Home Care Software Payments: WellSky, AxisCare, AlayaCare

On this page 7 sections

1. Built-In vs. Integrated vs. Standalone Home Care Software Payment Integration
2. How AxisCare, WellSky, and AlayaCare Handle Client Payments
3. Hidden Costs of Software-Bundled Processing Rates
4. Posting Home Care Billing Software Integrated Payments to Client Ledgers
5. Switching Processors Without Re-Collecting Every Client's Card
6. Questions to Ask Your Software Vendor Before Signing
7. Next Steps for Your Agency

Key takeaways

• Built-in processing is convenient, but its rates and card-data terms are often set by the software vendor's partner and are harder to negotiate.
• Ask for every cost in writing, including rate, per-transaction, ACH, chargeback and monthly fees and any termination terms.
• Automatic posting to client ledgers matters as much as the rate, especially with partial payments and multiple family payers.
• Before you sign, confirm in writing that stored cards and ACH details can be migrated securely if you leave.

Most private-pay home care agencies bill families weekly or every two weeks for visit hours, then collect by card or ACH. The software that schedules caregivers and builds invoices usually offers a way to take those payments too. This guide explains home care software payment integration: the three ways payments connect to platforms like AxisCare, WellSky and AlayaCare, where bundled processing costs hide, how payments should post to client ledgers, and how to keep stored cards if you ever switch processors.

Home care payments differ from typical recurring billing. Invoice amounts change with the hours worked. The payer is often an adult child, not the client. A single month can run into thousands of dollars per client. Those details affect which setup fits your agency.

Built-In vs. Integrated vs. Standalone Home Care Software Payment Integration

Every payment setup falls into one of three models. Knowing which one a vendor is offering tells you most of what you need to know about cost and flexibility.

Built-In (Software-Bundled) Processing

The software vendor offers payments as a feature, usually through a processing partner it has chosen. You apply through the vendor, and payments appear inside the billing module. Setup is simple. The trade-off is that the vendor and its partner set the pricing, and stored card data usually sits in that partner's vault.

Integrated Third-Party Processing

The software connects to an outside gateway or processor that you choose. If the platform supports standard gateways, you can bring your own merchant account and still have payments post automatically. This model keeps most of the convenience and gives you more room to compare pricing.

Standalone Processing

Payments run through a separate system, such as a virtual terminal for keyed and recurring charges, and someone on your staff records them in the care software by hand. This works for agencies with few private-pay clients. It becomes a reconciliation burden as you grow.

How AxisCare, WellSky, and AlayaCare Handle Client Payments

AxisCare, WellSky and AlayaCare are all widely used home care management platforms with billing functions. Payment features, processing partners, supported gateways and pricing change over time and can vary by plan and contract. Treat the points below as a checklist to work through in a demo, and get written answers before you rely on any of them.

AxisCare Payment Processing

If you run AxisCare or are evaluating it, focus on how payments connect to the invoices the system generates from scheduled and verified visits. Confirm:

• Whether card and ACH payments are offered inside the platform and which company actually processes them
• Whether families can pay or enroll in autopay through a portal, and whether they can update their own payment method
• Whether you can connect your own gateway instead of the built-in option
• How refunds and credits for missed or shortened visits flow back to the invoice

WellSky Personal Care Payments

WellSky offers products for several kinds of care providers, so for WellSky personal care payments it is worth checking whether payment terms are tied to your broader software agreement. Confirm:

• Whether payment processing is a separate agreement from your software license, and who the merchant of record is
• Whether processing pricing is fixed for the contract term or can change with notice
• Whether ending the payment service affects your software contract, or the reverse
• How payments from multiple payers on one client account are applied

AlayaCare Credit Card Processing

For AlayaCare credit card processing, ask the same core questions about who processes and on what terms. Also confirm the details that matter if your configuration covers several service lines or locations:

• Which payment provider applies to your U.S. accounts and what currency settles to your bank
• Whether each location or entity can have its own merchant account and deposit account
• Whether private-pay collections can be separated cleanly from other payer types in reporting
• What export or migration options exist for stored payment methods

Hidden Costs of Software-Bundled Processing Rates

Bundled processing often comes with a single advertised rate. That number rarely tells the whole story. Ask for a full fee schedule covering:

• Card rate and pricing model: flat, tiered or interchange-plus, and whether it differs by card type
• Per-transaction fees on top of the percentage
• ACH fees, including returned-payment fees
• Chargeback and retrieval fees
• Monthly or per-location fees for the payment feature itself
• Revenue sharing: whether the software vendor earns a portion of your processing. This is common and not improper, but it can affect how much room there is to lower your rate.
• Contract terms: length, auto-renewal and early termination fees

Small rate differences add up fast on large home care invoices.

Illustrative example: An agency bills 40 private-pay clients about $4,000 a month each by card. A difference of half a percentage point in effective rate is about $20 per client per month, or roughly $800 a month across the caseload. Your numbers will differ; run them with your own statements.

For a deeper look at the math, see our breakdown of home care credit card fees on large monthly invoices. If you want to steer families toward lower-cost methods, programs such as dual pricing or surcharging (where permitted) may apply. Rules vary by state and card brand, so confirm current requirements with your processor and a qualified professional before changing how you price.

Posting Home Care Billing Software Integrated Payments to Client Ledgers

The real value of home care billing software integrated payments is that each payment lands on the right invoice without anyone rekeying it. Test these scenarios in a demo with sample data:

1. Partial payments. A family pays part of an invoice. Does the balance stay open and age correctly?
2. Multiple payers. Two siblings split a parent's care. Can each have their own payment method and share of the invoice? Our guide to setting up family members as payers covers the authorization side.
3. Deposits and prepayments. Can you hold a deposit as a credit and apply it to later invoices?
4. Refunds and adjustments. When a visit is shortened, does the refund post to the same invoice and payment?
5. Chargebacks. Does a dispute reverse the payment on the ledger, or does someone have to catch it on a bank statement?
6. Net vs. gross funding. Are fees deducted from each deposit or billed monthly? Daily net deposits make bank reconciliation harder.
7. Accounting sync. If you use QuickBooks for accounting, confirm payments and fees sync cleanly.

Detailed invoices that tie charges to verified visit records also help when families question hours. See how to handle home care chargebacks over disputed caregiver hours.

Keep clinical notes out of payment descriptions, memo fields and receipts. What belongs where is a compliance question, so confirm your obligations with a qualified professional.

Switching Processors Without Re-Collecting Every Client's Card

The biggest switching cost is often not a termination fee. It is the stored payment methods. Cards saved through a built-in processor are usually stored as tokens that only work with that provider's systems. If you leave and the data can't move, you have to ask every family to re-enter a card.

Plan the migration before you need it:

1. Read the data portability clause. Look for language about transferring stored card data to a new provider on request.
2. Request a secure transfer. Card data should move directly between PCI DSS-compliant providers. Never move it by spreadsheet, email or a staff member's notes.
3. Confirm ACH authorizations. Bank details may be easier to move, but authorizations reference the company collecting. Ask your new processor whether re-authorization is needed.
4. Run both systems briefly. Keep the old account open until the last scheduled charges and any refunds clear.
5. Have a fallback for stragglers. For families whose data can't move, use a secure hosted payment page or call them and key the card into a payment gateway with stored-card tokenization. Get fresh written authorization for recurring charges.

Once you've switched, keeping cards current matters too. A card account updater for expiring cards can reduce declined autopays, depending on your processor.

Questions to Ask Your Software Vendor Before Signing

Bring this list to every demo and get the answers in writing:

Underwriting also matters. Processors may view home care as moderate risk because of large tickets and prepaid services. Our explainer on why processors hesitate with home care agency merchant accounts explains what they look for.

Next Steps for Your Agency

Start by pulling your last few processing statements and your software contract. Calculate your effective rate, list every fee, and check the data portability language. Then decide whether convenience or control matters more for your caseload. Built-in processing can make sense when you're small. Integrated or standalone processing often wins as private-pay volume grows.

MannyPay provides merchant accounts, gateways such as Authorize.net and NMI, and virtual terminals for home healthcare and medical staffing businesses. If you're weighing a switch, request a free processing quote and include your current statement and the name of your care software. A MannyPay specialist will respond within one business day. Confirm compatibility with your software vendor before you change anything.

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About the author

MannyPay Editorial Team

Beyond the Swipe's editorial desk researches the publication's guides and news and cites its sources in every article. Articles reviewed by a named MannyPay editor carry that editor's byline.

This article is for general educational purposes and is not legal, tax or financial advice. Card network rules and state laws change; confirm current requirements for your business.