Question Title

* 1. Provider name

Question Title

* 2. Doing Business As (DBA) name(s) (If applicable)

Question Title

* 3. Provider’s primary EVV contact’s name

Question Title

* 4. Provider’s primary EVV contact’s phone number

Question Title

* 5. Provider’s primary EVV contact’s email address

Question Title

* 6. Mailing Address

Question Title

* 7. Main office phone number

Question Title

* 8. MCDID (One MCDID per response)

Question Title

* 9. NPI (One NPI per response)

Question Title

* 10. Number of locations

Question Title

* 11. Survey respondent's name

Question Title

* 12. Survey respndent's email address

Question Title

* 13. Will you  provide personal care to Medicaid recipients in 2023?

Question Title

* 14. Will you provide  home health services to Medicaid recipients in 2023?

Question Title

* 15. Number of Medicaid members currently served?

Question Title

* 16. In which DE counties do your Medicaid members reside? (i.e. Kent, Sussex, New Castle)

Question Title

* 17. How many caregivers and/or workers do you currently employ to deliver personal care and/or home health services?

Question Title

* 18. Do you currently use an electronic visit verification (EVV)™ vendor? If yes, what is the EVV vendor’s name?

Question Title

* 19. Will your caregivers and/or workers need state-provided smartphones  to use the Sandata mobile application? We are encouraging all caregivers to use their own smartphone and download the app if possible.

Question Title

* 20. How many  state-provided smartphones will you need? Please be advised that back up devices are not allowed and only the amount that are currently needed will be provided.

Question Title

* 21. Are you an FMSA?

Question Title

* 22. Do you use a trading partner to submit EVV claims? If yes, what is  your trading partner’s name?

Question Title

* 23. If you plan to use Sandata as your EVV vendor, are there EVV-related topics that you would like to receive more information about via email?

Question Title

* 24. If you do not plan to use Sandata as your EVV vendor, are there EVV-related topics that you’d like to receive more information about via email?

Question Title

* 25. What has been most helpful in supporting your EVV education so far?

T