Countdown to Online Pre-authorizations!

The date is set to launch online pre-authorization! MCG Cite AutoAuth will launch September 25 for these elective inpatient procedures:

  • Spine, Joint Replacements and Fractures
  • Cardiovascular, Thoracic and Pulmonary
  • Gastroenterology
  • Urology

The system will also accept Home Health requests for nurse and therapy visits!

With AutoAuth, you receive immediate authorization and confirmation, and you can print your Approval letter right from the portal! The AutoAuth system will be easily accessed through the My Account provider portal at QualChoice.com. Register today if you haven’t already!

Using the My Account Online Provider Portal

Get the information you need through the fast and secure My Account portal, where you can:

  • Check member eligibility and benefits
  • Search and view claims and RAs
  • Search and view referrals and pre-authorizations
  • Generate useful reports
  • Access CPC+ information
  • Request pre-authorizations—Coming soon

Registration is required to access My Account for providers. Please review the training video and follow the instructions to register. For questions, call us at 501.228.7111 or 800.235.7111, ext. 7011.

Collaborating on Coordinated Care

In the Summer issue of Quality Results, we asked you to collaborate with us on finding the most efficient way to deliver high-quality, cost-effective, patient-friendly healthcare. Thank you for your response! We learned that coordinated care is important to you. It’s also important to us.

Dr. Milton Hammerly, QualChoice Chief Medical Officer, shares in his letter to you how QualChoice is helping improve care coordination. Read Dr. Hammerly’s letter.

New and Improved Payment System

When you indicated that quick reimbursement and efficient payment reconciliation are high priorities, we heard you. We’re excited to announce the implementation of our new payment solution, coming in November 2017!

We’re changing our Electronic Funds Transfer (EFT) system from ProviderNet to ECHO Health, Inc. With the Echo Health EFT system, you’ll realize:

  • Faster payments
  • Options for payment method
  • Online access to payment details
  • Email notification of payment, upon request

Sign up today for the ECHO Health EFT system. If you already use ECHO Health, Inc. for other EFT transactions, sign in to ProviderPayments.com to see your QualChoice payments after November 2017.

Stay tuned for updates – including exact launch date – coming soon!

Alerts and Reminders

Stay Up to Date on Medical Policies

Check your inbox on the first day of each month to find QualChoice New & Amended Medical Policies and Coming Amendments in one of these publications:

  • QualChoice Provider Quick Alert
  • Quality Results quarterly newsletter

To review a specific medical coverage policy, visit the Providers section of QualChoice.com. You can also find past email publications at Provider News at QualChoice.com.

Be Sure to Use In-Network Services

Contracted QualChoice providers are required to use in-network laboratory or pathology groups. Using out-of-network facilities violates your agreement with QualChoice and causes patients to pay significantly more for these services. When services are not available through an in-network provider, contact Care Management at 800.235.7111, ext. 7014 to submit an Out-of-Network Authorization Request

Review Your Demographic Information

Please check the information about your practice in our online directory to make sure it is current and accurate. If there are changes, please complete and send to us a Provider Practice Change Form