Billing integrated in your EHR creates a clinically driven revenue cycle, boosting operational efficiency and maximizing revenue. Our HIPAA-compliant, configurable billing module simplifies operations, increases clean bill rates, and enhances workflow efficiency, resulting in faster payments and higher revenue potential.

• Powerful rules-based Billing Matrix with program-specific settings to satisfy multiple funder contract requirements and rate cards
• Automated billing from clinical processes ensures claims are submitted accurately the first time
• Self-managed billing tools allow you to make real-time modifications to adapt to ever-changing regulations seamlessly
• Fast and automated access to detailed eligibility and medical benefit information from hundreds of payers
• Intelligent alerts notify staff of missing or incomplete information in real-time, allowing quick resolution
• Billing functionality that supports Certified Community Behavioral Health Clinics (CCBHC) and Value-Based Reimbursement (VBR) Models

Qualifacts end-to-end EHRs are designed to simplify your processes and minimize administrative tasks, making your agency more efficient and reducing the burden on staff. With easy-to-use, agency-specific, and configurable workflows, our solutions ensure a seamless and user-friendly experience, minimizing clicks and saving valuable time.

• Improve staff productivity using a highly flexible interdisciplinary service/treatment plan that enables an integrated record to be shared seamlessly across services
• Save time and enhance overall efficiency with mobile solutions that allow staff to document, schedule, and track clients for community-based services.
• Highly flexible interdisciplinary service and treatment plans seamlessly integrate and share records across various services, enhancing care coordination and improving outcomes.
• View one integrated client record for those receiving behavioral health and primary care services, ensuring continuity and comprehensive whole-person care
• Leverage Qualifacts iQ, our AI-enhanced documentation tool that auto-generates up to 70% of clinical notes, converting session transcripts into fully formatted notes for review and approval.
• Integrated patient portal and telehealth solutions bring all aspects of care delivery and client engagement into one platform

Empower your strategic decision-making with real-time access to your agency’s data. Easily track and visualize through analytics and business intelligence dashboards, gaining comprehensive insights into every aspect of your operations, from financial performance to staffing needs and client outcomes.

• Real-time access to integrated data provides valuable insights into your agency’s productivity and financial health, empowering informed decision-making
• Gain visibility into trends and impacts of Evidence-Based Practices with the ability to pull bulk data for Population Health Management
• Monitor quality and prove population health outcomes for value-based reimbursement and alternative payments models
• Comprehensive reporting to track client movement and placement for those served by multiple providers
• Evaluate service delivery cost related to outcomes and identify opportunities to reduce costs with Advanced Analytics, ad-hoc reporting, and Advanced Search tools
• Manage resources effectively, with data-driven insights into caseloads, productivity, service lines, kept appointments, no-shows, and more

Connect with key Michigan partners including HIEs, labs, primary care providers, health plans, and local hospitals to support patient-centered care.

• Promote interoperability with a configurable platform that integrates third-party systems through a secure, easy-to-use, web-based interface
• Alerts, notifications, and messaging tools enable cross-program collaboration and care coordination
• Eliminate paper prescriptions, save time, enhance patient safety, and support compliance requirements with eRx, ECPS, and PDMP capabilities
• Electronic integration with local Michigan-based laboratories allows you to simplify lab orders and results processing without the need for scans, faxes, or manual entry
• Conduct comprehensive biopsychosocial assessments with integrated American Society of Addiction Medicine (ASAM) criteria

Expand your service offerings and reach new markets with functionality for Certified Community Behavioral Health Clinic (CCBHC) models and a full CCBHC partnership as well.

• Evidence-based assessments, outcome instruments, and real time data on client progress
• Utilize a CQM Tool for meeting the federal/state requirements of Clinical Quality Reporting
• Billing Module supports PPS-1 & 2 (Prospective Payment System – Type 1 & 2) Billing of claims
• Clinical decision support can be built right into your programs and services, ensuring your clinical documentation best practices are integrated into your workflows
• CCBHC subject matter experts to guide you throughout the CCBHC experience with state-specific knowledge, training, and support
• National CCBHC Cohort provides a network of peers to support you every step of the way

Qualifacts Managed Care solution simplifies care coordination and population health with automated workflows and advanced analytics. It integrates business processes, helping improve client outcomes while lowering administrative costs and reducing security concerns. Modular components provide a seamless interface, combining reporting, claims adjudication, authorization review, and utilization management for unmatched efficiency.

• Gain insights from advanced analytics and profitability reports with drill-down capabilities, enabling effective management of authorizations, claims, and internal administrative expenses
• Simplify processes effortlessly with automated workflows, reducing manual tasks, and boosting productivity
• Enhance staff productivity, accelerate clinical data procedures, and optimize financial outcomes through administrative solutions that lower costs and improve user satisfaction
• Eliminate claims processing bottlenecks with automated claims submission, business rule-based auto-routing, auto-adjudication, and enhanced batch processing and re-processing capabilities
• Effortlessly navigate complexity with knowledge-sharing workflows to manage data exchange, care transitions, and consumer needs assessments