Medicaid & HCBS Billing · Standalone or Connected

Medicaid & HCBS Billing Software
That Works With Your Care System.

Generate or import billing data, validate and submit claims through clearinghouse-supported payer workflows, track status, work denials, post 835 ERAs, and reconcile remittance advice. Use Billing by itself or connect it to Case Management or ADHC. Exact payer, plan, transaction, enrollment, and claim-type fit is confirmed during setup.

Available without buying a Care Module
Generate from OCP care records or import billing data
Validate and submit claims with clearer follow-up
Post 835 ERAs and reconcile paid or denied claims
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From Service to Payment, With Fewer Manual Steps

See how One Care Portal handles the billing cycle across payer types, with specialized workflows for Medicaid and HCBS agencies.

1

Billing Data Prepared

Import billing data or generate it from reviewed Case Management or ADHC services.

2

Claims Validated

Review claim data and configured billing checks before submission.

3

Claims Submitted

Submit claims across payer workflows and keep status visible for follow-up.

4

Payments Posted

Post 835 ERAs, review denials, and reconcile remittance advice against claims.

Billing Features That Get You Paid

Pre-Submission Validation

Every claim checked against authorizations, documentation requirements, and state-specific rules before it leaves your system.

Electronic Claims Submission

Submit 837P and 837I claims electronically to Medicaid, MCO, Medicare, and commercial payers, including configured Medicaid and HCBS programs.

Auto ERA Posting

835 remittance files import and post automatically. Payments match to claims without manual data entry.

Denial Management

Denials flagged immediately with reason codes. Track appeals and resubmissions to resolution.

A/R Aging Reports

See outstanding claims by age, payer, and status. Know exactly where every dollar stands.

Multi-State, Multi-Payer Support

Configure billing workflows around the programs and payer requirements confirmed during implementation.

"We spend less time on documentation cleanup, and Medicaid submission review is much clearer. The operator insight behind the platform is built right in."
Rhonda, Director of Case Management

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Frequently Asked Questions

Can we use Billing without a One Care Portal Care Module?

Yes. Billing is available standalone. You can keep your current care or documentation workflow, or connect Billing to the Case Management or ADHC Care Module.

How do ERAs get posted?

We import 835 remittance files and auto-match payments to claims. Adjustments and denials are flagged for review.

What if we bill multiple payers?

The Billing Module supports all major payer types: Medicaid and Medicaid MCOs, Medicare and Medicare Advantage, and commercial payers through clearinghouse-supported workflows, including secondary claims. Exact payer, plan, transaction, enrollment, and claim-type fit is confirmed during setup.

How do you handle claim denials?

Denials appear in a worklist with reason codes and recommended actions. Track corrections and resubmissions through resolution.

Billing more than Medicaid?

This page covers our Medicaid and HCBS billing configuration, but the Billing Module is not limited to it. The same claim scrubbing, submission, 835 ERA posting, and denial workflow handles Medicaid MCO, Medicare and Medicare Advantage, and commercial claims — and Billing can be purchased on its own, without an HCBS program or a Care Module.

Medicaid Medicaid MCO Medicare & Medicare Advantage Commercial
See multi-payer billing

Exact payer, plan, transaction, enrollment, and claim-type fit is confirmed during setup.

Ready to Get Paid Faster?

See how connected documentation and billing checks can reduce claim rework and improve billing visibility.

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