California

Integrated Behavioral Health EHR Platform

With complex and shifting state healthcare regulations, you need an EHR partner that understands the changing landscape and keeps your organization ahead of the curve. Qualifacts currently supports more than 160 California agencies with our highly configurable solutions that optimize workflows and drive improved outcomes.

With actionable analytics, customizable workflows, and a powerful billing matrix, Qualifacts simplifies documentation and adapts to complex requirements without added costs. Specializing in meeting Medi-Cal and CalAIM needs, Qualifacts’ EHR solutions easily adapt to the evolving interoperability and reporting demands of these initiatives, empowering providers to enhance efficiency, maximize revenue, and deliver superior care.

Stay Ahead of California Changes

With requirements for interoperability and reporting continually evolving, a comprehensive EHR is vital for adhering to the objectives and challenges of California CalAIM initiatives.

Configurable billing modules help our California customers adapt rules to align with CalAIM Behavioral Health Payment Reform requirements.

Medi-Cal Short-Doyle Billing Module for compliant and timely revenue collection
Work efficiently with real-time eligibility checks for Medi-Cal & commercial clients
Workflows capture data that supports payer specific requirements to Enhanced Care Management (ECM)
Electronic submission of Medi-Cal Medicare, and third-party claims
Enhanced 835 functionality for California specific requirements
California Specific Liability worksheet and expanded liability processing support UMDAP, Share of Cost, and Sliding Fee Scale
Payment reconciliation and consumer financial reviews with sliding scale and UMDAP calculations
Generate 837 files for Mental Health Claims (Short Doyle) and SUD Claims – Drug Medi-Cal (DMC) in accordance with Medi-Cal
Billing Module is built with California billing rules to accommodate various scenarios with the ability to configure rules to comply with billing lockouts
Functionality to void or replace claims (including add-ons) if primary code is voided or replaced

Enhance treatment planning and progress note processes with clinical documentation capabilities that are customized to meet the rigorous requirements set by California regulations.

Supports the required elements of progress note to record the service delivered, interventions provided and plan for next steps based on California regulations
Capture Evidence Based Practice / Service Strategies (EBP/SS) in progress notes
Track the number of participants within a group to ensure group capacity is limited to 12
Transmit alternative client name and demographics to payers with Alternative Alias functionality
Stay compliant with 42 CFR separation of mental health and SUD charts and detailed administrative privileges that allow your team to limit access to records

Connect with other systems and organizations and support internal information exchange, to break down data silos and make care coordination simpler and easier.

Promote interoperability with a configurable platform that integrates third-party systems through our secure, easy-to-use, web-based interface
Connect with HIEs (LANES, SacValley, etc.), RHIOs, county systems, labs, and other systems
Receive notifications for ED visits and/or hospital admission, discharge, and transfer
ASAM criteria are integrated into Qualifacts’ systems to provide a holistic, biopsychosocial assessment, preventing duplicate data entry and logging ASAM responses for future reference

Access an intuitive suite of business intelligence (BI) tools and analytics to measure and track quality indicators. With easy-to-use tools and visualizations, you’ll spend more time acting on that data – not extracting it.

Access client, outcome, and program data in one convenient location with integrated reporting tools
Quickly and efficiently collect and report on outcomes with Clinical Quality Measure (CQM) reports and dashboards at the point of care
Clinical Decision-Making tools for enhance care quality, optimizing client outcomes through treatment suggestions, preventive care reminders, and identifying potential drug interactions
Evidence-based assessments, outcome instruments, and real time data on client progress
Reports built specifically to track outcome measures with the ability to pull in caseload characteristics data
Gain visibility into performance with metrics-tracking tools and reports tailored for behavioral healthcare and human services
Track and demonstrate client outcomes with real-time data, configurable dashboards, and visualizations

Simplify compliance with assessments, forms, fields, and reports tailored to Medi-Cal/Short-Doyle and CalAIM requirements.

Several industry standard screening tools and assessments are available (PHQ-9, GAD-7, WHODAS, Socrates, Audit, C-SSRS, ANSA, etc.)
California PSC 35 Assessment and California CANS Assessment is included in the assessment tools library
ASAM assessment integration used to determine the appropriate level of care for covered Substance Use Disorder (SUD) treatment services
Standardized Assessment covers the 7 required domains and more free-text area with data elements for tracking outcomes
Configurable forms for statewide screening and transition tools for adult and youth screening, and transition of care

To deliver client-centered care and succeed with value-based reimbursement, providers must evolve toward a more collaborative care model. With IBHIS-certified EHRs, Qualifacts makes it simple to connect with other systems and organizations.

Simplify processes with real-time data flow between the EHR, billing engine, quality improvement, reporting, and administrative dashboards
Meet interoperability requirements with Los Angeles County systems via an IBHIS-certified EHR, including IBHIS error management dashboards and automation tools
Full-Service Partnership (FSP) Outcomes Measures Application (OMA) forms and reports to capture data for entry into the County system
Establish a “Golden Thread” linking clinical documentation and client data throughout their care
Over 120 standard reports, “population behavioral health” reports, ad-hoc and custom reporting allow users to select filtering criteria, tailoring the report for their needs
Comprehensive reporting to track consumer movement and placement across multiple providers and systems to support whole person care

“When we knew how we wanted the workflows to go, they followed our lead, and when we wanted guidance from them, they offered it. They organized our cadences so that we had 1:1 meetings, team meetings, and group meetings as needed throughout the project.”

Pat Fitzgerald

Volunteers of America Northern California and Nevada