A Billiyo alternative is worth evaluating when your Minnesota agency's programs need more than a home care platform is designed to enforce: program-specific record elements for Community First Services and Supports (CFSS), Adult Rehabilitative Mental Health Services (ARMHS), 245D, Early Intensive Developmental and Behavioral Intervention (EIDBI), or adult day services, a pre-claim gate matched to Department of Human Services (DHS) pre-payment review, an audit export by client and date range, or a price that does not move with headcount. Billiyo, based in Minneapolis, describes itself as an all-in-one platform for home care (PCA) and home health providers with billing, scheduling, electronic visit verification (EVV), and payroll. Nothing in this guide argues that it is a poor product.
One note on method. Billiyo's public website returned an access error (HTTP 403) to automated review while this guide was prepared, so its self-description below comes from its knowledge base, its app store listing, and search snippets of its own pages, each cited in the sources. Where a detail could not be confirmed, this guide says so.
The rest is a decision framework: why agencies look, what Billiyo says about itself, a neutral comparison table, a migration checklist, and the questions to put to any vendor, including Trustora. It reflects Minnesota rules as of September 2026.
Why Minnesota agencies evaluate a Billiyo alternative
Five pressures drive most evaluations. None is a criticism of any one product. They are the points where Minnesota enforcement has tightened since 2025.
- Program-specific enforcement. A PCA agency rarely stays a PCA agency. Once it adds 245D, ARMHS, EIDBI, or adult day services, each program brings record elements in statute or rule: ARMHS notes under Minn. Stat. § 245I.08, subd. 4, 245D incident reports under § 245D.06, CFSS worker competency visits at 30 and 90 days, the EIDBI 97155 proportion, and adult day attendance by date and hours. A generic visit note does not know those rules.
- Pre-payment review. DHS pre-payment review applies to 14 high-risk services, including PCA/CFSS and individualized home supports. The claim has to carry its evidence before payment.
- The EVV threshold. Since January 1, 2026, providers subject to EVV must be enrolled with HHAeXchange and submit complete data for all visits. At least 80 percent of visits billed after July 1, 2026 must be EVV compliant, manually entered visits count as noncompliant, and corrective action for providers under 80 percent begins in October 2026. The Minnesota EVV requirements guide walks through the escalation steps.
- Audit readiness. Revalidate 2026 site visits and record requests ask for the complete record for a client and date range, including the worker file behind each claim.
- Pricing model. Per-caregiver, per-client, or percentage-of-collections pricing grows with the agency; some owners want a cost they can forecast.
What Billiyo says about itself
Everything here is attributed to Billiyo's own materials or to DHS. Confirm current details with Billiyo before relying on them.
- Company and location. Billiyo Health Inc. is based in Minneapolis, Minnesota. Its site does not state a founding year in the material we could review.
- Markets named. Search snippets of billiyo.com describe an all-in-one platform for home care (PCA) and home health providers; its page titles also reference home medical equipment (HME), hospice, and private duty nursing.
- Billing. Snippets of its site describe secure electronic claim submission, real-time eligibility checks, remittances, and payment auto-posting.
- Scheduling and payroll. Its site describes customized schedules for field staff with instant notifications, caregivers updating worked hours and signing timesheets electronically with EVV, and that data flowing to the agency's payroll software of choice.
- Caregiver app. Its knowledge base describes an app for Android and iPhone with clock-in and clock-out tied to a scheduled shift, a map with the client's location and directions, written or typed caregiver and client signatures, shift summaries, completed services, notes with attachments, and in-app messaging to the office. The Google Play listing describes an easy-to-use point-of-care application with electronic signature, availability and incident reporting, care plan and client medications, two-way communication to the office, and EVV.
- HHAeXchange. The knowledge base states that Billiyo automatically submits EVV visits to HHAeXchange once they are completed, that agencies enter their HHAeXchange API credentials in Billiyo, and that rejected visits are corrected and resubmitted from the EVV Report page. It also notes that resolution of some rejections requires contacting HHAeXchange or the payer directly. Its Minnesota EVV preparation article walks agencies through the DHS HHAeXchange provider enrollment form, selecting the option for an agency with its own EVV system integrating by EDI. As of September 2026, DHS's list of third-party EVV systems integrated with HHAeXchange includes Billiyo; DHS says that list is not complete and that third-party system costs are the provider's responsibility.
The knowledge base articles on the caregiver app do not describe offline capture or telephony clock-in, and the pages we could read do not name CFSS, ARMHS, 245D, EIDBI, or adult day services. None of that is a finding that the product lacks them; each is a question for a demo.
A comparison framework for Minnesota agencies
Use the same criteria for every candidate and for whatever you run today, and ask for a live demonstration of each row with your own client files.
| Criterion | What to ask any vendor |
|---|---|
| EVV to HHAeXchange | Show a rejected visit, the correction, and the resubmission. Are noncompliant and manual visits sent too, so the DHS report matches the in-app rate? |
| Caregiver app | GPS clock-in and clock-out, offline capture with later sync, client signature, tasks from the service delivery plan, manual entry only with a reason code and supervisor review |
| Telephony | Is landline clock-in offered, and how are those visits flagged? |
| Authorization tracking | Does scheduling warn or block when a shift is outside the service agreement or exceeds remaining units? |
| Program templates | Show the CFSS visit record, the ARMHS progress note with § 245I.08 elements, the 245D incident report, the EIDBI ITP, and the adult day attendance sheet |
| Pre-claim gate | Which checks run before an 837P line is released: eligibility, authorization, worker enrollment and affiliation, credentials, modifiers, EVV match? |
| Remittance | Is the 835 posted automatically, with denied lines queued and adjustment reason codes attached? |
| Audit export | Can you produce the complete record for one client and one date range in one step? |
| Security | Signed BAA, encryption at rest and in transit, second factor at login, role-based access, append-only audit log |
| Pricing | Per caregiver, per client, percentage of collections, tiers, or flat fee; what is extra; minimum term; export cost |
Compliance note: the compliance rate shown inside an app is not the monthly rate DHS reads from HHAeXchange. Ask every vendor, in writing, whether manual and edited visits are transmitted and how the two numbers are reconciled.
The PCA and CFSS software buyer's guide expands the EVV and authorization rows and covers the worker file, the ARMHS software buyer's guide covers the 245I rows, and the HIPAA compliance guide explains the BAA and audit log.
Pricing models, described neutrally
Vendors price this software per user or caregiver, per client or visit, as a percentage of collections, in feature tiers, or as a flat monthly fee, and none is wrong in itself. Model each at the size you expect in two years, add implementation, migration, support, and add-on modules, and read the contract for minimum terms and export fees.
Migration checklist
Switching platforms is a data and billing project first. Work through these steps in order.
- Inventory the data. Clients, workers, service agreements, schedules, visits with GPS and signature data, timesheets, plans, claims, and remittance history, plus anything kept outside the platform.
- Request a full export in a documented format with a data dictionary, and check the contract for export cost and timing before giving notice.
- Decide what to import. Demographics, active authorizations, and current plans usually import as structured data; older visits and notes may arrive as documents. Confirm how signatures are preserved.
- Keep EVV continuous. Update HHAeXchange enrollment to name the new system, complete the API configuration, and import caregivers before the first visit. Do not let two systems send the same day's visits.
- Work open claims from the old system until every one is adjudicated, and decide who does that and in which system.
- Configure and validate each program's templates against the framework table with your compliance lead.
- Run in parallel for one full billing cycle, then cut over just after a remittance with MN-ITS, clearinghouse, managed care, and HHAeXchange setups confirmed.
- Retain the old record for the longer of the HIPAA six-year period and the five-year MHCP billing record rule in Minn. R. 9505.2190.
Audit tip: before cutover, pull the same client's record for the same month from both systems and compare them field by field. Any difference is a question a reviewer may ask later.
The Caretap alternatives guide and the Alora alternatives guide apply this framework to two other platforms, and the Procentive alternatives guide covers the behavioral health EHR side.
Questions to ask any vendor
Send the same list to every vendor, including Trustora, in writing, and keep the answers with the contract.
- Will you sign a BAA, and do your subcontractors sign one with you?
- Which Minnesota programs do you support with program-specific templates? Show the CFSS visit record, the ARMHS progress note, the 245D incident report, the EIDBI ITP, and the adult day attendance record.
- How do visits reach HHAeXchange, how does a rejection appear, who resubmits it, and are manual visits transmitted?
- Which pre-claim checks run automatically, and can we see the 835 reason codes on each claim line?
- What is the pricing model, what is included, what is extra, and what is the term?
- Who owns the data, what does an export include, what format is it in, and what does it cost?
- What does onboarding include, how long does it typically take, and who does the migration work?
How Trustora helps
Trustora is one platform for PCA/CFSS, ARMHS, 245D, EIDBI, and adult day services, built for Minnesota agencies that run more than one program. The caregiver EVV app on iOS and Android captures GPS clock-in and clock-out and client signatures, visits are transmitted to the HHAeXchange aggregator, and clinical documentation enforces the required fields for each program. The compliance engine runs a pre-claim gate and gap-day alerts, the claims lifecycle covers eligibility, 837P, ERA reconciliation, denials, and appeal packets, and the one-click DHS audit binder assembles a client's record for any date range. The Minnesota home care software, Minnesota EVV software, and PCA and CFSS software pages show each workflow.
On the questions above: pricing is one flat monthly fee with unlimited users and clients, no per-seat fees, no percentage of collections, and a month-to-month term. Trustora runs on HIPAA-eligible AWS with AES-256 encryption at rest, TLS 1.3 in transit, a one-time code on every login, role-based field-level access, and an append-only SHA-256-chained audit log retained for seven years; a BAA is included. Onboarding, migration, and training are included and typically take one to two weeks.