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Billing Software For Medicaid 2022

There are many Billing Software in the world, but Billing Software For Medicaid is a system with many features. Medicaid provides a wide range of health coverage for eligible low-income individuals. Medicare Medicaid is a federally-operated program committed to providing health coverage to those who need it, regardless of income. That essential personnel includes senior citizens (65 and over) or those under 65 with disabilities.

Billing Software For Medicaid

There are many tasks, such as filing claims with health insurance organizations to reimburse services rendered by health care providers. Medicaid is a government-funded program. Therefore, consistency in medical coding practices is essential for their claims billing functions. Let’s take a look at the top billing software for Medicaid.

1. AlayaCare

AlayaCare software can help you maximize Medicaid support, move forward with denied bills, and improve cash flow. Now you don’t need to pay much attention to the billing process. You can also focus on growing your medical clinic or business and improving client outcomes.

AlayaCare features

  • Electronic claims submission
  • Remote patient monitoring
  • User-friendly interface
  • High-quality reporting
  • Data exploration
  • Scheduling
  • Care worker management
  • Secure API integrations

Services of AlayaCare Medicaid Home Care

AlayaCare has a claims management capability integrated with Wayster revenue cycle technology. So you can efficiently perform multiple tasks in the same system through the software.

Multi-Payer Handling: Advanced reporting and targeted care plans are available for Medicaid billing, private insurance, private payers, and health care providers.

AlayaCare Medicaid Billing software has an extensive partner system to support the agency’s procedures. Being a HIPAA compliant software, it also supports third-party integrations. You get more accurate data reporting facilities with better handling of claim denials. The software’s automated data import saves your Medicaid staff time.

Best for: Home health, Medicaid providers, Community programs, Home infusion, Home care

Support: Phone support, Email/Help desk, Forum/FAQs, Knowledge Base, Chat


Mobile – Android, iPhone, iPad

Cloud, Web-Based, SaaS

Pricing of Alayacare: No pricing details available yet. The vendor provides it.

2. TripSpark

Among the Billing Software For Medicaid, TripSpark is the software with the most straightforward claim submission platform. Here is a Medicaid-eligible interface for claims management. You can easily accept the service provider. TripSpare has many features for Medicaid, Bill Payments, Healthcare Organizations, and Brokers.

Features of TripSpark

  • Scheduling
  • Fixed route management
  • Mileage tracking
  • Driver management
  • Routing
  • Multi-way support
  • Paratransit Management

TripSpark’s Services

Providers can tailor the query to view results based on claim status when processing claims.

The user-friendly interface of this billing software allows providers to monitor claims through a single screen.

You can quickly identify denied claims, expedite their reconciliation, and identify the reason for denial.

In addition, it is straightforward for you to provide reports through this Medicaid billing software. This software tracks claims for medical and consumer audits very well. Also, This software presents trip completion facts. TripSpark’s state-of-the-art reporting tools best support NTD and federal funding agency needs.

Best for : TripSpark’s fixed routes are ideal for medium to large travel agencies. : Paratransit, Ridesharing, NEMT, K12

Support: Phone Support, Email/ Help Desk, Chat


Desktop – Mac, Windows

Mobile – Android, iPhone, iPad

On-Premise: Windows, Linux

Cloud, SaaS, Web-Based

TripSpark Pricing: Billing software pricing starts at $1.00.

3. AudioEye

We can call AudioEye the best responsible software for your Medicaid billing and continuous website monitoring. It features a more comprehensive digital accessibility system with automatic corrections. DCI’s integrated platform with the software enables you to perform tasks accurately, such as data entry, payroll, and billing.

AudioEye features

  • Scheduling
  • Care management
  • Custom Auto Streams
  • Training and compliance
  • Electronic Attendance Verification
  • Vendor Payment, Employer Reimbursement
  • Compliance Tracking
  • Real-time monitoring

Services of AudioEye

AudioEye Medicaid Billing software includes a document to ensure accessibility on your website. Also, features of legal updates related to Medicaid and digital connectivity are optimized here. Also, AudioEye’s platform is integrated with powerful machine learning.

The software uses AI-powered algorithms to flag issues for end-users. AudioEye can perform an automatic scan and WCAG check daily or monthly. The software’s proprietary technology will automatically detect and resolve issues. Also, the accessibility score is updated frequently to inform you how your website performs.

Support: Phone Support, Email/ Help Desk

Deployment: Web-Based, Cloud SaaS

AudioEye Pricing: Pricing for AudioEye Medicaid billing software starts at $49.00 per month. There is a free trial for this.

4. CareSmartz360

This software can help make paying your Medicaid bills more straightforward and accurate. For payments and reporting, CareSmartz360 has a more robust billing solution.

Caregivers can also submit claims on the same day they provide services. If you run an independent home care agency, then CareSmartz360 can best meet your business needs. This Medicaid Billing software is a HIPAA-compliant, cloud-based system.

Features of CareSmartz360

  • Management of care plans
  • Compliance Management
  • Mobile access
  • Insurance Management
  • Assessment Management
  • Scheduling appointments
  • Service Provider Management
  • Payroll Management
  • Time tracking by client

Services of CareSmartz360

CareSmartz360’s robust invoicing solution enables you to automate and track invoices. Also, this Medicaid software supports multiple payment sources. It includes everything from electronic travel verification to Medicaid billing. You no longer have to agonize about care delivery. CareSmartz360 also provides several features that most billing software for Medicaid does not.

Its electronic Medicaid billing module automatically manages all billing data. It gives you the ability to review a claim without errors quickly. Through this, you will also be able to work on better activities related to claims, such as rejected claims and expired statuses.

Best For :Home care Franchisors, Home care, Care providers, Independent home care agencies, Private Duty home care agencies

Support: Knowledge Base, Phone Support, Chat, 24/7 (Live Rep), Email/Help Desk


Desktop – Windows, Mac, Linux, Chromebook

Cloud, SaaS, Web-Based 

Mobile – iPad, iPhone, Android

CareSmartz360 Pricing: Pricing details are yet to be provided and are provided by the vendor.

5. EmbraceDS

Do you need a billing software for Medicaid to maximize revenue and compliance? It may be the best easy-to-use option for that. EmbraceDS has the most substantial software integration with Personal Service. It’s even more censorious to ensure that you and your Medicaid staff have the necessary tools and qualifications. EmbraceDS has also added IEP-specific certifications to the service for better quality reporting.

EmbraceDS features

  • Submission of claims
  • Compliance Audit
  • Update reports from internet-enabled devices
  • Verification of accuracy of records
  • Service Reminder
  • Tracking Services
  • Group data entry
  • Reimbursement with diversity

EmbraceDS Services

Embrace is the ideal Medicaid billing software with a user-friendly platform and minimal training. You can enter batch data for this, and it can speed up the documentation process. The time taken for many things, such as tests, individual and group therapy, drug administration, etc., is recorded here.

Medicaid reporting can ensure scheduled services in the IEP. EmbraceDS also informs staff of its service delivery using automated reminders. It also gives you the convenience of electronic storage to approve service prescriptions, billing Medicaid forms, etc. This Medicaid Billing Software is committed to providing a maximum contribution to services such as increasing monthly accurate report audits.

Best For: Especially engineers and ops, mobile teams

Support: Chat, 24/7 (Live Rep)


Mobile – Android, iPad, iPhone

Cloud, Web-Based, SaaS

EmbraceS Pricing

Pricing for EmbraceDS Medicaid billing software starts at $250 per month. There is a free trial here. You also get a free version. 

The price details will be provided to you by the seller.

6. EDI Auto claim

We recognize this as the most qualified Medicaid billing software for home or community-based services. It works as one of the most trusted HIPAA-protected billing software for Medicaid. 

It’s important to you for faster and more accurate billing, reporting, and payments.

Also, due to more logical and robust controls, errors in EDI Autoclaim are minimal. This software allows you to claim on the same day of service. Also, the user has the convenience of receiving payments quickly through this. EDI Auto Claims Automated Claims is a multi-billion dollar claims handler.

EDI Autoclaim Features

  • Compliance Tracking
  • Claims Management
  • Confirmation of insurance eligibility
  • Claims scrubbing
  • Providing remittance instructions
  • Invoicing history
  • Estimating prices

EDI Autoclaim services

You can send every claim you make to Medicaid flawlessly. EDI billing software reduces claims-related denials by 100%. You also get the ability to manage your cash flow in one go. EDI Autoclaim has integrated double-entry bookkeeping for all income. Through this, medical teams can get information about claims paid, claims to be followed up, etc.

As a billing software, EDI works more accurately with automated claims. That saves your Medicaid staff a lot of time. The software is committed to performing a faster set of tasks by submitting thousands of shares simultaneously. Also, EDI Autoclaim significantly improves your billing workflow. It also can work correctly with your existing tools.

Best For: Community-Based Service Organizations

Support: chat

Deployment: Cloud, Web-Based, Saas

Pricing of EDI Auto claim: The pricing of EDI Autoclaim Medicaid Billing Software is not mentioned.


You can efficiently work with Billing Software for Medicaid to make health and medical services more efficient. Use the above software features to maximize your customer service and increase revenue.

FAQs on Billing Software For Medicaid:

  1. How is Medicaid billed for services?

If the home and community-based services are billed electronically, HCBS uses Claim 837 Electronic Data Transfer. CMS-1500 is used for the majority of HCBS billing on paper.

  1. Can you bill a patient for a prescription if you are not a participating provider?

There is one possibility that a provider may bill Medicaid. That is, if Medicaid does not cover the service. The provider notifies the customer in advance to the customer. The customer is ready to pay for the non-covered service.

  1. Will Medicaid pay for past medical bills?

Yes. Federal law provides funds for state Medicaid programs to cover medical bills paid up to 3 months before a beneficiary’s application date. 

  1. Does Medicaid cover past medical bills?

Medi-Cal covers unpaid medical expenses starting the three months before you apply. You can enter that information when using it if you have overdue medical bills.

  1. Does Medicaid cover hospital bills?

Yes! Medicaid covers a much broader range of health services. Medicaid helps finance hospitals, community health centers, nursing homes, doctors, and health sector jobs.


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