Stay Informed and Stay Healthy
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    Play It Safe this Summer

    Summer brings many opportunities for outdoor fun! Warm days can include swimming, hiking, picnicking and playing ball. There are sightseeing vacations and backyard staycations. All of these good times are even better when we steer clear of accidents and illness. Before you head out the door, brush up on these safety tips to keep your summer safe and healthy.

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    Coverage for Routine and Complex Procedures

    In the past, you may have had to go to a hospital for certain healthcare services. Today, many of those same things are done in your doctor’s office. How much you pay for those services depends on if they are routine or complex.

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    Summer Workout Tips

    Whether you’re running, playing basketball or going for a power walk, exercising in hot weather puts extra stress on your body. Follow these summer workout tips to help reduce your risk of serious, heat-related illness while staying in shape.

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    Care Management Helps Employees and Employers

    Employees with serious medical conditions may find managing their health to be stressful. But if Care Management is included in their health plan, there are experts who can help.

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    How We Make Coverage Decisions

    We work to make sure our members get the right healthcare in every care setting. We support proper care decisions based on medical necessity and the member’s specific health plan. When a service needs pre-authorization, our Medical Director and clinical staff follow QualChoice Medical Coverage Policies. They also follow the peer-reviewed and nationally noted guidelines of MCG Health, LLC.

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    Employer Group Email: Demographic Verification

    QualChoice sends member lists each year to the Internal Revenue Service (IRS) as proof of members’ health coverage. If member records do not match IRS records, QualChoice has 30 days to submit the correct data to the IRS.

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    Keep Your Skin Safe in Summer

    Summer is right around the corner, and many of us will soon be spending more time in the sun. But that can increase the chance of skin cancer, the most common cancer in the U.S. One in five Americans will develop it at some time. But the good news is: you can prevent it!

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    Tips for Healthy Meal Planning

    Whether you are cooking for just yourself or a larger group, planning meals is a good place to start improving your food choices. Taking the time to plan a healthy evening meal can help you avoid a less healthful "drive-through" dinner -- and save you money in the process.