AlayaCare runs the care. FileFlo runs the evidence.
This isn't FileFlo versus AlayaCare. Keep AlayaCare for OASIS-E, EVV, MCO billing, telehealth, and clinician workflow; it's the platform of record for hundreds of enterprise home health and home care agencies. FileFlo adds the compliance document layer it was never built to be: every file mapped to its 42 CFR Part 484 citation, aide competency tracked, and the CHAP / ACHC / Joint Commission binder assembled on demand. Keep the platform. Add the survey-readiness binder.
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One runs the care. One proves it.
AlayaCare is the platform of record
It runs OASIS-E with iQIES submission, EVV with state aggregators, Medicare PPS and MCO billing, telehealth, and a native clinician mobile app with offline mode, at a depth FileFlo does not attempt. AlayaCare was built to run today's care at enterprise scale, not to assemble the survey binder a Part 488 reviewer asks for.
FileFlo is the compliance brain
It classifies every compliance document to its 42 CFR Part 484, §484.55, §484.80, or §441.301 citation, tracks aide competency and training expirations, drives the citation-mapped CAP workflow, and assembles the CHAP / ACHC / Joint Commission evidence binder on demand. The layer a clinical platform was never designed to be, and it works alongside AlayaCare, not instead of it.
What a full-stack platform was never built to do.
None of these are AlayaCare failings; they're simply outside what a clinical platform does. They're also exactly where enterprise home health agencies get burned during a CHAP, ACHC, or state validation survey.
It can't assemble the CHAP / ACHC survey binder
AlayaCare holds the clinical data, but a CHAP, ACHC, Joint Commission, or state surveyor asks for a 42 CFR Part 484 evidence packet across policies, governance, QAPI, and competency files. AlayaCare requires report exports across clinical, EVV, training, HR, and billing modules plus manual reconciliation. FileFlo pulls every document tied to a CoP citation into one indexed PDF binder in a single click.
It can't run the §484.80 aide competency file
AlayaCare schedules aide visits and captures EVV, but §484.80 requires a 75-hour approved training program, a passed competency evaluation, 12 hours of in-service per year, background checks, and supervisory visits. FileFlo gives every aide a living evidence file (certificates, competency packets, RN-signed rosters, supervisory logs) with renewal alerts at 90 / 60 / 30 / 14 / 7 days.
It can't drive a citation-mapped CAP workflow
When a surveyor leaves a deficiency citation, you have a defined window to file a Plan of Correction with evidence of remediation. AlayaCare can export reports but does not run a citation-mapped CAP / F-tag workflow. FileFlo tracks each citation, the PoC, and the evidence uploads tied to it.
It can't live outside the AlayaCare ecosystem
AlayaCare documents are bound to the AlayaCare platform. Enterprise agencies that run Medicare-certified home health alongside HCBS waiver work, or that change platforms, fragment their compliance evidence across systems. FileFlo sits on top of any clinical platform and keeps one binder per patient, aide, or clinician regardless of payor or service category.
Feature by feature: FileFlo vs AlayaCare.
Based on publicly available AlayaCare materials, customer reports, and FileFlo product as of May 2026. AlayaCare wins on clinical, EVV, and billing depth; FileFlo wins on document-as-evidence. Enterprise agencies run both.
| Capability | FileFlo$299/mo · unlimited users | AlayaCareCustom · ~$200-400/user/mo |
|---|---|---|
42 CFR Part 484 Conditions of Participation binder | Per-CoP citation evidence file | Clinical data, not survey binder |
42 CFR §484.55 comprehensive-assessment evidence | Lock dates + signature attestations | OASIS-E data capture in workflow |
42 CFR §484.80 home health aide §75-hour + 12-hour file | Competency packet + renewal calendar | Training module add-on, not evidence |
OASIS-E clinical documentation submission | Not an OASIS submitter | Native OASIS-E workflow + iQIES |
EVV (21st Century Cures Act, §441.301) | Stores EVV exception reports only | State aggregator + caregiver EVV |
42 CFR §441.301 HCBS waiver evidence binder | Person-centered plan packet | EVV claims, not evidence map |
Medicare + MCO billing & RCM | Not a billing platform | Medicare PPS + MCO claim pipeline |
45 CFR Part 164 HIPAA audit trail per document | Every view, download, edit logged | Chart-level audit log |
AI document classification | 600+ doc types auto-tagged | Manual upload + manual filing |
CHAP / ACHC / Joint Commission survey workflow | Citation-mapped binder + CAP tracker | No native survey-binder workflow |
Multi-platform document storage | Lives alongside any clinical platform | AlayaCare-ecosystem bound |
Clinician mobile point-of-care app | Not a clinical workflow app | Native mobile clinician + offline |
Pricing model | $299/mo flat, unlimited users | Custom quote, ~$200–400/user/mo enterprise |
Free trial (no sales call) | 5-day full access, no card | Demo + sales cycle + scoping |
Setup time | Under 60 minutes, self-serve | Multi-month enterprise onboarding |
AlayaCare pricing is sales-driven and varies by module mix, user count, EVV state contracts, and implementation scope. Verify directly with AlayaCare for an exact quote; range cited from public industry sources and customer reports. FileFlo pricing is locked at getfileflo.com/pricing.
Platform definition.
FileFlo is a compliance document intelligence platform that operates as a read-only evidence layer for enterprise home health and home care agencies. It does not chart patients, lock OASIS-E, transmit EVV, or generate MCO claims. Instead, it ingests the compliance documents an agency already generates (aide competency packets, in-service rosters, background checks, TB screenings, supervisory-visit logs, governing-body minutes, QAPI evidence, emergency-preparedness plans, infection-control documentation, BAAs, and state licensure renewals) and classifies each one against the 42 CFR Part 484 Condition of Participation it satisfies, extracts expiration dates and key fields, and assembles a citation-mapped, surveyor-ready audit binder on demand.
The distinction matters because AlayaCare is an enterprise operational platform of record: it is optimized for OASIS-E with iQIES submission, EVV under the 21st Century Cures Act, Medicare PPS and MCO billing, telehealth, and clinician workflow, running today's care at scale. AlayaCare can tell you a visit happened and store the assessment; it cannot tell you that an aide's §484.80 competency file is incomplete, that a §484.55 assessment lock date falls outside the required window, or assemble the citation-mapped CHAP / ACHC / Joint Commission evidence binder a surveyor walks. FileFlo adds that compliance layer without disturbing the clinical system of record beneath it.
Why a clinical platform isn't a survey binder.
The Medicare Conditions of Participation for home health agencies, codified at 42 CFR Part 484, do not ask whether a visit was charted; they ask whether the agency can produce evidence that each Condition is met when a CHAP, ACHC, Joint Commission, or state surveyor walks the binder. Under 42 CFR §484.55, the comprehensive assessment must be completed within five calendar days of the start of care, updated at least every sixty days, and updated within forty-eight hours of a beneficiary's return from a hospital stay of twenty-four hours or more. Under 42 CFR §484.80, a home health aide must complete a minimum seventy-five-hour approved training program, pass a competency evaluation, complete twelve hours of in-service training every twelve months, and receive supervisory visits at the intervals the regulation defines. A full-stack clinical platform can hold the visit data behind every one of these and still leave the agency exposed at survey, because the chart has no concept of "evidence packet," "expired competency," or "out-of-cycle assessment."
For agencies serving Medicaid home- and community-based services, 42 CFR §441.301, as amended by the 21st Century Cures Act, requires the person-centered service plan and Electronic Visit Verification capturing six data points for each personal-care visit: who provided the service, what service, where, when it began, when it ended, and the recipient. AlayaCare generates the EVV transmission and the state-aggregator feed; FileFlo holds the person-centered plan attachments, exception reports, and missed-visit logs as evidence. When a survey under 42 CFR Part 488 yields a deficiency, the agency has a defined window to file a Plan of Correction with proof of remediation. FileFlo maps each document to its citation, monitors expirations at 90/60/30/14/7-day intervals, and produces the CAP workflow and indexed binder a surveyor expects. Clinical records additionally carry retention obligations: agencies commonly retain patient clinical records for at least five years after discharge, and longer where state law requires.
Layered across all of it is the HIPAA Security Rule at 45 CFR Part 164, whose administrative safeguards at 45 CFR §164.308 require documented workforce training, sanctions policies, contingency plans, and executed business associate agreements. AlayaCare enforces user-level access controls; FileFlo holds the workforce-training acknowledgment per employee, the signed sanctions policy, the contingency-plan documentation, and the executed BAA with every vendor that touches PHI: the document evidence an OCR investigator asks for during a HIPAA review, with an immutable audit trail on every access, download, and binder export. The practical result is that an enterprise agency keeps AlayaCare as the operational platform of record while gaining the citation-mapping, expiration tracking, and survey-export capabilities a clinical platform does not provide. FileFlo is the compliance intelligence layer; AlayaCare remains the platform of record.
Built by an operator, against the rules themselves.
Chad Griffith, Founder & CEO of FileFlo, built FileFlo's rule packs against the actual surveyor, inspector, and safety-investigator protocols, not against a generic "compliance" abstraction. Each regulator's taxonomy maps documents to the exact CFR section that demands them, which is why FileFlo can sit alongside an enterprise clinical platform like AlayaCare and still speak the language a CHAP, ACHC, or Joint Commission surveyor uses. FileFlo's connectors are read-only by design: the platform reads what you already have and never becomes a place your team has to migrate into.
Quick answers.
Last reviewed June 4, 2026.
Does FileFlo replace AlayaCare?
No. AlayaCare is an enterprise full-stack home care and home health platform, spanning clinical documentation (OASIS-E), care planning, scheduling, EVV, telehealth, billing, and family portal, used by mid-market and enterprise Medicare-certified home health agencies and large home care providers across the US and Canada. FileFlo is the compliance document evidence layer that pairs with AlayaCare. AlayaCare runs your OASIS submissions, EVV claims, MCO billing, telehealth visits, and clinician workflow. FileFlo runs your 42 CFR Part 484 Conditions of Participation evidence binder, 42 CFR §484.55 comprehensive-assessment file, 42 CFR §484.80 aide competency documentation, 42 CFR §441.301 HCBS waiver attestations, and 45 CFR Part 164 HIPAA audit trail on every document. Agencies that run AlayaCare typically use FileFlo as the survey-readiness binder layer state surveyors and CMS contractors ask for during a CHAP, ACHC, or Joint Commission inspection.
How much does AlayaCare cost vs FileFlo?
AlayaCare does not publish list pricing. Every quote is custom, sales-driven, and built around modules, user counts, implementation services, and state EVV aggregator contracts. Customer reports and industry directories place AlayaCare in the enterprise tier with effective per-user costs typically in the $200 to $400 per user per month range once clinical, EVV, billing, and telehealth modules are stacked, plus a five- to six-figure implementation fee and multi-month onboarding. A mid-sized agency with 50 clinicians and 100 caregivers can easily hit five figures per month total contract value on AlayaCare. FileFlo is a flat $299 per month with unlimited users for the compliance document layer: no module add-ons, no implementation fee, no per-user inflation. The comparison is not apples-to-apples because AlayaCare is the operational platform of record while FileFlo is the compliance evidence binder. Verify AlayaCare pricing directly during a sales call; FileFlo pricing is locked at getfileflo.com/pricing.
Will FileFlo cover the 42 CFR §484.55 comprehensive assessment documentation?
Yes. This is one of the most cited Medicare Conditions of Participation during a CHAP, ACHC, or state surveyor visit. 42 CFR §484.55 requires the comprehensive assessment to be completed within five calendar days of the start of care, updated every sixty days, and updated within forty-eight hours of a beneficiary's return from a hospital admission of twenty-four hours or more. AlayaCare captures the OASIS-E data inside the clinical workflow. FileFlo holds the documentation evidence trail: signed assessment timestamps, RN signature attestations, OASIS-E lock dates, recertification update logs, and the chain-of-custody trail an OASIS auditor walks during a Medicare validation review. Agencies running both layer AlayaCare for the OASIS-E submission and FileFlo for the document-as-evidence audit binder mapped to §484.55.
Does FileFlo help with 42 CFR §484.80 home health aide competency tracking?
Yes, and this is where most home health agencies fail their CHAP or ACHC re-accreditation. 42 CFR §484.80 requires home health aides to complete a minimum seventy-five-hour training program from an approved source, pass a competency evaluation, complete twelve hours of in-service training every twelve months, and receive supervisory visits at intervals defined in the regulation. FileFlo tracks each aide's initial training certificate, the competency-evaluation packet, the twelve-hour in-service roster signed by the RN, supervisory-visit logs with citation to §484.80, and renewal calendar with automated alerts. AlayaCare schedules the aide's visits and captures EVV; FileFlo stores the §484.80 competency file a surveyor pulls from your binder during a Conditions of Participation review.
Can FileFlo generate an audit packet faster than AlayaCare for a CHAP, ACHC, or state survey?
FileFlo is purpose-built for survey readiness. One click pulls every document tied to a patient, clinician, aide, or regulation citation into a single PDF binder with an immutable 45 CFR Part 164 audit trail. AlayaCare can run individual reports across clinical, EVV, training, HR, and billing modules, but assembling a full 42 CFR Part 484 Conditions of Participation binder typically requires multiple report exports, cross-module reconciliation, and manual binder assembly across an implementation team. Survey-binder assembly is the workflow where FileFlo measurably outperforms a full-stack platform like AlayaCare, not because AlayaCare lacks data, but because document-as-evidence assembly is FileFlo's whole job and AlayaCare's job is running today's care.
Does FileFlo integrate with AlayaCare for clinical, EVV, and aide-training records?
Today, FileFlo does not write OASIS-E assessments, EVV claims, MCO invoices, or clinician schedules; those stay in AlayaCare. FileFlo accepts uploaded OASIS-E lock reports, EVV exception logs, aide training certificates, supervisor sign-offs, background checks, TB and competency packets, BAA executions, and HIPAA policy acknowledgments, then AI-classifies each document, attaches an immutable audit trail, and alerts on expiration, missing-signature, or out-of-cycle events. A native two-way AlayaCare integration is on the FileFlo roadmap and prioritized because AlayaCare-customer overlap with FileFlo is high in enterprise home health. Until that ships, the pattern is: export from AlayaCare, upload to FileFlo, AI classify, audit-ready binder under 42 CFR Part 484, §484.55, §484.80, §441.301, and 45 CFR Part 164.
Keep AlayaCare. Add the binder.
Build your first 42 CFR Part 484 evidence binder today, and keep AlayaCare for clinical, EVV, and billing. 5-day free trial, no credit card, no sales call, no multi-month implementation.
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