Pennsylvania

Qualifacts Knows Pennsylvania

Qualifacts is proud to serve nine behavioral health agencies in the Keystone State. Our customers in Pennsylvania alone have collected over $233,750 in first year Meaningful Use incentive payments!

To ensure our customers meet state reporting requirements, CareLogic includes functionality enabling agencies to electronically collect, batch and submit required information to the Pennsylvania Department of Welfare and individual payors. We built this functionality to accommodate our customers and the programs they are currently running.

Because CareLogic is a Software-as-a-Service (SaaS) platform, any new functionality is seamlessly distributed to Pennsylvania customers without upgrades, patches or service interruptions.

State Reporting

Project One Plus

The CRS Admission/Outcome module is used for reporting publicly-funded client information to the Philadelphia Department of Behavioral Health and Mental Retardation Services, Research and Information Management database.

Pennsylvania Outcomes Management System (POMS)

Gathers required state reporting data and the associated POMS state reporting batch.

EDI Files

The following EDI File Types have been built and are available to all customers:

  • Allegheny CO DHS 837
  • Aetna 837P/835
  • CCBHO 837
  • CCBH 837P/835
  • CBH / Healthchoice 837P/835
  • Highmark 837/835
  • Medicare 837
  • Magellan 837P/835
  • PA Medicaid 837/835
  • PA Promise 837 and 270/271
  • PROMISE Eligibility file
  • UHC 835
  • UBH 835
  • VBH 837P/835
  • VBH Base (County) 837
  • Westmoreland CO 837

Pennsylvania Custom Invoices: SCA Custom Invoice
Regions (Counties):

  • Allegheny
  • Berks
  • Carbon/Monroe/Pike
  • Chester
  • North Central: Bradford, Cameron, Centre, Clarion, Clearfield, Columbia, Elk, Forest, Huntingdon, Jefferson, Juniata, McKean, Mifflin, Montour, Northumberland, Potter, Schuykill, Snyder, Sullivan, Tioga, Union, Warren, Wayne
  • Northeast: Lackawana, Luzerne, Susquehanna, Wyoming
  • York/Adams