AuthentiCare from Fiserv/First Data API
AuthentiCare from Fiserv/First Data is software used to capture and verify in-home and community-based care visits so providers can get paid by Medicaid and Managed Care Organizations (MCOs). It tracks who delivered care, to whom, where, and for how long, then routes verified visit
What is AuthentiCare?
AuthentiCare is Fiserv’s Electronic Visit Verification platform used by home and community-based service providers and state Medicaid programs to comply with the 21st Century Cures Act. It supports mobile and telephony EVV capture, scheduling and visit management, authorization tracking, exception handling, and export/claim workflows for Medicaid/MCO reimbursement.
AuthentiCare is used in a range of state programs, including closed-model configurations where providers must use the state-selected EVV vendor. Deployments vary by state, but providers commonly encounter AuthentiCare or AuthentiCare-like workflows in programs such as Kansas, New Mexico, Oklahoma, South Carolina, and other government-run EVV environments.
Core product areas include:
- Electronic Visit Verification (mobile app, IVR/telephony, GPS and validation checks)
- Scheduling and visit management
- Patient/client and caregiver/provider rosters
- Payer authorizations and service codes
- Exception queues and compliance reporting
- Exports and claim support for Medicaid/MCO billing
Common data entities:
- Members/Clients (patients)
- Caregivers/Providers (aides, nurses, staff)
- Visits (check-in/out via mobile or IVR, service codes, tasks)
- Authorizations (payer, service code, units, date ranges)
- Payers/MCOs and programs
- Schedules and assignments
- Exceptions (missing events, GPS mismatch, overlapping visits, out-of-window)
- Claims and remittances (837/835 artifacts for reconciliation)
The AuthentiCare Integration Challenge
AuthentiCare is mission-critical, but turning portal-based workflows into automated pipelines is hard:
- State- and payer-specific rules: Each Medicaid program/MCO may require distinct service codes, modifiers, location rules, and EVV validation logic
- Strong enterprise security: SSO/MFA and network controls complicate headless automation
- Portal-first delivery: Key visit, exception, and authorization workflows often live in web apps or batch exports, not unified public APIs
- File interfaces and timing windows: SFTP/EDI feeds, batching constraints, and submission windows must be respected
- Compliance nuances: Visit edits require compliant reason codes and audit trails; record retention varies by jurisdiction
How Supergood Creates AuthentiCare APIs
Supergood reverse-engineers authenticated browser flows, batch interfaces, and network interactions to deliver a resilient API endpoint layer.
- Handles username/password, SSO/OAuth, and MFA (SMS, email, TOTP) securely
- Maintains session continuity with automated refresh and change detection
- Normalizes EVV, authorization, and claim objects so you can integrate once across states/MCOs
- Aligns with customer entitlements and licensing constraints to ensure compliant access
- Bridges batch exports and SFTP/EDI flows where applicable with signed URL retrieval and delivery
Getting Started
- Schedule Integration Assessment
Book a 30-minute session to confirm your AuthentiCare product mix, licensing, and authentication model.
- Supergood Builds and Validates Your API
We deliver a hardened AuthentiCare adapter tailored to your workflows and entitlements.
- Deploy with Monitoring
Go live with continuous monitoring and automatic adjustments as AuthentiCare evolves.
Use Cases
EHR-to-EVV Synchronization
- Push patient and caregiver rosters from your EHR into AuthentiCare - Create visits automatically from your scheduling system with correct service codes and modifiers - Maintain a single source of truth for demographics and eligibility
Authorization-Aware Scheduling and Eligibility
- Validate authorizations before scheduling or visit creation - Track remaining authorized units and prevent over-utilization - Surface program- and payer-specific rules to care coordinators
EVV Exception Resolution
- Pull exception queues and route issues (e.g., late arrival, missing check-out, GPS mismatch) to staff for resolution - Apply compliant reason codes on visit edits with audit trails - Escalate unresolved exceptions prior to claim submission
Claims Generation and Reimbursement Automation
- Bundle verified visits into 837P/I claims with payer-specific formatting - Submit via the configured channel (state portal, MCO gateway, or clearinghouse) - Track claim statuses and reconcile remittances alongside EVV evidence
Audit and Compliance
- Export complete visit packets with timestamps, locations, signatures, and reason codes - Maintain machine-readable audit trails aligned to state/MCO requirements - Prove EVV coverage and claim provenance during reviews
Technical Specifications
Authentication
Username/password with MFA (SMS, email, TOTP) and SSO/OAuth where enabled; supports service accounts or customer-managed credentials
Response format
JSON with consistent resource schemas and pagination
Rate limits
Tuned for enterprise throughput while honoring licensing and usage controls
Session management
Automatic reauth and cookie/session rotation with health checks
Data freshness
Near real-time retrieval of visits, authorizations, and claim artifacts
Security
Encrypted transport, scoped tokens, and audit logging; respects AuthentiCare entitlements and compliance requirements
Webhooks
Optional asynchronous delivery for exceptions, claim generation, and remittance updates
Latency
Sub-second responses for list/detail queries under normal load
Throughput
Designed for high-volume EVV and batch claims pipelines
Reliability
Retry logic, backoff, and idempotency keys minimize duplicate actions
Adaptation
Continuous monitoring for UI/API changes with rapid adapter updates
Frequently asked questions
Supergood supports workflows across commonly used AuthentiCare portals and agency-facing tools, subject to your licensing and entitlements. We scope coverage (e.g., mobile/telephony EVV, authorizations, visit exports, claim assembly) during integration assessment.
We support username/password + MFA (SMS, email, TOTP) and can operate behind SSO/OAuth when enabled. For batch flows, we manage SFTP/EDI timing windows, generate 837 files, and retrieve signed URLs or delivery confirmations programmatically.
Yes. You can assemble 837P/I from verified visits with payer-specific formatting. We can route submissions via your configured channel (state/MCO portals or clearinghouse) and return statuses and artifacts for reconciliation.