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: Current Issue

2018

Summer

  • Medical Records Collection for IVA
  • Orthotic Devices Require Pre-authorization
  • ARBenefits: Medical Necessity Review Required for Transplant
  • New Pre-Auths Available through AutoAuth®
  • Using the ECHO Health EFT Payment System
  • Opioid Misuse and Guideline for Prescribing
  • CPC+ Updates and Reminders

Spring

  • Medical Record Review for HEDIS Reporting
  • New! AutoAuth® Maternity and DRG Notifications
  • Helping PCPs Improve Healthcare
  • CPC+ News and Updates
  • Health Tips at QualChoice.com
  • Stay Up-to-Date on Medical Policies

2017

Winter

  • Coming Soon - ECHO Health EFT Provider Payment System
  • Save Time with AutoAuth-Pre-authorization!
  • No Out-of-State Coverage for Individual Metallic Members in 2018
  • Changes to Imaging Coverage Under Consideration
  • Pre-authorization Required for IOM Services
  • Changes Coming to Member Explanation of Benefits (EOB)
  • New Limits on Short-Acting Opioids
  • PCP Assignment and Specialist Claims

Fall

  • Countdown to Online Pre-authorizations
  • Using the My Account Online Provider Portal
  • Collaborating on Coordinated Care
  • New and Improved Payment System
  • Stay Up to Date on Medical Policies
  • Be Sure to Use In-Network Services
  • Review Your Demographic Information

Summer

  • Let’s Collaborate!
  • Please Submit Medical Records for IVA
  • Be Sure to Use In-Network Services
  • Denial of Coverage for Procedure Change
  • Data Sharing to Prevent Fraud, Waste and Abuse
  • Coverage Decisions

Spring

  • CPC+ Contracts Mailed
  • Using the Correct Request Form
  • Medical Record Review for HEDIS Reporting
  • CERiS Review Program FAQs
  • Stay Connected! Sign Up for My Account
  • Individual Metallic Plan Members Must Have PCP

2016

Winter

  • Individual Metallic Plan Members Must Have PCP
  • Medical Record Review for HEDIS Reporting
  • Reconsideration and Appeals Update
  • New eviCore Portal
  • Diabetic Retinopathy Screening
  • CPC+ Update

Summer

  • Review Your Demographic Information
  • Taxonomy Code Update
  • Diabetes and Eye Health Outreach
  • New Online Member Portal
  • Be Sure to Use In-Network Services
  • CPC+ Update

Spring

  • Now Accepting Medicare Crossover Claims
  • Use Correct Electronic Payer ID
  • eviCore Healthcare Update
  • CPT Code Update
  • Medical Record Review for HEDIS
  • File Corrected Claims Electronically

Provider Quick Alert

2018

2017

2016

CPC+ QuickNews

2018

2017

PCMH QuickNews

2018