Community Access Unlimited | Challenges
Approaching a decade of partnership with Qualifacts and the CareLogic EHR, Community Access Unlimited (CAU) has overseen growth and change while managing increasingly complex documentation, billing, and compliance requirements for the members it serves through its programs in the residential properties it owns and manages.
CAU chose Qualifacts and CareLogic for the flexibility the solution offers and for the company’s commitment to supporting compliance requirements. In the years since its 2015 GoLive, CAU has grown significantly, increasing the number of people and families served and the range of programs offered.
Statewide changes to billing and reporting were one of the initial drivers for CAU to choose Qualifacts and CareLogic. Changes continue to be frequent and extensive in New Jersey.
“We came off paper with Qualifacts, and we have been successfully managing the updating of our workflows and our billing to match ongoing state changes and our growth and expansion since then.”
“We chose Qualifacts knowing that New Jersey was going electronic, and our partnership has kept us ahead of the curve in keeping up with the state,” said Vanessa Yalakidis, CAU Assistant Executive Director of EHR Services. “We came off paper with Qualifacts, and we have been successfully managing the updating of our workflows and our billing to match ongoing state changes and our growth and expansion since then.”
CAU’s programs are staffed 24/7 with professionals who support the people living in 60+ residential settings, each serving four to six residents in a home, or in apartments in proximity. The work is demanding but meaningful, and staff retention is critical to organizational success and to the safety, comfort, and well-being of the people who live there. “We adapted CareLogic to meet our needs to maximize staff satisfaction and minimize staff burnout,” Yalakidis said.
Part of that 24/7 care includes medication administration. CAU uses CareLogic’s configurable MedPass and individual scheduling capabilities tied into the Electronic Medication Administration Record (eMAR). MedPass windows display upcoming medications, alert to late or missed doses, and are used to document medication status. “eMAR information is reportable as data, and our documentation exists as a digital record now,” Yalakidis said.
CAU’s growth and expansion includes adding buildings, apartments, and more staff to care for more members. “We add new homes on a regular basis, and CareLogic enables us to manage the additional programs in the system ourselves,” Yalakidis said. “The self-service aspect that Qualifacts provides means we can add what we need when we need it, and configure it so that it works for our teams.” Expansion also includes behavioral health services. “We have added services and staff, and built our workflows and documentation, managing it all ourselves,” Yalakidis said.
“Our denial rates are impressively below industry standards, because the claims we send out are supported by the accurate and compliant documentation we have built in CareLogic.”
Billing accuracy supported by completed, compliant, and timely documentation through CareLogic has led to faster reimbursement and lower denials for CAU. “What supports an agency this size is the billing, which is driven by the forms and workflows. We have created standardized pathways for staff, for tasks throughout the day. They know what they need to do when they clock in, and what they need to have accomplished when they clock out,” Yalakidis said. “Our denial rates are impressively below industry standards, because the claims we send out are supported by the accurate and compliant documentation we have built in CareLogic.”
CAU’s 24/7 care includes tracking referral results and next steps for services delivered to its members beyond its sites. “We track the information and the volume through forms we built that are reportable as data for whole person care, care coordination, so we can visualize how our clients fare. There is tremendous value in tracking referrals, contacts and outcomes, when we refer people out to the community,” Yalakidis said.
The availability of data for metrics and analytics through CareLogic reporting tools has brought visibility that supports data-driven tasks and decisions to CAU. “We can see where staff are in completing documentation, so we can submit timely claims, and where the organization is on deadlines and compliance related tasks,” Yalakidis said. “We write a lot of reports.”
As a regional leader in providing services and care, CAU has implemented the Qualifacts affiliate model, which supports larger organizations in leading and administering its solutions for smaller ones. CAU has CareLogic affiliate partnerships with five organizations, who Yalakidis supports through expertise and hands-on mentoring. “We have created many configurable forms for our affiliates, to support the day-to-day work of their staff, in the workflows that are best suited for them,” Yalakidis said.
Nine years post its GoLive with Qualifacts and CareLogic, CAU is looking ahead to ongoing change, continued self-service through growth and expansion, and support for the billing, documentation, and reporting requirements that the future will bring.
About Community Access Unlimited
Since our inception in 1979, Community Access Unlimited has continued to grow to support members to live full and self-directed lives in their communities. We were founded with a single grant to move 20 people with developmental disabilities from state institutions to homes in the community. The agency now serves over 3,000 members and families and owns 270 housing units.
