Montana DPHHS, Netsmart Launch State Solution for Electronic Visit Verification

VERLAND PARK, Kansas—Netsmart, a provider of software and services for payers, providers and state Medicaid Agencies, announced the deployment of the Netsmart electronic visit verification (EVV) system for the Montana Department of Public Health & Human Services (DPHHS). This implementation facilitates statewide aggregation of critical health care data aligned with the 21st Century Cures Act. As Montana’s designated aggregator, Netsmart has established an open vendor and provider model designed to support compliance and maximize provider choice and satisfaction.

“We are thrilled to collaborate with Montana to provide statewide technology supporting the goal of complying with the Cures Act while empowering providers to deliver accessible, high-quality health care services for all recipients,” said Hannah Patterson, vice president and general manager of workforce management for Netsmart. “By working together, we have provided valuable data to the state, surpassing federal requirements for electronic visit verification and supporting better outcomes for Montanans while simplifying the provider experience.”

“Netsmart facilitates over 2.5 million visits per month and assists more than 6,500 provider organizations,” Patterson continued. “We look forward to continued collaboration with Montana as together we navigate the evolving health care industry requirements.”

The State of Montana requested an EVV platform that offered ease of implementation and flexibility, along with the ability to aggregate data across providers and programs from multiple electronic health record (EHR) solutions or EVV solutions being used. The Netsmart EVV aggregation solution is equipped with near real-time visibility into the provider services rendered, adjudicates verified visits, generates claims and offers enhanced capabilities for utilization management to facilitate timely and appropriate care for Montanans.

Netsmart and Montana DPHHS launched the first phase of the EVV project in the fall of 2023, completing an expedited implementation that has enabled providers to receive recipient and authorization files, schedule and complete visits using GPS or interactive voice response (IVR), leveraging state-of-the-art technological capabilities and an advanced claims submission process. Montana providers utilizing the Netsmart EVV solution, MobileCaregiver+, have completed more than 85,000 visits, enhancing provider experience and supporting member outcomes for more than 1,700 individuals. In collaboration with DPHHS, Netsmart has provided ongoing provider and stakeholder education and training, resulting in increased adoption and provider satisfaction.

Montana DPHHS and Netsmart took part in a successful Operational Readiness Review with Centers for Medicare & Medicaid Services (CMS) in September 2023, with intentions to complete a full CMS Certification Review in late 2024 or early 2025.