Masada Community Health Services CalAIM Billing Success

mental health billing scaled

Masada Community Mental Health Services was facing a daunting challenge: how to continue providing quality mental health care and social services in Los Angeles County, while efficiently documenting and successfully billing under CalAIM’s clinical, financial, operational, and structural complexities. They also had to switch from their previous EHR platform quickly due to security issues. Masada needed a technology partner that understood the specific needs of LA County for long-term support and engagement with an EHR designed specifically for behavioral health organizations that could easily adapt to the ongoing CalAIM changes.

In April 2022, Masada selected Qualifacts and pursued an accelerated implementation of its CareLogic EHR solution to quickly address security concerns and stay ahead of payment reform changes.

With Qualifacts’ team of experienced CalAIM subject matter experts and an impressive footprint throughout LA County and California, the Masada team felt confident with its decision. And although the accelerated timeline required a higher than usual level of commitment from all participating stakeholders, the critical business need outweighed the added risk and effort.

“We knew we could do it, because we had our in-house expertise, and we knew Qualifacts would bring the right subject matter experts to the project,” said Patricia Tindbaek, Chief Development Officer, Masada Community Mental Health Services.

“Everything we accomplished through our CareLogic implementation a year ago prepared us to self-manage our documentation and our workflows in response to the monumental changes required by CalAIM in 2023.”

One year later, Masada reports sailing through the massive challenges presented by the ​​​​​​​​​​​​​​​​​CalAIM Behavioral Health Initiative Go-Live Date on July 1, 2023. “We are among the first LA County contracted providers to successfully submit claims and receive payment,” said Tindbaek.

Even before the July 2023 CalAIM Go-Live, LA County had unique, specific, and detailed requirements. “CareLogic made being able to claim and receive payments very straightforward and simple because we had the benefit of working with an EHR partner that we don’t have to explain everything to,” Tindbaek said. “The 2023 changes presented a new level of complexity, and we have worked side by side with the Qualifacts team as needed, building on the structures for success put in place with our rapid implementation.”

Before the July 2023 CalAIM changes, LA County already demanded specific and detailed clinical documentation. With the new changes, this demand became even higher. “Our in-house experts knew what we needed to do, and the Qualifacts team brought a similar level of expertise to the project,” Tindbaek said. “We worked together, from the configuration of the system to the structure of the clinical documentation, to leverage CareLogic’s flexibility,” Tindbaek said.

“Our team at Masada collaborated with our Qualifacts counterparts from the first day to build our CareLogic structures and workflows to align with what was coming,” said Iva Svetlikova, Chief Quality and Compliance Officer for Masada.

“The configurable CareLogic platform allows us to continue to make updates as needed, which will be an ongoing requirement.”

Over the years, Masada has added services and locations to keep up with the demand for innovative and accessible treatment programs. Masada now provides a complete range of community-based mental health services to children, youth, adults, and families.

About Masada Community Mental Health Services

Masada Community Mental Health Services is a non-profit organization whose mission is to provide comprehensive, solution-based mental health and social services that enhance the lives of children, youth, families, and adults, while contributing to the overall well-being of communities.

Masada is committed to supporting the well-being of those they serve. They understand that developing life-long skills for improving and preserving emotional health is critical to the success of an individual. Their staff is highly trained and equipped to offer clients the vital tools to improve their quality of life.

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