Welcome to CPC+
Congratulations to our provider partners who are participating in the CPC+ program. The program offers care management fees and performance-based incentives to practices, with an opportunity for added payment outside the fee-for-service system.
Tools for participating in CPC+ with QualChoice will soon be available when you sign in at My Account. Review CPC+ FAQs here. For more about CPC+, visit Centers for Medicare and Medicaid Services
Medical Record Review for HEDIS Reporting
We are compiling data on 2016 clinical outcomes for Healthcare Effectiveness Data and Information Set (HEDIS) standards, which are designed to help consumers compare performance across plans. Data collection begins this month and continues until mid-May. Advantmed,a medical record retrieval company, will contact your office by fax and telephone to collect medical records on our behalf. Learn more about HEDIS and records collection
New for 2017: PCP Required for Individual Plan Members
Beginning January 1, 2017, QualChoice individual metallic plan (Bronze, Silver, Gold, Platinum and Catastrophic) members, as well as those with insurance through HealthCare.gov or Arkansas Works will be in the Select network and will be required to choose a PCP. A unique QualChoice ID card will help you identify them.
Members who do not choose a provider will be assigned one. Rosters of newly assigned members will be available through My Account* under the Provider Reports tab. Learn more.
Welcome Providers & Administrators
We value our healthcare providers and the care they bring to our members. Registered providers may log in to conduct many QualChoice transactions conveniently and securely online.
Resources & Tools
This quarterly electronic newsletter provides comprehensive news and information to make working with QualChoice easy for you.
Time-sensitive administrative and billing updates, medical policy revisions, etc. delivered electronically.
Partner with QualChoice
Call or email to join our network or to find out more information about physician and facility credentialing.
800.235.7111 or 501.228.7111, ext. 7004
Provider Relations Representatives