Behavioral Health & Human Service EHRs for California Counties

Qualifacts Credible EHR platform is designed to support core California County operations and adapt to the ever-changing landscape of complex requirements. Counties are switching Qualifacts to support CalAIM program initiatives, including data analytics, consumer engagement, and care coordination tools.

• Full access to all data critical for compiling and analyzing data received from providers, demonstrating improved outcomes, and better treatment protocols
• Multiple reporting tools to harvest data and a Business Intelligence module to provide real time dashboards measuring Key Performance Indicators (KPIs) to demonstrate continuous improvement and contract compliance
• Connect with other systems and organizations — including patient data access and system-wide health information exchange — to break down data silos
• California specific font requirements for documentation (Arial or Times New Roman) – All release information is in 14 point font size while Treatment plans, assessments, intake forms, etc. are in 12 or 18 point font size
• Separate EHR by Program and Teams to easily run reports, create billing rules, and setup administrative privileges to ensures records are only accessible to authorized personnel
• Residential features provide quick bed search and placement, bed holds, and census reporting
• Compliant with 42 CFR separation of mental health and SUD charts and detailed administrative privileges allow your team to make changes in accessing records as requirements evolve

To deliver client-centered care and succeed with value-based reimbursement, providers must evolve toward a more collaborative care model. Qualifacts can help you connect with other systems and organizations—and make the right connections internally—to break down data silos and make that care coordination simpler and easier.

• Coordinate care via flexible integrations with labs, Health Information Exchanges, providers, and third-party systems
• Consumer engagement tools and a client portal with online access to scheduling, medication renewals, form and assessment completion, and payment processing
• Monitor service authorizations and interventions, measure adherence to established benefit plans, authorize medically necessary services, and review utilization
• Comprehensive reporting to track client movement and placement for those served by multiple providers
• Receive referrals, generate data exports into standard referral letter templates, and manage the referral process to outside providers with Integrated Primary Care
• Our flexible reporting outputs include over 80 standard reports, dashboards, and custom reporting capabilities for improved decision support.  
• Comprehensive reporting to track consumer movement and placement across multiple providers and systems to support whole person care

Qualifacts EHR’s configurable reporting and billing modules help our California Counties meet their unique needs. As a result, they experience an average 99% clean bill rate and 8% fewer claim denials versus the industry standard. From claims automation to Medi-Cal billing requirements, we have you covered.

• Fully integrated, rules-based Revenue Cycle Management ensures claim accuracy, minimizes denials, and optimizes claims error procedures
• Medi-Cal Short-Doyle Billing Module for compliant and timely revenue collection
• Ability to match clients automatically or manually and automatically add or update insurance using the California specific MMEF file
• Ensure revenue integrity by automating the billing process as part of the clinical workflow with built-in claim scrubber, denial work queues, and payment posting
• Module to share client and payer eligibility, authorize providers, process, adjudicate and pay claims and track expenditures for services within defined covered benefits across care systems
• California specific 837 file functionality and 835 processing capabilities
• Aligned with CalAIM Behavioral Health Payment Reform billing requirements, with functionality for CCBHC and VBR Models
• California Specific Liability worksheet and expanded liability processing capabilities that support handling for UMDAP, Share of Cost, and Sliding Fee Scale

Our Credible EHR fully supports Medi-Cal, CalAIM and other federal reporting requirements. With experience in meeting specific requirements in 50 states, you will have a partner that understands the security and certifications needed to stay ahead of what’s coming federally and within California. You can feel confident that your EHR will be ready to support you as CalAIM and the 21^st Century Cures Act continue to evolve.

• Quickly and efficiently collect and report on outcomes with Clinical Quality Measures dashboards
• Ability to collect, track, and submit data electronically to State such as CSI, CalOMS, FAST, MHSA-FSP, OSHPD, ASAM LOC, and outcomes
• Qualifacts supports agencies in complying with applicable laws and incentive programs, including HIPAA, 42CFR Part 2, Quality Payment Program (MIPS or APM), Value-Based Reimbursement (VBR), state and county reporting requirements, and many other federal and local regulations
• Full support of CalAIM documentation and billing requirements for Medi-Cal transition to fee-for service, and Qualifacts is prepared to support value-based-reimbursement as those requirements are implemented
• Certification with the Office of the National Coordinator (ONC) — providing nationally compliant and certified products
• 21st Century CURES Act compliance with FHIR API and USCDI support 
• Ability to create audit roles and permissions to restrict access to client records and forms

With a Qualifacts EHR you’ll have the access and knowledge to make more strategic, data-driven decisions at the point of care. Designed with user experience in mind, Qualifacts EHRs provides intuitive intake workflows and robust configuration.

• Reminders and Alerts for assessments, treatment plans, transfers, or discharges
• Supports the required elements of progress note to record the service delivered, interventions provided and plan for next steps based on California regulations
• Evidence Based Practice / Service Strategies (EBP/SS) are captured in progress notes
• Medication Administration module to track, add reported medications, create prescriptions, complete reconciliation, and check Rx Eligibility and medication history
• Electronic lab orders and results, with encrypted security
• Assessment tools (CANS, ASAM, PHQ9, etc.) to inform care plan development that all members of inter-disciplinary teams can contribute to and update Progress Notes
• Treatment Planning problem list for improved integration with primary care and includes dates and role or owner
• Align clinical documentation with a “Golden Thread” of client data from assessments to treatment plans with the ability to enter specific objectives and goals

Support the “Golden Thread” by pulling data (recommendations, problems, strengths, barriers, medications, lab results) from assessments into treatment plan to inform plan development.

• Several industry standard screening tools and assessments are available (PHQ-9, GAD-7, WHODAS, Socrates, Audit, C-SSRS, ANSA, etc.)
• California PCS 35 Assessment is included in the EHRs assessment tools
• ASAM assessment integration used to determine the appropriate level of care for covered Substance Use Disorder (SUD) treatment services*
• Assessment tool library includes the California CANS 50 assessment
• Standardized Assessment covers the 7 required domains and more free-text area with data elements for tracking outcomes

Our platform’s disconnected mobile workflows allow clinicians to access and document the data they need at the point of care. Collect the data that matters, then relax. That info will securely upload to your EHR for immediate review, processing, billing, and reporting once an Internet connection is available.

• Work from anywhere with fully disconnected mobile solutions for Home & Community Based Services (HCBS)
• Collect data, including client signatures, at the point of care with electronic forms
• Integrate community-based care, scheduling & paperwork via any secure tablet, laptop or mobile device