A Procentive alternative is worth evaluating when the programs your agency runs have outgrown a general behavioral health electronic health record (EHR). Procentive by Ensora Health (Ensora is the 2025 rebrand of Therapy Brands) is a cloud-based behavioral health EHR with integrated billing, scheduling, and clinical documentation, and it is widely used by Minnesota mental health providers. Nothing in this guide argues that it is a poor product.
The question is fit. Minnesota agencies rarely run one program. An Adult Rehabilitative Mental Health Services (ARMHS) provider adds 245D home and community-based services; a PCA agency transitions to Community First Services and Supports (CFSS) and takes on electronic visit verification (EVV); an outpatient practice opens an Early Intensive Developmental and Behavioral Intervention (EIDBI) program. Each of those carries record elements, billing rules, and audit expectations that a system designed around outpatient therapy notes was not built to enforce.
This guide gives you a way to decide: the reasons agencies look, a program-by-program comparison framework, a neutral explanation of pricing models, a migration checklist, and the questions to put to any vendor, including Trustora. It reflects Minnesota rules as of September 2026.
Why Minnesota agencies look for alternatives
Five reasons come up repeatedly. None is a criticism of any one product; they are the points where a general EHR and a multi-program Minnesota agency pull in different directions.
- Program-specific workflows. ARMHS records under Chapter 245I, 245D support plans and incident reports under Minn. Stat. § 245D.06 and § 245D.071, PCA and CFSS visit records, EIDBI individual treatment plans with the 97155 proportion rule, and adult day attendance records each have required elements. A generic note template leaves it to staff to remember them; a program-specific template enforces them.
- EVV. Since January 1, 2026, Minnesota PCA and CFSS providers must be enrolled in HHAeXchange and submit complete data for every visit, and at least 80% of visits billed after July 1, 2026 must be EVV compliant. If the EVV app, the schedule, and the claim live in separate systems, mismatches are routine. The Minnesota EVV requirements guide explains the thresholds and enforcement.
- Pricing model. As an agency adds caregivers, per-seat pricing grows with headcount, and percentage-of-collections pricing grows with revenue. Some agencies want a cost that does not move when they hire.
- Field mobile use. Caregivers and ARMHS workers document in homes and in the community. They need an app that works offline, captures GPS and signatures, and writes the note in the same record the biller sees.
- Audit readiness. DHS reviews, Minnesota Revalidate 2026, and pre-payment review all ask for the complete record for a client and date range. Assembling that by hand from several systems is where agencies lose weeks.
A comparison framework: what to require for each Minnesota program
Evaluate any candidate, including your current system, against the programs you actually run. Ask for a live demonstration of each row, not a slide.
| Program | Record elements to enforce | Billing and authorization | Field or attendance link |
|---|---|---|---|
| ARMHS | Diagnostic assessment, functional assessment with domain narratives, LOCUS, ITP with client signature, progress note per § 245I.08, subd. 4, supervisor approval within 10 business days, MHRW co-signature | H2017 in 15-minute units, modifiers per the DHS manual, units derived from clock times | Mobile note entry in the community |
| 245D | CSSP addendum within 15 and 60 days for intensive services, progress reviews, incident reports within 24 hours, staff orientation and annual training records | Waiver service agreements in units, DWRS rates | EVV for some services (individualized home supports), otherwise service documentation |
| PCA / CFSS | Care plan, visit record with tasks, worker competency visits within 30 days of hire and every 90 days in the first year | CFSS codes, service agreement units, EVV-matched claims | EVV app with GPS clock-in and signatures, HHAeXchange aggregator feed |
| EIDBI | CMDE, ITP with justification for 97155 proportion, session notes, progress monitoring, QSP as agency employee | 97151 to 97157 and 0373T, authorization tracking by code | Mobile session notes |
| Adult day | Attendance by date and hours, service plan, licensing records under Minn. R. 9555 | S5102 daily, S5100 in 15-minute units, T2003 UC transportation | Attendance capture, not EVV |
Cross-cutting requirements apply to every program: a business associate agreement (BAA) as defined in 45 CFR 160.103, role-based access, an audit log, eligibility checks, 837P submission, 835 reconciliation, a denial queue, and a documented data export. The HIPAA compliance guide covers the security requirements in detail, and the MHCP claim denials guide lists the pre-claim checks a billing module should run.
Compliance note: for each program, ask the vendor to show a completed record next to the statute or rule it is meant to satisfy. If the demo cannot point to the rule, the software will not help you point to it during a review either.
The ARMHS software buyer's guide and the PCA and CFSS software buyer's guide go deeper on the two programs where agencies most often switch.
Pricing models explained neutrally
Vendors use three models, and each is reasonable for a certain kind of buyer. The mistake is comparing list prices instead of modeling your own cost over time.
| Model | How it is charged | Cost grows with | Suits |
|---|---|---|---|
| Per seat (per user) | A monthly fee for each named user or concurrent login | Headcount, including part-time caregivers | Small clinical teams with few field staff |
| Percentage of collections | A share of what the system bills and collects, often bundled with billing services | Claim volume and rates | Agencies outsourcing billing entirely |
| Flat monthly fee | A fixed amount regardless of users or clients | Nothing tied to growth; tiers may exist | Agencies with many field staff or growth plans |
Model each at the staff count and revenue you expect in two years. Read the contract for implementation fees, training fees, add-on modules (EVV, telehealth, e-prescribing, reporting), data export fees, minimum terms, and auto-renewal. A low per-seat rate with a three-year term and an export fee can cost more than a higher flat fee that is month to month. Do not accept a verbal quote; ask for the fee schedule in writing.
Migration checklist
Switching systems is a data and billing project first and a training project second. Work through these steps in order.
- Inventory the data. Clients, staff, authorizations, assessments, plans, notes with signatures and timestamps, incident reports, claims, and ERA history. Note what lives outside the EHR (spreadsheets, paper, the EVV vendor).
- Request a full export from the current vendor in a documented format, with a data dictionary. Confirm what your contract says about export cost and timing before you give notice.
- Decide what to import. Demographics, active authorizations, and current plans usually import cleanly; historical notes may be imported as documents rather than structured records. Confirm how the new system displays imported history and how signatures are preserved.
- Handle open claims. Claims already submitted from the old system will pay or deny into the old system's ERA. Decide who works those denials, in which system, and for how long. Keep the old system's 835 posting active until every open claim is adjudicated.
- Preserve ERA history. Remittance records support claims for the retention period under Minn. R. 9505.2190 (at least five years after initial billing). Export them or keep read-only access.
- Configure programs and templates in the new system and validate each against the framework table above with your own compliance lead.
- Run in parallel for at least one full billing cycle: document and bill in the new system while keeping the old system available to compare.
- Cut over on a date just after a remittance, with EVV enrollment, MN-ITS mailbox, clearinghouse, and MCO payer setups confirmed in the new system.
- Retain the old record. Keep read-only access or a complete export for the longer of the HIPAA six-year documentation period and your program's record retention rule.
Questions to ask any vendor
Send the same list to every vendor 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 ARMHS progress note, the 245D incident report, the CFSS visit record, and the EIDBI ITP.
- How do you send visit data to the HHAeXchange aggregator, and how does a mismatch show up before the claim is sent?
- Which pre-claim checks run automatically, and can we see the 835 codes on each claim line?
- What is the pricing model, what is in the fee, 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?
- What is in the audit log, how long is it kept, and can we export it for a date range?
- What happens to our data and our access at the end of the contract?
How Trustora helps
Trustora is built for Minnesota agencies that run more than one program. It covers ARMHS, 245D, PCA/CFSS, EIDBI, and adult day services in one platform, with clinical documentation that enforces the required fields for each program, a caregiver EVV app on iOS and Android with GPS clock-in and client signatures, scheduling, supervision, a payroll bridge, and a claims lifecycle that runs eligibility, 837P, ERA reconciliation, denials, and appeal packets behind a pre-claim gate. Access is role-based and field-level, the audit log is append-only and SHA-256-chained with seven-year retention, a BAA is included, and the one-click DHS audit binder assembles a client's record for any date range. The features page shows each program's workflow so you can compare it against the framework table with your own client files.
On the questions above, the answers are short. 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; see the pricing page for the current model. Onboarding, migration, and training are included and typically take one to two weeks: the team imports demographics, authorizations, plans, and note history, sets up MN-ITS, clearinghouse, MCO, and HHAeXchange connections, and configures each program's templates against the current rule before cutover.