We've done this before.
At state-Medicaid scale.
Webauthor Flex is in production today submitting Electronic Visit Verification (EVV) data to Netsmart (Tellus) for home- and community-based services funded under Georgia Medicaid. Same integration patterns — state-mandated data elements, batch acknowledgment, HIPAA audit trails, multi-tenant provider configuration — are what we'd apply to Healthy Start Florida's reporting and outcome-exchange needs.
State-approved EVV vendor since 2021. Still on the list today.
Webauthor appears by name in the "Completed Integration — Approved and Production Ready" column of the Georgia Department of Community Health's official third-party EVV vendor roster. We've been a state-approved EVV vendor since 2021, and we're still on the list — nearly five years of continuous state-verified production status on a roster that DCH has since closed to new entrants.
This isn't a self-reported claim. It's the State of Georgia's own published record. Any reviewer can verify directly at the Georgia Medicaid EVV page.
21st Century Cures Act
Section 12006 of Pub. L. 114-255. Mandates electronic verification of all Medicaid PCS & HHCS visits.
SSA Section 1903(l)
Further amended by Pub. L. 115-222. Sets the EVV requirements state Medicaid agencies must enforce.
SSA 1915(c) HCBS Waivers
Covers Georgia's Home & Community-Based Services waiver populations — ICWP included.
GA Pediatric In-Home Nursing
Georgia State Plan pediatric in-home nursing services — a sensitive, high-acuity population.
Integration begins
GA EVV program launches for PCS — Webauthor integrating with Netsmart from the start.
Attestation signed
DCH deadline to initiate met — signed contract with Netsmart + active Georgia user.
Production-ready
DCH deadline to complete integration met. Named on first published DCH vendor list.
Still approved
On every DCH publication since — nearly 5 yrs continuous. List now closed to new integrators.
On the "Production Ready" list alongside (selected):
What is EVV — and why does it matter for Healthy Start?
The 21st Century Cures Act requires all state Medicaid programs to electronically verify personal-care and home-health visits with six specific data elements. Non-compliant submissions can delay or forfeit federal funding. The discipline required to deliver EVV — real-time capture, state-mandated field mapping, batch reconciliation, immutable audit, HIPAA-grade security — is the same discipline Healthy Start Florida needs to submit HRSA MCH Block Grant data, exchange with OB/pediatric providers, and report outcomes across 32 coalitions. We've been doing it for Georgia Medicaid since 2021.
End-to-end data flow
Caregivers capture visits on mobile (GPS-verified) or by IVR phone. Webauthor Flex builds the state-mandated XML payload, transmits to Netsmart over HTTPS, and reconciles acknowledgments pulled from SFTP.
Caregiver · Field
- Mobile app: GPS check-in / out
- IVR: phone-based capture (fallback)
- Offline queue; sync on reconnect
- Recipient + caregiver signatures
Webauthor Flex
- Compose
RenderedServicesXML - Map jurisdiction / payer / plan codes
- Async submission via
cfthread - Retry & resubmit on rejection
- Immutable audit log:
xm_log_evv
Netsmart → GA Medicaid
- Netsmart (Tellus) Tellus EVV
- Outbound XML to
sftp-gov.4tellus.com - Ack / reject polled back to Flex
- Batch IDs:
WATR_SRVC_[ts]
All six federally mandated EVV data elements — captured and verifiable
Section 12006 of the 21st Century Cures Act requires six data elements per home-care visit. Flex captures each with explicit provenance (who, when, how) so submissions pass state validation and auditors can reconstruct every event.
Type of service
Service code + up to 4 modifiers per CPT/HCPCS. Program type auto-maps to xml_type_code.
Individual receiving service
Recipient name, DOB, Medicaid ID, member ID, diagnosis codes (ICD-10, up to 4).
Date of service
Scheduled & actual dates, UTC-normalized with time-zone metadata.
Location of service
Start & end addresses plus GPS (lat / lon) from device or IVR reverse-geocode.
Caregiver delivering service
Caregiver name, license number, provider NPI, EIN, Medicaid provider ID.
Time service started / ended
Actual check-in / check-out with verification method (GPS, IVR, manual).
State machine — from schedule to acknowledgment
Every state transition is signed, timestamped, and re-transmitted to Netsmart. If Netsmart rejects, Flex surfaces the reason, increments the visit ID suffix, and resubmits — all audited.
Newly Scheduled
NEWSVisit created & transmitted on status change. date_initial_visit_sent recorded; default rate applied.
In Progress
INPRCaregiver check-in (GPS or IVR). Actual start time + location captured; async re-transmit.
Checked Out
HOLDActual end time + GPS. Invoice units auto-computed (15-min increments, or hourly for GA ICWP).
Completed
COMPAuto-completes when within ±15 min of scheduled window, > 2 hrs post-checkout. Final payload sent.
Acknowledged
ACCEPTED / REJECTEDNetsmart response polled from SFTP. Rejections surfaced with reason; visit moves to Pending Resubmit.
Battle-tested patterns
The integration has shipped since 2021. Along the way we've built the tooling a production state-MMIS integration requires.
Async transmission
SendVisitAsync() spawns a cfthread so the mobile app never blocks on network latency.
Offline capture
Mobile caches pending check-in / out in localStorage; batch-processed on reconnect.
Retry & resubmit
Utilities like resend-failed-visits and fix-missing-batch-ids keep rejections recoverable.
Scheduled jobs
_send_new_visits hourly · _evv_runner hourly (geocode + push) · daily stats at 5 AM / 9 PM.
GPS fallback
Missing coordinates auto-geocoded via Google Maps before transmission, so payloads never fail on location.
Caregiver nudges
Firebase push 1 hr before check-in and 15 min before checkout deadline. Email digest of tomorrow's visits.
Admin reconciliation
Daily dashboard: not-sent / accepted / rejected counts by visit status, drilldown to the offending record.
Immutable audit
Every request + response stored in xm_log_evv with batch ID, packet XML, and ack content.
State-configurable, not state-hard-coded
Jurisdiction, payer, plan, and delivery-system codes are driven off an evv_code lookup that
maps human-readable values to the state-mandated XML type codes. Georgia's ICWP program has its own billing
rules (hourly, not 15-minute) — all implemented as configuration, not code.
Jurisdiction codes
A single lookup maps csv_type_code = 'GA' to the XML format Georgia Medicaid expects — switch a provider to another state and the integration adapts.
- Per-provider config (payer, jurisdiction, plan, delivery system)
- Production / testing endpoint routing
- Per-site Basic-Auth credentials
Program-aware billing
ICWP (program 8164) bills hourly; all other Georgia programs bill in 15-minute units. Different programs = different rules, one codebase.
- Invoice = duration ÷ 60 + rounding (ICWP)
- Invoice = 15-min units (default)
- Rate auto-populated from provider setup
XSD-valid payload
Netsmart validates every submission against its XSD. Flex composes payloads that consistently pass validation, and when they don't, we surface the error field-by-field.
- ICD-10 diagnosis (up to 4)
- CPT/HCPCS service + 4 modifiers
- Provider NPI, EIN, Medicaid ID
HIPAA-grade security on a state Medicaid data exchange — since day one
Encrypted transport (HTTPS + SFTP with key auth · watr.pem), per-site credentials via secrets,
immutable audit trail of every request/response, access controls on batch resubmission. All of it
applies identically to a HIPAA-regulated program like Healthy Start Florida.
From Georgia EVV to Florida Healthy Start
The problem shape is the same: capture in the field, transform to a state-mandated format, transmit with acknowledgment, reconcile rejections, audit every step. Only the vocabulary changes.
Georgia EVV (today)
- GPS + IVR visit capture
Mobile app and phone-based check-in for rural caregivers - RenderedServices XML
State-mandated payload with ICD-10, CPT, modifiers, NPI - Netsmart SFTP ack / reject
Batch IDs, reasons, retry with incremented suffix - Immutable audit
Every submission + response stored & queryable evv_codeconfig lookups
Jurisdiction / payer / plan / delivery all data-driven
Florida Healthy Start (proposed)
- Home-visit capture
Case managers check-in at prenatal/postpartum visits; GPS + signature - HRSA MCH Block Grant extract
Same transform-and-validate discipline, applied to federal reporting - Coalition & OB data exchange
Ack-and-retry pattern applied to inter-coalition transfers & OB referrals - HIPAA audit trail
Same immutable log — now covering PHI access for a maternal-health population - Coalition / program config
32 coalitions + state rollup, all driven by the same config-lookup pattern