Qualifacts Billing Services
Yes - Medtransic works inside Qualifacts systems, and behavioral health billing is the work we do in them. For organizations already running the system, this page sets out what we handle and what stays with your team.
What does not change
- You keep Qualifacts and everything configured in it.
- Your clinicians document exactly as they do now.
- Your program structure and reporting setup are untouched.
- Your data stays yours. Nothing of yours leaves with us if you go.
What we run inside your Qualifacts
Claims from your existing documentation
We work from what your clinicians already complete. Nothing is submitted before the note supports it.
Medicaid and managed care claims
Behavioral health organizations usually bill more Medicaid and MCO volume than commercial, and the rules differ by state and by plan.
Authorizations tracked across programs
Where a client receives more than one service, authorizations run down independently. We track them rather than discovering the limit after the fact.
Denials appealed with the cause recorded
Every denial gets a reason logged so recurring ones get fixed at source.
A/R worked in age order
Oldest first, because those claims are closest to their filing deadlines.
How the switch works
The part most practices are wary of. Here it is in order.
- 01
We review your recent claims
A sample of what you have been submitting shows what is denying and why, before anything changes.
- 02
Access, not migration
You give us user access to the Qualifacts you already run. Nothing moves.
- 03
We confirm enrollment across your clinicians
Organizations with staff turnover carry enrollment gaps almost by default. We check before submitting on anyone’s behalf.
- 04
New claims start immediately
Current work comes to us straight away so nothing stalls.
- 05
Then the backlog
Outstanding claims get worked, oldest and largest first.
What your staff still do
- Document services as they do today.
- Schedule clients and manage program intake.
- Tell us when a client’s coverage or program changes.
- Answer anything a payer needs the treating clinician to confirm.
Where practices like yours lose money
Qualifacts is certified health IT
Qualifacts is the developer; its EHRs include Credible and CareLogic. Credible Behavioral Health holds an active certification on the ONC Certified Health IT Product List, listing 11776, certified on 23 February 2026 against 42 criteria. CareLogic is separately certified under the same developer, verified 19 August 2026.
Mixed funding makes the billing harder than the volume suggests
Insurance, Medicaid, managed care and contract or grant funding often sit side by side, sometimes for the same client. Which pot a service belongs to is a billing decision before it is an accounting one.
Staff turnover creates enrollment gaps by default
Where clinicians join and leave regularly, enrollment is perpetually catching up. Services get delivered by someone not yet enrolled, and the claims deny long after the work was done.
One client, several services, several authorizations
A client in more than one program has authorizations running down at different rates. Missing one denies a block of already-delivered sessions.
Questions we get asked
- Do you actually work in Qualifacts?
- Yes. It is among the systems we bill in.
- Do we have to change systems?
- No. We work inside the Qualifacts system you already have.
- Can you handle Medicaid and managed care alongside commercial?
- Yes, and for most behavioral health organizations that is the bulk of the volume. Rules differ by state and by plan, which is exactly why it is worth having someone whose job it is to track them.
- What access do you need?
- User access with billing permissions, plus the payer portals you are enrolled with. Your organization stays the account owner.
- How much does Qualifacts cost?
- Qualifacts does not publish its prices; you get a quote by booking a demo. Its ONC cost disclosure for Credible, attested March 2026, lists the kinds of fees, a one-time implementation fee and a monthly fee, but no amounts.
- What does it cost?
- Billing costs 4-8% of collections; programs that need us to handle authorizations or many clinicians land higher in that range. Credentialing is a flat $150 per application, per provider. See our pricing page.
- Is Qualifacts a good company?
- Qualifacts is a long-running behavioral health EHR company: it says it has served behavioral health and human services providers for more than 25 years, offers three EHRs (Credible, CareLogic and InSync) and has headquarters in Nashville and Tampa. It also says all its platforms are ONC-certified. Whether it suits you depends on your organization, so ask for references from organizations like yours and read its implementation and support terms.
See what your Qualifacts billing is leaving behind
We look at a sample of your actual claims and show you, line by line, where money is going uncollected. Nothing follows it unless you want it to.
Related
- Medtransic Behavioral Health
- Mental and behavioral health billing services
- Behavioral health credentialing
- Provider credentialing
- Pricing
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