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.
Download CalAIM GuideStay 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 withpredefined California billing rules to accommodate various scenarios with the ability to configure rules to comply with billing lockouts
- Functionality to void or replace services (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 capability 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
- California specific font type (Arial or Times New Roman) and font size requirements for documentation
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, local hospitals, 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 tools and analytics to measure and track quality indicators.
- Access client, outcome, and program data in one convenient location
- 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
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 PCS 35 Assessment and California CANS 50 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
What Makes Us Exceptional
Proudly Serving All 50 States
Customers across the US trust Qualifacts for state reporting and compliance.
6 Month Average Implementation
Our proven implementation methodology quickly gets your staff up and running quickly.
97% Customer Support Satisfaction
Implementation is just the beginning, we’re with you every step of the way.
Serving 3,000+ Organizations
Agencies have trusted Qualifacts solutions for nearly 25 years.
#1 & #2 Best in KLAS
Recognized as Best in Behavioral Health Market Segment based on the feedback of thousands of providers
170+ CCBHC Customers
Proudly serving 33% of all CCBHCs in the United States
$10 Billion Claims Processed Annually
Maximize revenue with seamlessly integrating billing and claims management
8.6 Million Lives Covered
Qualifacts’ EHRs simplify workflows, helping you spend more time where it matters most – with clients.
“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.”
Talk to a California Behavioral Health EHR Expert
Schedule a custom demo directly with a California representative to learn more about our state-specific capabilities.
Success Stories from Your Peers
