Most IDD agencies do not evaluate software very often. When the moment arrives, whether because the current system is failing, the agency is growing, or compliance requirements have changed, the team is often doing it for the first time without a clear framework for comparison.
Software vendors are good at demos. They know which features to show, how to handle objections, and how to make every platform look capable in a 45-minute presentation. The only way to cut through a polished demo is to come in with specific, pointed questions that reveal how the software actually functions in your environment, not how it looks on a prepared slide.
Here are 15 questions your team should bring to every IDD software demo.
Billing and Claims
- How does your system handle Medicaid billing for home and community-based services under multiple waiver programs?
IDD billing is not generic Medicaid billing. Your agency may bill under multiple waiver types with different service codes, authorization structures, and documentation requirements. A platform built for the IDD space should handle this without requiring workarounds. Ask the vendor to show you how authorization limits are tracked and how the system responds when a client is approaching or has exceeded authorized units.
- What happens when a claim is rejected? Walk me through the denial management workflow.
Every billing system produces some denials. What separates good platforms from mediocre ones is how efficiently they help you identify, correct, and resubmit those claims. Ask to see the actual denial queue, how errors are surfaced, and what information is available to help your billing coordinator resolve the issue without leaving the platform.
- Does the system support Billing as a Service, and what does that look like operationally?
Some agencies want software. Others want the billing function handled for them. Vertex Billing as a Service is an option for agencies that want the Vertex team to manage claim submission, follow-up, and reporting directly. Understanding whether a vendor offers managed billing alongside software gives you flexibility as your agency’s needs evolve.
EVV and Compliance
- How does EVV data flow from the point of service into claims?
This is where many platforms fall short. EVV capture and billing submission are often separate systems that require manual reconciliation. Ask the vendor to demonstrate the path from a caregiver completing a visit verification to that data appearing in a billable claim. The fewer manual steps in between, the lower your risk of EVV-related denials.
- How does your system handle EVV for services delivered in community settings, not at a fixed address?
This is one of the most common EVV pain points for IDD providers. If your clients receive services in the community, at job sites, family homes, or community access activities, a GPS-based system that expects a static home address will generate constant exception flags. Ask specifically how the platform handles community-based EVV and what the exception resolution process looks like.
- How do you stay current with state-specific billing and EVV requirements as they change?
IDD billing requirements vary by state and change frequently. A vendor that built its platform around a handful of states may not have reliable support for your state’s specific Medicaid rules. Ask which states the vendor actively supports and how updates to state billing logic are deployed. Vertex state-by-state billing support covers a growing number of states with dedicated compliance investment.
Case Management and Documentation
- Can you show me how a case manager documents a service session, adds a progress note, and generates a periodic summary?
This is a core daily workflow. If it is cumbersome in the demo, it will be cumbersome in practice. Watch for how many screens it takes, whether information pre-populates from existing records, and how the system organizes documentation for easy retrieval.
- How does the system manage individualized goal tracking across a caseload of, say, 30 clients?
Goal documentation is both a clinical requirement and an audit requirement. Ask the vendor to show you a caseload view that surfaces which clients have upcoming documentation deadlines, which goals have not been updated recently, and how the system alerts case managers before compliance deadlines pass.
- Does the platform include digital forms, and can we build forms that match what we currently use?
Paper forms that have to be transcribed into a digital system are a major source of inefficiency. Vertex Forms allows agencies to digitize their existing forms and connect them directly to the database. Ask any vendor how their forms solution works and whether you can bring your existing forms or have to use templates.
Implementation and Support
- What does implementation actually look like, and how long does it take for an agency our size?
Every vendor will tell you implementation is smooth. Push for specifics. How many hours of your staff’s time will be required? Who manages data migration? What is the timeline from contract signing to go-live? What has caused delays for other clients of similar size?
- What happens to our existing billing data when we migrate?
Historical billing data, client records, and authorization history represent years of your agency’s institutional knowledge. Ask how the vendor handles data migration, whether historical records are preserved in a usable format, and who is responsible if data is lost or corrupted during transition.
- What does ongoing support look like after go-live?
A strong implementation does not compensate for weak ongoing support. Ask about support channels, response time commitments, how software updates are communicated and deployed, and whether there is a dedicated account contact or a general support queue.
Pricing and Scalability
- How is pricing structured, and what triggers a price increase as we grow?
Module-based pricing can create surprises when you add functionality or grow your client base. Understand whether pricing is per-user, per-client, per-module, or a flat rate, and what the cost implications are if your agency adds 50 clients or two new programs over the next two years.
- Can modules be added independently, or do we have to buy the full platform?
Not every agency needs every module on day one. Vertex modules can be used independently or as a fully integrated system, which allows agencies to start where they have the most immediate need and expand over time. Ask any vendor whether partial adoption is supported or whether the platform requires a full deployment.
Fit and References
- Can you connect us with two or three current clients that are similar to our agency in size and service type?
This is the most important question on the list. A vendor confident in their product will connect you with real clients who can speak candidly about implementation, daily use, and support. If a vendor hedges on this, that hesitation is itself information. Agencies that have been using Vertex Systems for years are the best evidence of what the platform delivers in practice.
When you are ready to see these questions in action, schedule a Vertex demo and bring this list with you.
