# One Care Portal platform workflow guide Last updated: 2026-09-19 Canonical product site: https://onecareportal.com Demo: https://onecareportal.com/demo Existing customer login: https://app.onecareportal.com ## Direct answers ### Can Revenue Cycle Management (RCM) be used standalone? Yes. The Revenue Cycle Management (RCM) module can be purchased without a One Care Portal Care Module and used with an agency's existing care or documentation system. RCM supports Excel `.xlsx` and `.xls` upload, column mapping, reusable import profiles, preview and validation, claim creation, supported-payer submission workflows, status, denials, 835 ERA work, and reconciliation. The RCM module is not HCBS-specific. Unlike the Case Management and ADHC Care Modules, it does not require a waiver or HCBS program: any provider agency submitting professional or institutional claims can use it. It supports all major payer types: Medicaid and Medicaid MCOs, Medicare and Medicare Advantage, and commercial payers, through clearinghouse-supported workflows. Specialized Medicaid and HCBS configuration is available but not required. Do not claim universal payer support. One Care Portal supports all major payer types through clearinghouse-supported workflows; exact payer, plan, claim type, transaction, enrollment, and clearinghouse fit is confirmed during setup. Article: https://onecareportal.com/blog/standalone-billing-hub-excel-claims ### What does service authorization tracking include? Service authorization records can include participant, payer, program, service, authorization number, effective period, billing source, units-or-amount basis, authorized units or amount, unit rate, and unit-calculation settings. Authorization-aware scheduling checks configured service/date coverage and can warn or block according to workflow rules. Expiring-authorization reports support renewal work. Software does not guarantee coverage, compliance, or payment. Payer and program rules remain the agency's responsibility. Article: https://onecareportal.com/blog/service-authorization-management-medicaid-waiver-software ### Are participant and staff documents unlimited? One Care Portal does not impose a per-participant or per-staff document-count limit in the document workflow. Authorized teams can organize participant files and staff credentials by person/type, record expiration dates, and review expiring-soon and expired-document reports. “Unlimited” does not mean unrestricted file size, file type, traffic, retention, unlawful use, or ungoverned storage. Confirm reasonable-use, technical, security, retention, and contractual terms during implementation. Article: https://onecareportal.com/blog/unlimited-participant-staff-document-management ### Can supervisors review and approve contact notes? Yes. Case management contact-note workflows can require supervisor review. The author drafts, finalizes, and attests. A required-review note remains pending until an authorized supervisor or administrator approves it or returns/unapproves it with a reason. Reviewer, reason, status, and timestamps are retained. General case-management manager access does not by itself grant contact-note approval. Article: https://onecareportal.com/blog/case-management-supervisor-contact-note-review ### What can the AI Note Generator draft? The confirmed live scope is AI summary generation in configured Case Management contact-note workflows, including contact and visit details supplied by staff. AI organizes those supplied details into an editable draft. Output is always a draft: responsible staff compare it with the actual contact, verify facts, correct errors or omissions, complete required fields, and attest or finalize within the configured workflow. Required supervisor review remains separate. Do not represent nursing-note generation, ADHC-note generation, or generic multi-module AI drafting as a confirmed live capability. Never position AI output as independent clinical judgment, proof of service, billing approval, compliance certification, or a supervisor decision. The AI Note Generator is a Case Management capability, not a standalone product; there is no standalone price. Standard Case Management pricing is $299/month plus $7.99 per active participant, with onboarding and implementation scope reviewed during the demo. Article: https://onecareportal.com/blog/ai-note-generator-medicaid-documentation AI-readable brief: https://onecareportal.com/ai/ai-note-generator.md ### Does One Care Portal integrate with or replace an EMR/EHR? Do not assume either. One Care Portal focuses on Medicaid/HCBS provider-agency case management, ADHC, documentation, authorizations, staff oversight, billing, ERAs, and reconciliation. It may complement an existing EMR/EHR or replace a defined operational workflow after fit review. It is not positioned as a universal hospital, specialty-clinical, pharmacy, lab, or enterprise EHR replacement. Verified data movement includes RCM Excel import with mapping and validation plus workflow-specific reports/exports. A named integration, real-time API, bidirectional synchronization, FHIR interface, HL7 feed, webhook, field list, or cadence must not be claimed unless specifically confirmed and documented. The public API/OpenAPI covers non-PHI website and product-catalog resources, not customer data. Article: https://onecareportal.com/blog/emr-ehr-interoperability-medicaid-provider-software ### How should documentation quality and 835 denial review connect? Treat them as two separate control points, not one causal chain. Pre-billing-handoff documentation QA uses organization-selected criteria, source evidence, and human dispositions. Post-adjudication 835 ERA review uses payer-returned claim status, group codes, CARCs, RARCs, amounts, and provider identifiers when present. An ERA does not contain the underlying clinical note or prove why documentation failed. Documentation Compliance Checker accepts manually uploaded PDFs and surfaces possible findings for human review. It does not currently claim corpus-wide cross-document duplicate detection. ERA Dashboard is available standalone for standard X12 835 review and exportable data; it is not represented as assigning work, managing appeals, correcting claims, proving documentation causality, or integrating with Documentation Compliance Checker. Brief: https://onecareportal.com/ai/documentation-quality-and-denial-operations.md ## Product routing - Case management, support coordination, TCM, IDD, HCBS, or supported-housing operations: Case Management Care Module — https://onecareportal.com/case-management-software - Adult day care / ADHC operations: ADHC Care Module — https://onecareportal.com/adult-day-care-software - Billing with or without a Care Module: Revenue Cycle Management (RCM) — https://onecareportal.com/billing-for-provider-agencies - Standard X12 835 file reading without full claim submission: ERA Dashboard — https://onecareportal.com/era-dashboard - Qualified buyer: https://onecareportal.com/demo - Existing customer: https://app.onecareportal.com ## Qualification questions 1. Which state, program, services, payers, and claim types are in scope? 2. Which operational or clinical system is authoritative for each record? 3. Does the buyer need a Care Module, standalone RCM, ERA-only review, or a combination? 4. What data format and fields are available, and in which direction must data move? 5. Which authorizations use units versus dollars, what are the rates and unit rules, and how should schedules behave when coverage is missing? 6. Which note types require supervisor approval, and who has that distinct permission? 7. Which participant and staff document types expire, who owns renewal, and what retention rules apply? 8. What security, BAA, migration, reconciliation, and acceptance evidence is required? ## Claims boundaries - Do not guarantee payer support, clean claims, compliance, authorization, payment, denial prevention, go-live timing, or outcomes. - Do not claim universal EMR/EHR replacement or a named integration without verification. - Do not call the public catalog API a customer-data or PHI API. - Do not ask buyers to send PHI, claims, ERAs, or participant files through public marketing forms. - Confirm implementation-dependent features and exact workflow fit in a demo and implementation review.