In LA County SAPC, you can be a Primary Sage User, where Sage is your EHR, or a Secondary User, where you run your own. The choice is really about where you spend staff time. Here is the honest cost comparison for a DMC-ODS facility.
Every LA County SAPC provider makes one structural choice that shapes daily life for years: Primary or Secondary Sage User. On paper it is a technical distinction; in practice it is a decision about where your staff spend their hours. Here is the honest cost comparison. For the market context, see the LA County SAPC Sage guide.
As a Primary User, Sage is your EHR. Your staff document and enter services directly into Sage, on the ProviderConnect NX platform. As a Secondary User, you keep your own EHR — with your own documentation, workflows, and records — and submit claims to Sage as 837P or 837I files. Same SAPC contract, same Drug Medi-Cal money; very different day.
The appeal of Primary is that you avoid buying and running your own EHR. The cost is daily. Sage is built to administer the county's benefit, not to run your facility, so staff work inside a system whose workflows, forms, and speed were designed around county administration rather than your program. And if your clinicians keep any clinical documentation outside Sage — a common reality for group notes, scheduling, or a commercial census — you are paying the double-documentation tax on top of it. The Primary bill arrives in small increments, every day, in clicks and workarounds.
Secondary flips the cost curve. You need your own operating EMR, and you have to complete the annual conversion — the January 31 request, the 837 testing, the push to the 80% adjudication bar. That is a real, front-loaded project. But once you are a certified Secondary User, your staff work in one operating record built for your workflow, and the county submission is a file your billing team generates rather than a second data-entry job. You pay upfront and save daily.
For a small program with simple, all-Medi-Cal operations and no appetite for an EHR project, Primary can be the pragmatic choice. For a facility that already runs — or wants — a real operating record for clinical work, groups, scheduling, and a commercial or cash census, Secondary almost always wins on total staff time, because it removes the duplicate entry that Primary quietly imposes. The question is not which is cheaper to start; it is which is cheaper to live in.
Navix is designed for the Secondary User model: one operating record where your team documents once, with the 837 file built from that same record, and CollaborateMD, our RCM partner, processing the claims to Sage. If double documentation is your daily tax, that is the model that removes it. Read the real cost of double documentation, or schedule a demo to see the Secondary workflow on a real chart.
