Massachusetts Client Profile Setup Guide

Create a complete client profile before services begin to help ensure successful EVV compliance and reduce the need for manual visit corrections.

Before You Begin

Before creating a client profile, make sure you have:

The client's MassHealth Medicaid ID or AGE Consumer ID
The client's date of birth
The client's program information
The service(s) the client will receive
Authorization information (if your agency is responsible for creating authorizations)

Important Note: Massachusetts does not import authorizations for all Payers, Programs, or Services. Please consult with your Payer or FFS Program Lead to understand if authorizations should be imported automatically by the Payer or FFS Program OR whether you need to manually input authorizations.

Client Setup Overview

Complete these steps in order:

Create the client.
Assign the client's program.
Change the client status to Active.
Add at least one service.
Add an authorization (if required).
Create schedules (optional but recommended).

Why Complete Client Setup Before the First Visit?

Completing the client profile before services begin helps:

Make clock in and clock out easier for employees.
Automatically associate the correct Payer, Program, and Service with visits.
Reduce manual visit corrections.
Improve EVV compliance.

Step 1: Create the Client

Navigate to Clients > Client Management.
Select Create Client.
Search for the client using any of the following:
1. MassHealth Medicaid ID
2. AGE Consumer ID
3. Date of Birth
Select the correct client.
Select Create Client.

Note: You must use the client's MassHealth Medicaid ID or AGE Consumer ID along with the correct date of birth to locate the client.

Expected Results

After the client is created, Sandata automatically imports:

Client name
Client ID
Date of Birth
Address
Phone number
Payer

The client is also created with:

Program: Default
Status: Pending

Find the Newly Created Client

Newly created clients are assigned a Pending status, so they do not appear in the default Client List. Use either of these methods to locate the client:

Filter the Client List:

Status: Pending
Program: Default

Search using either the client's:

MassHealth Medicaid ID
AGE Consumer ID

It's important to note that clients in Pending status can receive visits, but:

Payer and program are not automatically associated with the visit
Employees must manually select visit details
Manually editing a visit later makes the visit non-compliant

Best Practice: Complete the remaining client setup before employees begin providing services.

Step 2: Update the Client Program

Once the client has been created, assign the correct program.

Open the client profile.
Select the Program tab.
Select Change Payer.

Note: Although the button is labeled Change Payer, this workflow is used to assign the client's program.
Set the Effective Date to the date the client started the program.
Select Continue.
Select the appropriate Program from the dropdown.

Note: Only programs that are valid for the client's payer and are in scope for EVV are displayed.
No action is required for on the Copy Payer screen.
Select Continue.
Review the selections and select Complete.

Expected Results

After the program is assigned:

The program appears next to the client's name.
The program appears in the profile header.
Service Details becomes available.
Authorization Details becomes available.
The client is now ready for service setup.

Step 3: Change Client Status from Pending to Active

After assigning the program, activate the client.

Open the Program tab.
Change Status from Pending to Active.
Set both the Effective Date and Created Date to the client's Start of Care (SOC) date.
Select Save.

Why This Matters

Using the correct Start of Care date helps:

Prevent date-of-service conflicts
Ensure visits validate correctly for EVV

Expected Results

The client now appears as Active and is available in the default Client List.

Step 4: Add a Service

The client must have at least one service before authorizations or schedules can be created.

Open the Program tab.
In the Service Details section, select Add Service.
Select the appropriate service.
Select Save.

Note: The available services depend on the program assigned to the client.

Why This Matters

Adding the correct service helps:

Employees select the correct service during visits
Ensure visits are associated with the appropriate EVV service
Reduce visit errors

Expected Results

The service appears in the Service Details section of the client profile.

Step 5: Add an Authorization

If your agency is responsible for managing authorizations, add an authorization after the client service has been created.

Open the client's Program tab.
In the Authorization Details section, select Add Authorization.
Complete the required fields.

Field	What to Enter
Payer	Select the payer associated with the authorization.
Service	Select the service included in the authorization.
Event Code	Select the service code modifier, if applicable.
Format	Select the measurement used by the payer for the authorization (for example, Units, Hours, or Visits).
Date Range	Enter the authorization start and end dates.
Maximum	Enter the total number of authorized units, hours, or visits for the authorization period.

Important: Select the Format that matches how the payer issued the authorization. The selected format determines how Sandata tracks authorization utilization.

Example: How Format Affects Authorization Utilization

If the Authorization Uses...	Maximum	A 3-Hour Visit Uses	Remaining Authorization
Units (15-minute increments)	200 units	12 units	188 units
Hours	200 hours	3 hours	197 hours

Note: Sandata automatically generates authorization numbers for manually created authorizations. These numbers cannot be edited.

Expected Results

The authorization appears in the Authorization Details section, and Sandata begins tracking authorization utilization as visits are completed.

Step 6: Create Schedules (Optional)

After the client profile is complete, you can create schedules, although it is not required in Massachusetts . When feasible, using schedules generates the following benefits:

Guides Employees: Schedules direct employees to the correct client, service, and visit, reducing guesswork at clock-in/out.
Reduces Errors: Schedules limit incorrect selections by predefining visit details.
Improves Data Accuracy: Scheduled visits ensure consistent and correct EVV data is captured automatically.
Supports Compliance: Schedules help ensure visits align with required EVV elements and authorized services.
Simplifies Daily Workflows: Schedules streamline the clock-in/out process, making visits quicker and easier for employees.

For instructions, see the Scheduling article.

If Your Agency Does Not Use Schedules

Employees can still capture visits using one of the following workflows.

Search Client

Employees search for the client using one of these identifiers:

Sandata Client ID
MassHealth Medicaid ID
AGE Consumer ID

For more information, see the Sandata Mobile Connect Clients Screen article.

Unknown Client

The Unknown Client workflow captures:

Caregiver
Visit date
Clock in and clock out times
GPS location
Service

However, it does not automatically associate:

Client
Payer
Program

As a result, visit maintenance is required before the visit reaches a Verified status. Any manual edits made to associate the client after the visit will make the visit non-compliant. For more information, see the Start Visit on Sandata Mobile Connect article.

Client Setup Checklist

Before employees begin providing services, confirm that the client profile is complete.

Client profile has been created.
The correct program has been assigned.
Client status is Active.
At least one service has been added.
An authorization has been added (if required).
A schedule has been created (recommended).