New Jersey's Split-Aggregator Problem and What It's Costing Providers

Most states pick one EVV aggregator and build from there. New Jersey didn't. Depending on who the member's managed care plan is, visit data routes through HHAeXchange or CareBridge — and getting that routing wrong means the visit doesn't match the claim, and the claim doesn't get paid.

How New Jersey's EVV Setup Actually Works

New Jersey operates an open EVV model, meaning providers can use any compliant EVV system as long as it transmits to the state's designated aggregator. HHAeXchange holds the primary contract and serves as the aggregator for most of the state's managed care organizations — Aetna, UnitedHealthcare, Fidelis Care/WellCare, and Fee-for-Service members. CareBridge handles Amerigroup and Horizon.

For agencies serving members across multiple plans, that means managing two separate aggregator relationships. A caregiver clocking in on the same app for two different members may have their visit data routed to completely different systems depending on which MCO holds that member's enrollment.

Where the Billing Breaks Down

The failure point isn't usually the EVV capture itself — it's the routing. Providers using a third-party EVV system need to confirm their software is actively integrated with both HHAeXchange and CareBridge, not just one. A visit transmitted to the wrong aggregator or not transmitted at all creates a missing EVV record, which triggers a denial when the claim hits adjudication.

There's also the Fee-for-Service complexity. Home Health FFS providers weren't required to go live with EVV until June 24, 2024 — later than managed care — and DDD made a series of changes to its HHAeXchange portal around the same time, including adding bundle codes for EVV-exempt visits to streamline billing for members who qualify for an exemption. Providers who hadn't updated their workflows by that deadline found themselves billing outside the new process and facing rejections.

What Providers Need to Audit Right Now

Agencies operating in New Jersey should verify three things about their current setup: that their EVV system has an active integration with both HHAeXchange and CareBridge, that caregiver visit data is transmitting successfully for every payer type they serve, and that any EVV-exempt members are being billed using the correct bundle codes through the FFS portal rather than the old dual-billing process.

Manual EVV entries won't automatically cause a denial in New Jersey, but DMAHS monitors compliance rates and providers falling below thresholds face escalating scrutiny.

The agencies that stay clean in a multi-payer state like New Jersey are the ones whose platform handles aggregator routing automatically — not the ones relying on caregivers or billing staff to remember which system goes with which plan.