CertifyMed
Electronic Visit Verification

CertifyMed integrates with state EVV aggregators to pull confirmed visit data and reconcile it against service authorizations, unit balances, and service-plan interventions. It consumes aggregator data under the 21st Century Cures Act mandate. It does not replace your state EVV aggregator. Aggregator integration is in active development.

Aggregator Integration (In Development)

Pull Verified Visit Data From Your State Aggregator

Rather than building a parallel EVV capture system, CertifyMed connects to the aggregator your state already mandates and works with the verified data it produces. Adapters for Sandata, HHAeXchange, and Tellus/Netsmart are in active development.

Aggregator Adapters (Roadmap)
Dedicated adapters for Sandata, HHAeXchange, and Tellus/Netsmart. Each adapter normalizes the aggregator data format into the CertifyMed authorization and unit model. In active development.
21st Century Cures Act Posture
CertifyMed is designed to consume the six required EVV data elements from compliant aggregators and map them to the service authorization record, supporting state and federal audit documentation.
State Program Compatibility
Each state Medicaid EVV program selects its own aggregator. CertifyMed connects to whichever aggregator your state mandates rather than requiring providers to switch capture systems.
Visit-Level Audit Records
Every verified visit imported from an aggregator is stored with its source, timestamp, and matched authorization, creating a complete audit trail from EVV capture to unit consumption.
Reconciliation & Exception Management

Match Every Visit to an Authorization. Surface Every Gap.

Once aggregator data is imported, CertifyMed reconciles each verified visit against the active service authorization, decrements the unit balance, and flags mismatches for review before they become billing denials.

Visit-to-Authorization Matching
Each incoming verified visit is matched to the corresponding service authorization by client, service, payer, and date. Matched visits decrement the consumed unit balance automatically.
Automatic Unit Decrement
Verified visits from the aggregator update the consumption ledger directly. No manual entry: the authorized vs. utilized unit balance reflects every confirmed visit.
Exception and Mismatch Management
Visits that cannot be matched (no active authorization, service mismatch, date outside effective period) are surfaced as exceptions with the reason code, so coordinators can resolve them before the billing cycle.
Reconciliation Reporting
A reconciliation summary per authorization period shows authorized units, verified visits, consumed units, and remaining balance, with unmatched visits and resolution status visible to coordinators and billing staff.

Frequently asked questions

Does CertifyMed replace my EVV vendor?+

No. CertifyMed integrates with your state EVV aggregator and consumes the verified visit data it produces. It does not replace Sandata, HHAeXchange, Tellus/Netsmart, or any other state-mandated aggregator. Your providers continue to capture visits through the aggregator; CertifyMed reconciles those confirmed visits against your service authorizations and unit balances.

Which EVV aggregators will CertifyMed integrate with?+

The initial integration roadmap targets the aggregators most common across state Medicaid EVV mandates: Sandata, HHAeXchange, and Tellus/Netsmart. Adapter development is in progress. Contact us to discuss your state program and aggregator.

Does CertifyMed comply with the 21st Century Cures Act EVV requirements?+

CertifyMed is designed to support Cures Act compliance by integrating with compliant state aggregators and reconciling the six required EVV data elements (type of service, individual served, date, location, provider, time) against the service authorization record.

Platform Overview

One Platform. Every Module You Need.

Twelve integrated modules that replace scattered tools, spreadsheets, and paper binders - so you can focus on your clients, not your compliance gaps.

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Assessments & Screening

InterRAI engine plus 14 validated screening tools. Scored automatically with clinical bands and safety protocols.

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Service Planning

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Sessions & Telehealth

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HCBS Settings Compliance

CHCS compliance scoring (0-100) across 6 modules for 90+ setting types.

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Incident Reporting

9 categories, 34 subcategories, automated severity scoring, and 5-stage investigation workflow.

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Workforce Compliance

Staff credentials, expiration alerts, payer enrollment, and OIG/SAM exclusion monitoring.

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Compliance Dashboard

One view of all compliance areas with priority action items and per-module health cards.

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Organization Management

Client registry, team management, roles & permissions, and 10-tab client profiles.

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Client Portal

Clients view their own care plan, appointments, and care team with restricted access.

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Platform & Security

HIPAA compliant, end-to-end encryption, multi-role architecture, 2FA, and AI integration roadmap.

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Service Authorization & Billing

Authorize services in units, track utilization automatically, enforce frequency caps, and keep every change auditable.

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Coming Soon

Electronic Visit Verification

Integrate with state EVV aggregators and reconcile verified visits against authorizations and units. Cures Act ready.

Learn more
Available Now

Assessments & Screening

InterRAI engine plus 14 validated screening tools. Scored automatically with clinical bands and safety protocols.

Learn more
Available Now

Service Planning

Person-centered service plans auto-populated from assessments. CMS 42 CFR §441.725 compliant.

Learn more
Available Now

Sessions & Telehealth

Video, audio, chat, in-person consultations with recording, live transcription, and scheduling.

Learn more
Available Now

HCBS Settings Compliance

CHCS compliance scoring (0-100) across 6 modules for 90+ setting types.

Learn more
Available Now

Incident Reporting

9 categories, 34 subcategories, automated severity scoring, and 5-stage investigation workflow.

Learn more
Available Now

Workforce Compliance

Staff credentials, expiration alerts, payer enrollment, and OIG/SAM exclusion monitoring.

Learn more
Available Now

Compliance Dashboard

One view of all compliance areas with priority action items and per-module health cards.

Learn more
Available Now

Organization Management

Client registry, team management, roles & permissions, and 10-tab client profiles.

Learn more
Available Now

Client Portal

Clients view their own care plan, appointments, and care team with restricted access.

Learn more
Available Now

Platform & Security

HIPAA compliant, end-to-end encryption, multi-role architecture, 2FA, and AI integration roadmap.

Learn more
Available Now

Service Authorization & Billing

Authorize services in units, track utilization automatically, enforce frequency caps, and keep every change auditable.

Learn more
Coming Soon

Electronic Visit Verification

Integrate with state EVV aggregators and reconcile verified visits against authorizations and units. Cures Act ready.

Learn more

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