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What You Need to Know About Referrals and Pre-authorization
While QualChoice does not require referrals, some services require pre-authorization (pre-approval). Find out ahead of time if the services you need call for a pre-auth. Your claim could be denied if pre-authorization was needed and you didn’t get it before you received care.
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Outpatient Surgery? Consider an ASC
There are more options available today to get quality health care at a lower cost. If you need outpatient surgery, an Ambulatory Surgery Center (ASC) may be an option to consider.
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Where to Go for Care
When you or a member of your family needs medical attention, knowing the right place to go for care are critical to getting the care you need and getting the most from your benefits. Review these tips so you will know where to go to get the care you need ahead of time.
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National Imaging Associates Online Training for Providers
QualChoice recently announced an agreement with National Imaging Associates, Inc. (NIA) to manage diagnostic and cardiac imaging services. Providers are encouraged to register for one of the upcoming online training sessions provided by NIA.
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High-Tech Imaging Change
National Imaging Associates, Inc. (NIA), a subsidiary of Magellan Health, will manage QualChoice diagnostic and cardiac imaging.
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Reporting Health Coverage on Your 2020 Taxes
Here are some tips on which forms you’ll need if reporting health coverage on your taxes.
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Requirements for Availity 270/271 Eligibility Check
Review the requirements for Availity 270/271 eligibility processing.
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COVID-19 Vaccine Coverage
The Centers for Medicare and Medicaid Services (CMS) has released an interim final rule addressing COVID-19 vaccine coverage.
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270/271 Change Effective December 15
Eligibility verification for QualChoice will now be provided by Availity.
