FileFlo vs. AlayaCare:
AlayaCare Runs Clinical Care.
FileFlo Runs Survey Evidence.
AlayaCare runs your OASIS-E, EVV, MCO billing, telehealth, and clinician workflow as a full-stack enterprise home care and home health platform. FileFlo runs the 42 CFR Part 484, §484.55, §484.80, and HIPAA evidence binder. Here is an honest side-by-side.
I hear this question almost every week from home health administrators and home care directors: "We use AlayaCare. Why would we also need FileFlo?" AlayaCare is one of the most-adopted enterprise home care and home health platforms in North America — clinical documentation, OASIS-E, care plans, EVV, telehealth, and revenue-cycle management all live in one stack. FileFlo is a compliance document evidence platform — both are required to survive a CHAP, ACHC, Joint Commission, or state CMS survey under 42 CFR Part 484, the Medicare Conditions of Participation for home health agencies, and the HIPAA Security Rule under 45 CFR Part 164 — but they cover different evidence categories. AlayaCare holds the OASIS-E submission, the EVV ping, the clinician note, and the payor claim. FileFlo holds the operational, training, competency, policy, and survey-binder evidence trail required by §484.55, §484.80, and 42 CFR §441.301.
This page is not a takedown. AlayaCare is the platform of record for hundreds of mid-market and enterprise Medicare-certified home health and home care agencies in the US and Canada, and it does clinical workflow, EVV, and RCM at a depth FileFlo does not attempt. If you are evaluating FileFlo and AlayaCare head to head, you almost certainly need both. The comparison below is honest about where each system wins, where they overlap, and where FileFlo is the only one of the two that does the job.
Quick Verdict
- CHAP, ACHC, Joint Commission, and state CMS survey binders
- 42 CFR §484.80 aide §75-hour + competency + in-service evidence
- 42 CFR §441.301 HCBS waiver + person-centered plan packet
- Cross-platform document storage (you keep AlayaCare clinical)
- 45 CFR Part 164 HIPAA audit trail on every document access
- Flat $299/mo unlimited users — no enterprise per-user inflation
- OASIS-E clinical documentation + iQIES submission
- EVV under the 21st Century Cures Act (§441.301)
- Medicare PPS + MCO billing & revenue-cycle management
- Native clinician mobile point-of-care app (offline mode)
- Telehealth + virtual care visit workflow
- Day-of clinical operations for enterprise home health
The honest answer for most enterprise home health agencies: keep AlayaCare for clinical, EVV, and RCM — add FileFlo for survey-binder evidence.
Feature-by-Feature Comparison
Based on publicly available AlayaCare materials, customer reports, and FileFlo product as of May 2026.
| Feature | FileFlo$299/mo · unlimited users | AlayaCareCustom quote · ~$200-400/user/mo enterprise |
|---|---|---|
| 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.
Where Each Tool Sits Inside Part 484, §441.301, and Part 164
The Medicare Conditions of Participation, the HCBS waiver rule, and the HIPAA Security Rule map cleanly onto the right system. Here is who handles what.
42 CFR Part 484 — Home Health Agency Conditions of Participation
Part 484 is the regulation a CHAP, ACHC, Joint Commission, or state surveyor walks during a re-accreditation or validation visit. AlayaCare stores the clinical data — OASIS-E, visit notes, care plans — that supports the CoPs. FileFlo wins for survey-binder assembly: policies, governing-body minutes, QAPI evidence, emergency preparedness plans, infection-control documentation, contracted-service files, and the citation-mapped binder a surveyor pulls together evidence per CoP citation. AlayaCare is the chart; FileFlo is the binder of evidence around the chart.
42 CFR §484.55 — Comprehensive assessment of patients
§484.55 requires the comprehensive assessment to be completed within five calendar days of start of care, updated every sixty days, and updated within forty-eight hours of return from a twenty-four-hour-plus hospital admission. AlayaCare captures the OASIS-E clinical data inside the workflow. FileFlo holds the 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. Both are required during a CHAP or ACHC visit — together they make the §484.55 evidence file defensible.
42 CFR §484.80 — Home health aide services
§484.80 is one of the most cited Conditions of Participation during re-accreditation. It requires aides to complete a minimum seventy-five-hour training program from an approved source, pass a competency evaluation, complete twelve hours of in-service every twelve months, and receive supervisory visits at intervals set in the regulation. FileFlo wins here cleanly — initial training certificates, competency packets, in-service rosters signed by the RN, supervisory-visit logs with §484.80 citation, and renewal calendars with automated alerts live in FileFlo as discrete documents with audit trail. AlayaCare schedules aide visits; FileFlo holds the §484.80 binder a surveyor pulls during a CoP review.
42 CFR §441.301 — HCBS waivers + 21st Century Cures EVV
AlayaCare wins here cleanly for Medicaid HCBS agencies — EVV is what AlayaCare does at scale, with state-aggregator integrations across multiple US states. The §441.301 person-centered service plan, the visit verification, the six EVV data points (who, what, where, when start, when end, recipient), and the state aggregator transmission live inside AlayaCare. FileFlo accepts the resulting exception reports, person-centered plan attachments, and missed-visit logs into the evidence binder, but does not generate EVV claims.
45 CFR Part 164 — HIPAA Security Rule
Both tools meet 45 CFR Part 164 obligations for PHI handling. The difference is scope: AlayaCare's audit trail covers OASIS-E, EVV pings, visit notes, and payor claim events at the chart level; FileFlo's audit trail covers every document access, download, edit, and binder export — including the non-PHI compliance documents (training records, governance policies, BAAs, background checks, state licensure renewals) that auditors still want evidence of during a state survey or HIPAA risk review under Part 164.
45 CFR §164.308 — HIPAA administrative safeguards
Workforce training documentation, sanctions policies, contingency plans, and business associate agreements live on opposite sides of the same regulation. AlayaCare tracks user-level access controls and the role-based permission model. FileFlo tracks 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 auditor asks for during a HIPAA investigation.
Real Pricing Comparison
FileFlo is one flat price. AlayaCare is custom-quoted enterprise pricing — sales-driven, module-stacked, per-user, plus a five- to six-figure implementation cost. The math depends on clinician count, module mix, state EVV contracts, and implementation scope.
* Pricing range based on public industry directories and customer reports. Contact AlayaCare for exact enterprise quote.
The pricing comparison is not apples-to-apples. AlayaCare is a full clinical, EVV, billing, and telehealth platform of record; FileFlo is the compliance evidence layer. The right comparison is “AlayaCare + FileFlo” vs “AlayaCare + spreadsheets + shared drives + paper binders”.
When to Pick Each
Add FileFlo if you...
- Already run AlayaCare for clinical + EVV but your CoP binder lives in shared drives
- Need 42 CFR §484.80 aide §75-hour + competency + in-service evidence
- Have a CHAP, ACHC, Joint Commission, or state validation visit coming
- Run Medicare-certified home health plus HCBS waiver work in one shop
- Want unlimited user seats without enterprise per-user inflation
- Have multiple branches and need unified compliance evidence
- Want AI to auto-classify uploaded documents — no manual filing
Keep / start AlayaCare if you...
- Need OASIS-E clinical documentation + iQIES submission
- Need EVV under the 21st Century Cures Act mandate
- Need Medicare PPS + MCO billing + revenue-cycle management
- Need a clinician mobile point-of-care app with offline mode
- Need integrated telehealth + virtual visit workflow
- Are running enterprise mid-market home health at scale
"We Added FileFlo on Top of AlayaCare Because..."
Real workflows enterprise home health administrators describe after layering FileFlo onto an existing AlayaCare install.
"AlayaCare runs our OASIS-E, our EVV, and our Medicare billing across two states. Our CHAP survey binder lived in a shared drive. The surveyor asked for §484.80 aide competency files across 80 aides and I had to dig through years of folders — that is why we added FileFlo as the survey-binder layer."
"We got a CHAP citation for §484.55 comprehensive-assessment timing — the data was in AlayaCare but the signature attestation evidence and OASIS-E lock-date proof was scattered. FileFlo gave us the citation-mapped CAP workflow with evidence uploads tied to the citation. AlayaCare is the chart, FileFlo is the evidence file."
"We run Medicare-certified home health and HCBS personal care side by side through AlayaCare. Our compliance evidence was scattered across clinical, HR, training, and billing exports. FileFlo gives us one binder per patient, aide, or clinician regardless of which payor or service category they are in."
Frequently Asked Questions
Does FileFlo replace AlayaCare?
No. AlayaCare is an enterprise full-stack home care and home health platform — 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 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.
Authored by Chad Griffith, Founder of FileFlo. Last reviewed 2026-05-29. References: 42 CFR Part 484, 42 CFR §484.55, 42 CFR §484.80, 42 CFR §441.301, 45 CFR Part 164.
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