Submit claims, post 835 ERAs, work denials, and track every dollar from service to payment — for Medicaid, Medicaid MCO, Medicare and Medicare Advantage, and commercial payers.
Billing is a separate module. Buy it on its own and run it alongside the care or documentation system you already use, or connect it to OCP Case Management or ADHC — no HCBS program required.
Supported through clearinghouse workflows. Exact payer, plan, transaction, enrollment, and claim-type fit is confirmed during setup.
One Care Portal’s Care Modules focus on HCBS, waiver, and adult day programs. The Billing Module is a separate revenue cycle product with no such limit — if your agency submits professional or institutional claims, you can use it, whether or not you run a waiver program and whether or not you use our care software.
Medicaid, Medicaid MCOs, Medicare and Medicare Advantage, and commercial payers through supported clearinghouse workflows. Exact payer, plan, transaction, enrollment, and claim-type fit is confirmed during setup.
From service delivery to payment posting, manage your entire billing workflow.
Generate claims automatically from verified visits and documented services.
Catch errors before submission. Fix issues that cause denials.
Submit 837P and 837I claims electronically to Medicaid, MCO, Medicare, and commercial payers through supported clearinghouse workflows. Track status in real time.
835 ERAs post automatically. Match payments to claims without manual entry.
Track denials by reason code. Rework and resubmit from one screen.
See aging by payer, client, and service across every payer you bill. Know exactly what's outstanding.
The same claim scrubbing, submission, ERA posting, and denial workflow supports the major payer categories below.
State Medicaid programs and Medicaid managed care plans, including waiver, HCBS, TCM, and adult day services.
Commercial and group health plans, submitted as 837P or 837I through supported clearinghouse workflows.
Medicare and Medicare Advantage claims, with the same validation, remittance, and denial tracking.
Billing several payer types at once, including secondary claims. See A/R and denials broken out by payer.
Agencies using this today include case management, adult day and ADHC, waiver and HCBS, IDD, and supportive housing providers — alongside provider agencies with no HCBS programs at all. Exact payer, plan, transaction, enrollment, and claim-type fit is confirmed during setup.
Documentation captures the service
System creates claims with correct codes
Errors caught, clean claims sent
Payments auto-posted to claims
Balances reconciled, denials flagged
"We reduced duplicate entry and our billing workflow is much cleaner. ERA posting and denial visibility save our team review time each week."
Deep dive into Medicaid-specific billing features.
Learn moreAttendance and service documentation that supports billing.
Learn moreDocumentation that supports billing compliance.
Learn moreUsing another care system? Read the standalone Billing Hub and Excel-to-claims workflow, or review remittances in the all-payer 835 ERA Dashboard.
The Billing Module supports all major payer types: Medicaid and Medicaid MCOs, Medicare and Medicare Advantage, and commercial payers through supported clearinghouse workflows. Exact payer, plan, transaction, enrollment, and claim-type fit is confirmed during setup.
Yes. Billing is sold separately at $1.50 per submitted claim and runs alongside the care or documentation system you already use. You can import service data from Excel, and connect a Care Module later if you want to.
No. Our Care Modules are built for HCBS and waiver programs, but the Billing Module is a standalone revenue cycle product. Any provider agency that submits professional or institutional claims can use it.
We receive 835 files electronically and automatically match payments to the original claims. Adjustments and denials are flagged for review.
Yes. The denial dashboard shows all denied claims by reason code, payer, and date. You can rework and resubmit from the same screen.
Yes. When primary payers process, we can generate secondary claims with the appropriate adjustments.
See how provider agencies reduce billing rework and improve claim visibility across Medicaid, MCO, Medicare, and commercial payers — with or without our Care Modules.