Netsmart API
Netsmart’s EVV (provided via Tellus) is software used by home and community-based service providers, clinics, and provider groups to verify in-home services, track authorizations, manage visits, and support Medicaid billing. An unofficial API lets you create and verify EVV visits, syn
What is Netsmart?
Netsmart provides healthcare IT solutions across behavioral health, home care, hospice, and social services. Its EVV offering—delivered via Tellus—helps providers meet the 21st Century Cures Act requirements by capturing visit evidence (check-in/out, caregiver, client, GPS), managing authorizations and service codes, and connecting verified visits to Medicaid and Managed Care Organization (MCO) reimbursement workflows.
Core product areas include:
- Electronic Visit Verification (mobile app, telephony, aggregator connections)
- Scheduling and visit management
- Member/client and caregiver/provider rosters
- Payer authorizations and service codes
- Exception handling and compliance reporting
- Export and billing support for Medicaid/MCO claims
Common data entities:
- Members/Clients (patients)
- Caregivers/Providers (aides, nurses, staff)
- Visits (EVV check-in/out, service codes, tasks)
- Authorizations (payer, service code, units, validity dates)
- Payers/MCOs and service programs
- Schedules and assignments
- Exceptions (late/missing events, GPS mismatch, overlapping visits)
- Claims (837P/I line items referencing verified visits)
- Remittances (835 summaries for reconciliation)
The Netsmart Integration Challenge
Organizations rely on Netsmart EVV daily, 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, and EVV validation logic (e.g., Florida, Georgia, Kentucky, Montana, Nebraska)
- Strong enterprise security: SSO/MFA and network controls complicate headless automation
- Portal-first delivery: Key EVV and exception handling lives in web apps or batch exports, not unified public APIs
- File interfaces and timing windows: SFTP/EDI feeds, batching constraints, and daily submission windows must be respected
- Compliance nuances: Visit edits require compliant reason codes and audit trails, and data retention rules vary by jurisdiction
How Supergood Creates Netsmart 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 Netsmart/Tellus product mix, licensing, and authentication model.
- Supergood Builds and Validates Your API
We deliver a hardened Netsmart adapter tailored to your workflows and entitlements.
- Deploy with Monitoring
Go live with continuous monitoring and automatic adjustments as Netsmart evolves.
API Endpoints
Authentication
/sessionsEstablish a session using credentials. Supergood manages MFA (SMS, email, TOTP) and SSO/OAuth when enabled. Returns a short-lived auth token maintained by the platform.
Authorizations
/authorizationsRetrieve payer/member service authorizations with allowed units, service codes, and date ranges. Use this to validate scheduling and claim eligibility.
EVV Visits
/evv/visitsCreate or update an EVV visit record with check-in/out events, service details, and verification metadata. Supports compliant edit reason codes.
Claims
/claimsAssemble an 837P/I claim from verified visits. Supergood normalizes service lines and can route the generated file to the configured submission channel.
Use Cases
EHR-to-EVV Synchronization
- Push patient and caregiver rosters from your EHR into Netsmart EVV - 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-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 Netsmart/Tellus 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 Netsmart/Tellus EVV 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.