they are a strategic investment. By centralizing EVV tasks into a dedicated role, whether fully focused or blended with other responsibilities, home care and home health agencies can:
- Avoid costly fines, denied claims, or reimbursement delays
- Reduce staff burnout and wasted time correcting errors
- Improve operational efficiency and consistency
- Free up local staff to focus on caregiving, client satisfaction, and growth
If your agency is facing growing compliance burdens, mismatched claims, or uncertainty around EVV requirements, consider partnering with SallySupport. For $1,700/month, you can add a trained EVV Compliance Specialist who takes on all the detail work, helping you stay compliant, avoid losses, and keep your local team focused on what matters most.
Visit SallySupport.com to learn more about how our remote specialist model works, view sample workflows, and see if this solution fits your agency’s needs.