Compliance
Electronic Visit Verification
Coralia's Electronic Visit Verification (EVV) module documents that each ABA visit really happened — who was there, where, and when — through a per-session mandate check, clock-ins carrying a GPS (Global Positioning System) location proof, a client check-in chain of custody, and point-of-care caregiver visit verification. Claim release is gated for payers that require EVV; clinical documentation is never blocked.
The problem in real agencies
When a Medicaid payer requires electronic visit verification (EVV) for home and community services, the agency has to prove each visit actually happened — who rendered it, where, and when. Most ABA agencies handle this with a separate EVV vendor that knows nothing about the authorization the visit consumes, the session note that documents it, or the claim it feeds. The proof lives in one system, the money in another, and reconciling the two falls on a biller at month-end.
Verification systems that block are worse than none. If a hard location gate stops an RBT (Registered Behavior Technician) from clocking in because a phone returned a coarse cached fix, field staff learn to route around the system — and the agency loses both the proof and the trust. Clinical recording can never hinge on satellite reception in a client's apartment. Coralia's doctrine is flag, don't block: nothing about location or verification ever stops a session from being documented.
Center-based agencies carry a different burden: physical custody of children. Who dropped a client off, who is authorized to pick them up, which children are still in the building at 6 PM — in most centers this lives in a paper binder and the front desk's memory. When a pickup runs late or an unfamiliar adult shows up, there is no timestamped record to point to, and no automatic escalation when a child is never checked out.
How it works in Coralia
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Every session is born with an EVV verdict
When a therapy session is created or cloned, Coralia births one visit-verification record for it and runs a five-gate mandate check: is the agency's EVV master switch on, does the payer require EVV, is the funding Medicaid, is the place of service home (code 12) or community (code 99), and is the CPT (Current Procedural Terminology) code one of six point-of-care codes — 97153, 97154, 97155, 97156, 97158, or 0373T. Any gate failing resolves the visit to not-applicable, with the reason recorded. The place of service and CPT behind the verdict are snapshotted, so a later edit is distinguishable from the verdict's basis.
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Compliance alerts, never hard stops
EVV birth runs after the session commits, and a failure only warns — recording is never held hostage to the verification layer. A false-negative guard watches for the dangerous silent case: a home or community visit for a payer that requires EVV resolving to not-applicable, usually a configuration gap. That raises a warning alert flagging recoupment risk for compliance review. Alerts carry record IDs only — never names, coordinates, or clinical content. The module also ships dormant: the agency master switch and every payer flag default to off, so agencies without a state EVV mandate see zero behavior change until they opt in.
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The check-in board documents chain of custody
Front-desk staff generate the day's board from scheduled calendar events; a one-step Quick Check-In handles walk-ins and adopts the day's closest scheduled event, so a scheduled child never falsely reads as a walk-in. Drop-off and pick-up each record who brought or collected the child — a validated known caregiver or an ad-hoc name — with one of ten relation options and the confirming staff member. The board flags late arrivals, early pickups, and late pickups in the agency's timezone; open check-ins age to overdue with background nudges and an end-of-day sweep, and are never auto-closed. Check-ins auto-link to the day's session, and a no-show releases its reserved authorization units.
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Clock-ins carry an honest GPS proof
When staff clock in or out, the punch carries a location proof: coordinates stored encrypted and graded high, low, or unavailable confidence, so supervisors see an approximate or missing location instead of silently trusting it. A poor or failed fix never blocks the punch — the full acquisition mechanics live in the Time Clock module. The clock permission covers office and administrative staff by default, though an agency can grant it more widely; for RBT-delivered home and community visits, the verification leg is the caregiver visit verification at the point of care, not a clock punch.
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A foreground location trail with an audited monitor
While the app is open, staff holding the clock permission upload throttled, encrypted position events — every 30 seconds when clocked in, more slowly when idle or hidden, or on a meaningful move or accuracy improvement. Tracking is foreground-only: it stops when the screen locks or the app closes. Admins holding the audit permission review a Location Monitor page with a live map, per-staff summaries, an activity trail, and GPS precision telemetry — median and 90th-percentile accuracy, accuracy buckets, time-to-fix — over 15-minute to 24-hour windows. Every view of the monitor is itself logged as PHI (protected health information) access.
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Caregiver visit verification at the point of care, a gate at the claim
The caregiver visit verification is captured at the point of care: the caregiver signs an attestation that the visit occurred — date, time, and duration, never the clinical note — with a typed or drawn signature on the staff member's device, no portal login needed. The signature is content-hashed against those visit facts, and its date is validated to fall between the visit date and the current day in the agency's timezone. This verification is required on every billable treatment note, whether or not the payer mandates EVV — it is one of the three signatures a claim needs. For a payer flagged as requiring EVV, the three-way match additionally holds the claim until the visit's verification is reconciled. The gate is claim-side only — the session note is never blocked.
The specifics
Five mandate gates per visit: agency opt-in, payer EVV flag, Medicaid funding, home (12) or community (99) place of service, and an in-scope CPT code.
Six EVV-mandated CPT codes — 97153, 97154, 97155, 97156, 97158, 0373T; clinic, school, and telehealth places of service are out of scope.
Each visit-verification record carries one of eight lifecycle states, including pending check-in, matched, exception, corrected, and unresolved.
Clock-proof fixes count as high confidence only when contemporaneous — within 2 minutes of server receipt, with at most 15 seconds of future clock slop; a stale fix is still recorded, flagged low confidence.
Check-in timing flags: late arrival past 10 minutes, early pickup past 10 minutes, late pickup past 15 minutes, all computed in the agency's timezone.
Overdue aging: 30 minutes after scheduled end (4 hours in care for walk-ins), a monitor every 30 minutes during center hours, and a daily end-of-day sweep.
Ten caregiver relation options at drop-off and pick-up, with caregiver identity validated against the client's record before it attaches to the custody log.
Every staff GPS coordinate — clock proof and location trail alike — is stored encrypted as PHI; alerts and the precision telemetry carry only IDs and non-identifying scalars.
Location Monitor telemetry: median and 90th-percentile accuracy, five accuracy buckets, warm-cache hit rate, and time-to-fix percentiles over 15-minute, 1-hour, 6-hour, and 24-hour windows.
Integrations
Claim.MD clearinghouse — claims for EVV-flagged payers hold in the three-way match until the visit's verification leg is satisfied · Device GPS through the browser's built-in geolocation — no separate hardware, tablet, or standalone EVV app · In-app notifications — overdue check-in nudges to the assigned RBT and admins, plus an end-of-day report of anything never checked out · Coralia's compliance alert feed — mandate-unverified and verification warnings surface as reviewable alerts carrying IDs only
Access control
Seven permission codes gate the module: two for the check-in board (view and manage), four for the time clock (clock, view all, edit, approve), and the audit permission for the Location Monitor — where every page view is additionally logged as PHI access. Clinical roles (behavior analysts and behavior technicians) do not hold check-in or time-clock permissions, making these admin and front-desk tools.
Frequently asked questions
Does EVV ever block an RBT from documenting a session?
No. Coralia's doctrine is flag, don't block. The visit-verification record is created after the session commits, and a failure only warns. A poor GPS fix never blocks a clock punch, and a configuration gap raises a compliance alert instead of a hard stop. The only gates are claim-side: every billable treatment note already needs the caregiver visit verification, and for payers that require EVV the claim additionally holds in the three-way match until that verification is reconciled.
How does Coralia decide which visits require EVV?
A five-gate check runs when the session is created: the agency's EVV master switch, the payer's requires-EVV flag, Medicaid funding, a home (12) or community (99) place of service, and one of six point-of-care CPT codes (97153, 97154, 97155, 97156, 97158, 0373T). If any gate fails, the visit resolves to not-applicable and the reason is recorded, with the place of service and CPT behind the verdict snapshotted on the record.
Do caregivers need a portal account to verify a visit?
No. The caregiver signs — typed or drawn — on the staff member's device at the point of care, with no login. The attestation covers only that the visit occurred: date, time, and duration, never the clinical note. Coralia content-hashes the signature against those visit facts and requires its date to fall between the visit date and the current day in the agency's timezone.
Is staff location tracked continuously?
Only in the foreground, only for staff holding the clock permission, and only while the app is open — position events stop when the screen locks. Uploads are throttled (every 30 seconds clocked in, slower when idle or hidden), and every coordinate is stored encrypted as protected health information. Admins need the audit permission to open the Location Monitor, and each view of it is itself logged as PHI access.
What changes when we flag a payer as requiring EVV?
The payer's detail card shows "EVV: Required," the flag appears as an "EVV expected" item on each client's coverage-readiness checklist, and claims for that payer hold in the three-way match until the visit's verification is reconciled — on top of the caregiver visit verification that every billable treatment note already requires. Nothing changes for clinical staff — sessions and notes record exactly as before. You can try the flow in the live demo at coralia.app/demo, a full synthetic agency with no sign-up.