Document the service
Clinicians record outpatient and community services in myAvatar or myEvolv. Netsmart says myEvolv can generate claims directly from clinical notes, so documentation quality decides claim quality.
Keep myAvatar or myEvolv. Hand off the claims work.
Netsmart's myAvatar and myEvolv build claims from clinical documentation and handle Medicaid, Medicare, and commercial billing rules. Many outpatient and community programs still need people to work rejections, denials, and aging A/R. This guide covers what to settle before handing that work to Taiga.
Book a demoThe key question is which Netsmart billing screens and reports a Taiga biller can use, and who keeps program and funding setup.
Clinical note
Service documented in myAvatar or myEvolv
Claim build
Netsmart generates the claim from documentation
Payer follow-up
Denials, appeals, and A/R worked by Taiga
How a Netsmart claim moves today
myAvatar and myEvolv are built for organizations with several programs and funding sources. A billing handoff has to respect that setup.
Apply payer and program rules
Netsmart describes coordination of benefits logic that sets payer rates in myEvolv, and support for grant funding and value-based reimbursement in myAvatar. That configuration usually belongs to your billing administrator and should stay with the practice.
Submit and track
Claims go out through the organization's clearinghouse, which for some Netsmart clients is RevConnect, Netsmart's own claims management tool. Decide whether Taiga works rejections from those reports or from exports your team shares.
Work denials and A/R
This is where Taiga picks up: payer follow-up, every denial and appeal including small-dollar ones, and patient statements. Taiga can take over open A/R or run in parallel with your current staff.
What changes for a Netsmart practice
Clinicians and program staff keep the system they know. The follow-up work moves to a dedicated team.
Program setup stays put
Service definitions, funding sources, and program rules remain where your billing administrator built them.
Small balances get worked
Low-dollar Medicaid and commercial denials get the same appeal effort as large ones instead of aging out.
Clinicians approve codes
Taiga drafts ICD-10 and CPT codes from notes, and the treating clinician approves them before anything is submitted.
Questions to answer before a Netsmart handoff
Netsmart deployments vary widely by organization. These answers shape the scope.
Which product is in use?
Confirm whether you run myAvatar or myEvolv, which billing features are turned on, and who administers them.
Which programs bill insurance?
List the outpatient and community programs that send claims, and set aside residential, inpatient, or grant-only programs that sit outside this scope.
Where do claims and remittances go?
Name your clearinghouse, explain how 835 remittances post, and identify the reports that show rejections and unpaid claims.
How much A/R is open?
Pull an aging report by payer so Taiga and your team can agree who owns older claims at cutover.
A fit for outpatient and community programs
Practices and smaller agencies that bill outpatient mental health services from myAvatar or myEvolv, with payer follow-up that has outgrown their billing staff. Taiga names mental health among its public specialties. For substance use, IDD, or other service lines, bring your service mix and Taiga will tell you straight whether it fits.
What this guide does not cover
Taiga does not claim a Netsmart integration, partnership, or automatic write-back, and the exact access is confirmed on a call. Residential, inpatient, and state contract billing are outside this page. Netsmart also sells its own RCM services, so you can compare that option with an independent partner.
Questions from Netsmart practices
Do we have to leave myAvatar or myEvolv to work with Taiga?
No. Taiga works alongside the system you already use. Clinicians keep documenting in Netsmart, and billing access is set up with your team.
How does this compare with Netsmart's own RCM services?
Netsmart offers full or partial billing outsourcing for its clients. Taiga is an independent option built for independent practices, so weigh the scope, reporting, and price of each.
Can Taiga work our open A/R in Netsmart?
Yes. Taiga can take over open A/R or run in parallel with your current billing. Share an aging report so both teams agree who owns each claim.
Does Taiga handle residential or grant-funded billing?
This guide covers outpatient and community services billed to insurers. Bring your full service mix and Taiga will tell you straight what fits.
Map your Netsmart billing with Taiga
Bring your product, program list, and an aging report. Taiga will show which claim work it could take on and what the roughly two-week path to a first claim would look like.