AuthentiCare

Supergood | AuthentiCare from Fiserv/First Data API

Alex Klarfeld

Alex Klarfeld

— 6 min read
Supergood | AuthentiCare from Fiserv/First Data API

Programmatically access Electronic Visit Verification (EVV), authorizations, visit verification, and Medicaid reimbursement workflows in AuthentiCare with a stable REST API. Supergood builds and operates production-grade, unofficial AuthentiCare integrations so your team can automate critical EVV and billing pipelines without heavy custom engineering.

In plain English: 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 visits to billing. With an unofficial API, you could create and edit visits, synchronize patient and caregiver rosters from your EHR, validate authorizations before visits occur, assemble claims from verified visits, and reconcile payments end-to-end.

If you’re a clinic, provider group, or a business focused on revenue cycle management, integrating your tech stack with AuthentiCare can unlock concrete data flows and features—especially if you operate in closed-model EVV states (e.g., Kansas, Maryland, New Mexico, Oklahoma, South Carolina, and others where program configurations vary by state):

  • Pull: Patient/member profiles, caregiver rosters, payer authorizations, visit statuses, exception queues, verified visit exports, claim statuses, remittance summaries
  • Push: New/updated patients and caregivers from your EHR, scheduled visits, check-in/out events (mobile or IVR), visit edits with compliant reason codes, claim submissions referencing verified visits
  • Build: Authorization-aware scheduling, real-time EVV exception resolution, automatic claim assembly for 837P/I, reconciliation dashboards driven by EVV and remittance data

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

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

Available Endpoints

Authentication

POST /sessions: Establish 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.

curl --request POST \
  --url https://api.supergood.ai/integrations/<integration_id>/sessions \
  --header 'Authorization: Basic <Base64 encoded token>' \
  --header 'Content-Type: application/json' \
  --data '{
    "username": "[email protected]",
    "password": "<password>",
    "mfa": {
      "type": "totp",
      "code": "123456"
    }
  }'

Example response

{
  "authToken": "eyJhbGciOi...",
  "expiresIn": 3600,
  "user": {
    "id": "u_29b71a",
    "name": "EVV Admin",
    "entitlements": ["evv", "authorizations", "claims"]
  }
}

Authorizations

GET /authorizations: Retrieve payer/member service authorizations with allowed units, service codes, and date ranges. Use this to validate scheduling and claim eligibility.

Query parameters

  • memberId: string
  • providerId: string
  • serviceCode: string (HCPCS/HCPCS-like)
  • activeOn: ISO 8601 date
  • payerId: string

Example response

{
  "items": [
    {
      "authorizationId": "auth_7342c1",
      "authorizationNumber": "A-2025-11872",
      "memberId": "mem_9b42f0",
      "memberName": "Jordan Patel",
      "providerId": "prv_41cf92",
      "payerId": "payer_nm-medicaid",
      "program": "HCBS",
      "serviceCode": "T1019",
      "modifiers": ["U1"],
      "unitsAuthorized": 120,
      "unitsRemaining": 84,
      "startDate": "2026-01-01",
      "endDate": "2026-03-31",
      "status": "active"
    }
  ],
  "page": 1,
  "pageSize": 50,
  "total": 1
}

EVV Visits

POST /evv/visits: Create or update an EVV visit record with check-in/out events, service details, and verification metadata. Supports compliant edit reason codes and IVR call references.

curl --request POST \
  --url https://api.supergood.ai/integrations/<integration_id>/evv/visits \
  --header 'Authorization: Bearer <authToken>' \
  --header 'Content-Type: application/json' \
  --data '{
    "clientId": "mem_9b42f0",
    "caregiverId": "cgv_2208aa",
    "authorizationId": "auth_7342c1",
    "payerId": "payer_ok-medicaid",
    "program": "Personal Care",
    "serviceCode": "T1019",
    "modifiers": ["U1"],
    "checkIn": {
      "timestamp": "2026-01-19T14:02:33Z",
      "method": "mobile",
      "location": {"lat": 35.4676, "lng": -97.5164},
      "deviceId": "ios-12a3"
    },
    "checkOut": {
      "timestamp": "2026-01-19T15:01:47Z",
      "method": "mobile",
      "location": {"lat": 35.4676, "lng": -97.5166}
    },
    "tasks": ["bathing", "meal_prep"],
    "notes": "Client requested meal prep and light housekeeping.",
    "verification": {"gpsMatch": true, "signatureCapture": true},
    "ivr": {"callInId": null, "callOutId": null},
    "editReasonCodes": [],
    "referenceId": "ehr-schedule-42391"
  }'

Example response

{
  "visitId": "vst_58d3e0",
  "status": "verified",
  "exceptions": [],
  "createdAt": "2026-01-19T15:02:02Z",
  "referenceId": "ehr-schedule-42391"
}

Claims

POST /claims: Assemble an 837P/I claim from verified visits. Supergood normalizes service lines and can route the generated file to the configured submission channel.

curl --request POST \
  --url https://api.supergood.ai/integrations/<integration_id>/claims \
  --header 'Authorization: Bearer <authToken>' \
  --header 'Content-Type: application/json' \
  --data '{
    "claimType": "837P",
    "payerId": "payer_sc-medicaid",
    "billingProvider": {
      "npi": "1234567890",
      "taxonomy": "Home Health",
      "name": "BrightCare Home Services",
      "billingAddress": {
        "line1": "100 Care Way",
        "city": "Columbia",
        "region": "SC",
        "postalCode": "29201"
      }
    },
    "visits": [
      {"visitId": "vst_58d3e0", "units": 4, "serviceCode": "T1019", "modifiers": ["U1"]}
    ],
    "submissionChannel": "state_portal",
    "referenceId": "billing-batch-jan19"
  }'

Example response

{
  "claimId": "clm_71af2b",
  "status": "queued",
  "edi": {"format": "837P", "size": 51234},
  "submissionChannel": "state_portal",
  "createdAt": "2026-01-19T16:05:42Z",
  "reviewUrl": "https://download.authenticare.example/signed/abc123...",
  "referenceId": "billing-batch-jan19"
}

Get full API Specs →

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

Performance Characteristics

  • 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

Getting Started

  1. Schedule Integration Assessment

Book a 30-minute session to confirm your AuthentiCare product mix, licensing, and authentication model.

  1. Supergood Builds and Validates Your API

We deliver a hardened AuthentiCare adapter tailored to your workflows and entitlements.

  1. Deploy with Monitoring

Go live with continuous monitoring and automatic adjustments as AuthentiCare evolves.

Schedule Integration Call →

Frequently Asked Questions

Q: Which AuthentiCare products can this integration cover?

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.

Q: How are MFA, SSO, and batch interfaces handled for automation?

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.

Q: Can I generate claims directly from verified visits?

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.

Ready to automate your AuthentiCare workflows?

Supergood can have your AuthentiCare integration live in days with no ongoing engineering maintenance.

Get Started →

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