Netsmart (myAvatar) vs AZZLY Rize — 2026 Comparison

Overview: Enterprise Legacy vs Modern Focused Platform

Netsmart and AZZLY Rize both serve the behavioral health market, but they come from fundamentally different design philosophies. Netsmart has been building health IT infrastructure since 1968 and its flagship myAvatar platform powers thousands of community mental health centers, state agencies, and large multi-site behavioral health organizations. It is the market-share leader at the enterprise tier. AZZLY Rize, by contrast, was purpose-built in 2014 as an all-in-one cloud platform for addiction treatment and behavioral health providers that need to move fast without a dedicated IT department.

The difference matters because the EHR you pick will shape your clinical workflows, billing efficiency, compliance posture, and staff satisfaction for years. Netsmart myAvatar offers breadth and configurability that large organizations demand — state reporting interfaces, population health dashboards, and deep integration with health information exchanges. AZZLY Rize trades some of that configurability for a dramatically simpler implementation, tighter SUD-specific workflows, and a user experience that clinicians consistently rate higher.

This comparison walks through every category that matters so you can decide which trade-offs align with your organization's size, specialty mix, and growth plans.

Clinical Documentation

Netsmart myAvatar

myAvatar's clinical documentation engine is built around a highly configurable form designer. Organizations can construct virtually any assessment, progress note, or treatment plan template using drag-and-drop tools and custom data fields. For large community mental health centers running dozens of programs — outpatient, residential, crisis stabilization, assertive community treatment — this flexibility is essential. The platform also includes standardized instruments (PHQ-9, Columbia Suicide Severity Rating Scale, and many more) and supports clinical decision support rules that fire when certain values are entered.

The downside is complexity. Building and maintaining custom forms often requires a dedicated Netsmart administrator or even Netsmart professional services. Updates to forms can take weeks to deploy through a change-management process, and clinicians frequently report that the interface feels dense and requires many clicks to complete routine notes.

AZZLY Rize

AZZLY Rize takes a different approach: rather than giving you a blank canvas, it ships with pre-built templates designed specifically for substance use disorder and behavioral health workflows. Intake assessments, biopsychosocial evaluations, group therapy notes, individual session notes, and discharge summaries follow industry-standard structures out of the box. Clinicians can start documenting on day one without weeks of template configuration.

The templates are still customizable — administrators can add fields, modify section labels, and adjust required-field rules — but the starting point is already 80-90% of what most SUD and behavioral health facilities need. The result is a dramatically faster time to value and less ongoing maintenance burden. Clinicians routinely cite the clean, modern interface and reduced click count as key reasons they prefer it to legacy systems.

Bottom Line

If your organization runs highly specialized programs that demand bespoke forms with intricate business rules, Netsmart gives you the raw flexibility. If you primarily deliver SUD and behavioral health services and want templates that work well from the start, AZZLY Rize saves significant time and training cost.

ASAM Integration & SUD Compliance (42 CFR Part 2)

Substance use disorder treatment programs operate under 42 CFR Part 2, which imposes stricter privacy rules than standard HIPAA. Both platforms support Part 2 consent tracking, but the depth of integration differs meaningfully.

Netsmart myAvatar

Netsmart has built-in consent management modules and supports segmentation of SUD records from general behavioral health data within the same enterprise instance. For organizations that treat both SUD and general mental health populations, this segmentation is important. Netsmart also offers state-level reporting interfaces for TEDS (Treatment Episode Data Set) and other mandatory submissions. ASAM Criteria assessment is available, though in many installations it exists as a separate module or requires additional licensing and configuration to integrate into the clinical workflow.

AZZLY Rize

AZZLY Rize was designed from the ground up for SUD providers, so 42 CFR Part 2 consent management is woven into the core workflow rather than bolted on. The platform includes native ASAM Criteria-based assessment tools that map directly to level-of-care recommendations, helping clinicians match patients to the appropriate treatment intensity — from early intervention through medically managed intensive inpatient. Consent forms, disclosure tracking, and revocation workflows are built into the patient chart, and the system enforces Part 2 segmentation rules automatically.

For facilities that bill Medicaid managed care plans or participate in state SUD waiver programs, AZZLY Rize's pre-configured compliance workflows reduce the risk of audit findings related to improper disclosure of protected SUD records.

Bottom Line

Both platforms can meet 42 CFR Part 2 requirements, but AZZLY Rize delivers a more integrated, out-of-the-box experience specifically because its architecture was designed around SUD from inception. Netsmart can achieve equivalent compliance in large installations, though it often requires additional configuration and may depend on add-on modules.

Billing & Revenue Cycle Management

Netsmart myAvatar

Netsmart offers a full-featured revenue cycle management suite that handles eligibility verification, claim generation, electronic remittance processing, and denial management. The billing engine supports the complex multi-payer environments that large behavioral health organizations face — Medicaid, Medicare, commercial insurance, grant funding, and sliding-scale self-pay. For organizations that bill hundreds of thousands of claims per year, myAvatar's batch processing and clearinghouse integrations are well-proven.

However, users frequently note that billing configuration is complex. Setting up fee schedules, payer rules, and modifier logic typically requires deep Netsmart expertise, and troubleshooting claim rejections can be time-consuming without dedicated billing staff.

AZZLY Rize

AZZLY Rize includes integrated billing that covers claim scrubbing, electronic submission, ERA posting, and denial tracking within the same platform — no separate billing module to purchase or integrate. The system is pre-configured for common behavioral health and SUD billing scenarios, including group therapy billing (with proper attendee-level claim generation), bundled per-diem rates used in residential treatment, and authorization tracking for managed care plans.

Because clinical documentation and billing share the same database, charge capture is automatic: when a clinician completes a note, the corresponding CPT and revenue codes are generated without manual intervention. This tight integration reduces the lag between service delivery and claim submission, which has a direct impact on cash flow for smaller treatment centers.

Bottom Line

Netsmart is built for the scale and payer complexity of enterprise-level behavioral health organizations. AZZLY Rize offers a more streamlined billing experience that works well for SUD and behavioral health facilities with fewer payer contracts and a preference for simplicity. Organizations that lack a large billing department will generally find AZZLY Rize easier to manage day-to-day.

Implementation Complexity

Netsmart myAvatar

Enterprise Netsmart implementations are major projects. A typical myAvatar deployment for a mid-to-large community mental health center takes 9 to 18 months and involves form configuration, data migration, workflow mapping, interface builds (lab, pharmacy, HIE), and extensive training. Organizations usually need to assign internal project managers and clinical champions to work alongside Netsmart's professional services team. The implementation cost alone can run into six figures or higher, separate from the ongoing license fees.

This investment is justified when the organization is large enough to recoup it through operational efficiency at scale, but for smaller providers it can be a significant barrier.

AZZLY Rize

AZZLY Rize's cloud-native architecture and pre-built templates translate to dramatically shorter implementation timelines. Most facilities are live within 4 to 8 weeks, including data migration, staff training, and go-live support. There is no on-premise infrastructure to provision — the system runs on Microsoft Azure — and the pre-configured workflows mean less time spent in design sessions deciding how a progress note should look.

For organizations opening a new treatment facility or transitioning from paper-based records, the speed advantage is substantial. Faster go-live means faster revenue capture, which matters enormously in the cash-sensitive addiction treatment market.

Bottom Line

If your organization has the project management capacity and budget for a 12-plus-month implementation, Netsmart can deliver a deeply customized system. If you need to be operational quickly — and most SUD providers do — AZZLY Rize's 4-to-8-week timeline is a significant competitive advantage.

Reporting & Analytics

Netsmart myAvatar

Netsmart's reporting ecosystem is extensive. myAvatar includes a built-in report writer, Crystal Reports integration, and optional advanced analytics modules (Netsmart Insights) that provide population health dashboards, outcome tracking, and predictive analytics. For organizations that participate in value-based care arrangements or need to submit data to state mental health authorities, this depth is valuable.

The trade-off is that building custom reports often requires SQL knowledge or Netsmart professional services, and the learning curve for report development is steep. Many organizations end up relying on a small number of power users for all reporting needs.

AZZLY Rize

AZZLY Rize provides a library of pre-built reports covering census, utilization, financial performance, clinical outcomes, and compliance metrics. The reports are accessible through the web interface without needing to write queries. The platform also supports ASAM-aligned outcome reporting and tracks key treatment metrics like average length of stay, readmission rates, and completion rates by level of care.

For organizations that need more advanced analytics, AZZLY Rize supports data exports and integrations with external business intelligence tools. While it does not match Netsmart's depth in population health analytics, it covers the reporting needs of most SUD and behavioral health providers without requiring a dedicated analyst on staff.

Bottom Line

Netsmart wins on raw reporting power and is the better choice for organizations with dedicated data teams and complex state reporting obligations. AZZLY Rize delivers practical, ready-to-use reports that serve the day-to-day operational and compliance needs of most treatment providers.

User Experience & Learning Curve

Netsmart myAvatar

myAvatar has been evolving since the early 2000s, and its interface reflects that history. While Netsmart has invested in modernizing the UI (particularly with its CareManager and newer web-based modules), the core myAvatar experience still relies on dense screens with many tabs, fields, and navigation layers. Training new staff typically takes several weeks, and ongoing support requests are common, particularly among clinicians who interact with the system only occasionally.

User satisfaction ratings on third-party review sites like KLAS and G2 tend to cluster in the mid-3-star range, with common complaints about navigation complexity and the number of clicks required to complete common tasks.

AZZLY Rize

AZZLY Rize was built with a modern web interface from day one. The navigation is organized around the patient journey — intake, assessment, treatment planning, progress notes, billing, discharge — rather than around system modules. Clinicians report that the interface is intuitive and that most staff can become proficient within a few days of training rather than weeks.

The platform's 4.5-star average rating on review sites reflects this usability advantage. In an industry where clinician burnout is a serious concern, the reduced documentation burden and cleaner interface can meaningfully improve staff retention and satisfaction.

Bottom Line

AZZLY Rize has a clear edge in user experience and learning curve. This translates to lower training costs, faster staff onboarding, and higher clinician satisfaction — factors that are increasingly important as behavioral health organizations compete for talent.

Pricing & Total Cost of Ownership

Neither vendor publishes list pricing, so both require a quote based on organization size, user count, and selected modules. That said, the total cost of ownership differs significantly between the two.

Netsmart myAvatar

Netsmart pricing is enterprise-grade. Expect annual licensing fees that scale with user count and module selection, plus substantial upfront implementation costs. Organizations that choose on-premise deployment also bear the cost of server infrastructure, maintenance, and IT staff. Add-on modules — CareManager, Insights analytics, patient engagement portal — each carry incremental licensing fees. For a 200-user community mental health center, the first-year total cost of ownership (including implementation) can easily exceed $500,000, with annual recurring costs in the mid-six figures.

AZZLY Rize

AZZLY Rize uses a subscription model with pricing based on facility size and service volume. Because the platform is cloud-only and includes billing, clinical documentation, and reporting in a single package, there are fewer add-on surprises. Implementation fees are also significantly lower due to the shorter timeline and reduced configuration requirements. For a mid-size SUD treatment center (50-100 beds), the total first-year cost is typically a fraction of what an equivalent Netsmart deployment would cost.

Bottom Line

AZZLY Rize generally offers a lower total cost of ownership, particularly for small-to-mid-size organizations. Netsmart's enterprise pricing can be justified for large organizations that fully utilize its advanced features, but smaller providers may find the cost disproportionate to the value they extract.

Who Should Choose Netsmart (myAvatar)

• Large community mental health centers serving thousands of patients across multiple programs (outpatient, residential, crisis, ACT teams) that need a single platform to manage diverse service lines.
• State-contracted organizations that must interface with state health information exchanges, TEDS reporting systems, or Medicaid Management Information Systems with pre-built connectors.
• Multi-entity health systems with both behavioral health and physical health service lines that need enterprise-level interoperability and population health analytics.
• Organizations with dedicated IT departments that can manage on-premise infrastructure, custom report development, and ongoing system configuration.
• Agencies prioritizing population health and value-based care analytics that benefit from Netsmart's Insights platform and CareManager module.

Who Should Choose AZZLY Rize

• Substance use disorder treatment centers — residential, intensive outpatient, partial hospitalization, and outpatient programs — that need an EHR purpose-built for addiction treatment workflows.
• Behavioral health practices that want an all-in-one platform (EHR + billing + reporting) without managing multiple vendor relationships or module add-ons.
• Organizations opening new facilities that need to go live in weeks rather than months and cannot afford a prolonged implementation timeline.
• Providers transitioning from paper or spreadsheets who want a low-friction onboarding experience with pre-built templates and minimal configuration.
• Small-to-mid-size treatment centers that lack dedicated IT staff and prefer a fully managed cloud platform with automatic updates and no server maintenance.
• Programs focused on ASAM Criteria compliance that need native level-of-care assessment and matching built into the clinical workflow.

Frequently Asked Questions

Can Netsmart myAvatar handle SUD-specific workflows as well as AZZLY Rize?

Netsmart can be configured to support SUD workflows, and many addiction treatment programs do use it. However, the configuration typically requires custom form builds, module licensing, and professional services, whereas AZZLY Rize ships with these workflows ready to use. For organizations where SUD is the primary specialty, AZZLY Rize generally offers a more efficient path to compliance and clinical documentation.

Is AZZLY Rize scalable enough for a multi-site organization?

Yes. AZZLY Rize supports multi-site configurations with centralized reporting and role-based access across locations. While it is not designed for the 5,000-plus-user scale of Netsmart's largest deployments, it comfortably serves treatment organizations with multiple facilities, and its cloud architecture scales without on-premise infrastructure constraints.

How do the two platforms compare on telehealth?

Both platforms offer integrated telehealth functionality. Netsmart provides telehealth through its myHealthPointe module and third-party integrations. AZZLY Rize includes built-in telehealth within the platform at no additional module cost, with session documentation tied directly to the patient chart. For organizations where telehealth is a growing service line, AZZLY Rize's integrated approach avoids the need to manage a separate telehealth vendor.

Which EHR has better interoperability and data exchange capabilities?

Netsmart has a clear advantage in interoperability for large-scale health information exchange. It offers HL7, FHIR, and CCD-based integrations with state HIEs, labs, pharmacies, and acute care hospitals. Its CommonWell and Carequality participation enables nationwide provider-to-provider data exchange. AZZLY Rize supports standard data exchange and integrates with labs, pharmacies, and clearinghouses, but does not offer the same breadth of HIE connectivity that Netsmart provides at the enterprise tier.

What are the contract and switching considerations?

Netsmart enterprise contracts typically run 3 to 5 years with annual escalation clauses, and switching costs are high due to the depth of customization and data migration complexity. AZZLY Rize generally offers more flexible contract terms, and the cloud-native architecture simplifies data export if you need to transition in the future. Regardless of which platform you choose, be sure to negotiate data portability terms and understand the process for extracting your data at the end of the contract.

Verdict

Netsmart myAvatar and AZZLY Rize serve overlapping but distinct segments of the behavioral health market. Netsmart remains the strongest choice for large, complex organizations — community mental health centers with thousands of clients, multi-entity systems that need enterprise interoperability, and state-contracted agencies with mandated reporting requirements. Its breadth of features, deep interoperability, and population health analytics are unmatched at scale.

For substance use disorder treatment centers, behavioral health practices, and mid-size organizations that prioritize speed, usability, and SUD-specific compliance, AZZLY Rize is the stronger fit. Its modern cloud architecture, pre-built clinical templates, native ASAM integration, and significantly faster implementation timeline mean that providers can start delivering — and billing for — services in weeks rather than months. The lower total cost of ownership and higher user satisfaction ratings make it a compelling choice for organizations that do not need the full weight of an enterprise platform.

Ultimately, the right decision depends on your organization's scale, specialty mix, IT capacity, and timeline. If you are a multi-program enterprise with dedicated IT resources and complex state reporting needs, Netsmart will serve you well. If you are a SUD or behavioral health provider that values simplicity, speed, and clinician satisfaction, AZZLY Rize delivers more value per dollar for your specific use case.