Quality Results

An e-newsletter for doctors, other health care experts and facilities affiliated with QCA Health Plan, Inc., and QualChoice Life and Health Insurance Company, Inc.

Quality Results


Winter 2023

  • Integrated Data Solutions to Improve Patient Care
  • Act 575 and Provider Exemption Status
  • Medicare and Marketplace Medical Record Retrieval
  • Clinical Documentation Improvement
  • Medical Coverage Policies Updates

Fall 2023

  • Introducing our 2023 Primary Care Quality Program
  • Prenatal and Postpartum Service Codes
  • Individual and Small Group Metallic Plans Chart Chase Program
  • CPT® II Codes
  • Medical Coverage Policies Updates

Summer 2023

  • Individual and Small Group Metallic Plans Chart Chase Program
  • End of the Federal Public Health Emergency
  • Glucagon-Like Peptide 1 (GLP-1) Agonists for Weight Loss: Drug Shortages and Labeled Indications
  • Medical Coverage Policies Updates 

Spring 2023

  • QualChoice Performing Post-Payment DRG Clinical Validation Audits of Facility Claims
  • Updated Forms Available on the Find a Form or Document Section of QualChoice.com
  • Health Literacy and Patient Outcomes
  • Appointment Accessibility Standards
  • 27th Edition of Care Guidelines Now Available from MCG Health: Changes Effective June 1, 2023, for QualChoice Providers
  • Medical Coverage Policies Updates


Spring 2022

  • Updating Demographic Information
  • Prior Auth Updates for Some Imaging Services
  • Medicare and Marketplace Medical Record Retrieval Projects (MRR)
  • Managing Symptoms in Members with Allergies
  • Medical Coverage Policies Updates

Winter 2022

  • Submit Requests With Appropriate Documentation
  • COVID-19: Vaccine Information
  • Update for 270/271 Eligibility Requests
  • Temporary Changes to Admission Requirements
  • eRemits: An Enhancement for the Paper Check Process
  • Medical Coverage Policies Updates


Summer 2021

  • Updated Telehealth & Virtual Services Guide
  • COVID Update Effective June 1, 2021
  • Updated MCG Guidelines
  • Providing Quality Care
  • Updated Provider Manual
  • Medical Coverage Policies Updates

Spring 2021

  • COVID Waiver Updates
  • Upcoming Changes to Clinical Editing Rules
  • High Tech Imaging Change
  • Lawrence Health Hospital Services Pre-authorization List
  • Avoid Imaging for Lower Back Pain
  • Medical Coverage Policies Updates