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    Archived pages: 257 . Archive date: 2014-09.

  • Title: Homepage | Qualis Health
    Descriptive info: .. Home.. Search:.. Healthcare Professionals.. Overview.. Alabama Medicaid.. Alaska Medicaid - Behavioral Health.. Alaska Medicaid - Health Care Services.. Alaska Medicaid - TEFRA.. DC Medicaid.. Idaho Medicaid.. iEXCHANGE® - Web UR.. Medicare QIN-QIO.. Patient-Centered Medical Homes.. Qualis Health Provider Portal - Web UR.. Regional Extension Center.. Safety Net Medical Home Initiative.. Washington Labor Industries.. Washington Medicaid.. Other Insurance Plans.. Award of Excellence in Healthcare Quality.. Patients Families.. Carpenters Trust of Western Washington.. Medicare.. About Us.. Mission, Vision Values.. Population Health Management Services.. Care Management.. Healthcare Consulting: Information Technology.. Healthcare Consulting: Patient-Centered Medical Home.. Healthcare Consulting: Quality Improvement and Safety.. Newsroom.. Press Releases.. In the News.. Events.. Calendar.. Leadership.. Report to the Community.. Awards and Recognitions.. Contact Us.. Careers.. Search and Apply for Jobs.. Benefits.. FAQs.. Select.. Qualis Health Provider Portal.. Washington Labor & Industries.. Quick Links.. iEXCHANGE.. Our Services.. To learn more about how Qualis Health can help you, click the link to your benefit plan in the following list.. Select Your Insurance Plan.. Qualis Health Careers.. Advance healthcare quality and your career with Qualis Health.. At this significant time in the transformation of healthcare, we invite you to join us in this vital work.. Explore Qualis Health Careers.. Latest Qualis Health News.. 1.. 2.. 3.. 4.. Posted 08.. 18.. 2014.. Qualis Health Launches YouTube Channel.. In June, Qualis Health launched its new YouTube channel and has been updating it regularly since then.. Over a dozen vide.. [ learn more ].. Posted 07.. 28.. Patient Engagement in Hospital Infection Control: Online Toolkit Provides a New Solution.. Implement a hand hygiene huddle to engage patients, families and frontline staff  ...   Health Performance Measures Coordinating.. Posted 05.. 2014 Qualis Health Washington Quality Award Winners Announced.. Qualis Health Recognizes Washington Organizations for Improvements in Healthcare Qualis Health, one of the nation s.. Posted 04.. 03.. 2014 Qualis Health Idaho Quality Award Winners Announced.. Qualis Health Recognizes Idaho Organizations for Improvements in Healthcare Qualis Health, one of the nation s lead.. Posted 03.. 26.. New White Paper Details Learnings from REACH Healthcare Foundation Medical Home Initiative.. A new white paper prepared by Bonni Brownlee, Qualis Health s Director of Quality Improvement and Compliance Consult.. 12.. Qualis Health Launches Online Quality Reporting Resource Center for Hospitals.. With the implementation of the Affordable Care Act, Medicare is now aligning hospital and provider reimbursement with pe.. Posted 01.. 30.. Qualis Health Wins MarCom Award.. Report to the Community Honored with Gold Award in Print Design Qualis Health s 2011-2012 Report to the Community h.. 16.. Qualis Health Announces Contract with District of Columbia, Department of Health Care Finance.. Qualis Health signs multi-year contract to provide utilization reviews and quality improvement activities to Medicaid pa.. View All Qualis Health News Stories.. Tweets.. QualisHealth.. #EHRs.. can 'significantly' increase.. #reimbursement.. over time.. http://t.. co/hs7YAUrlR4.. #meaningfuluse.. 6 hours 8 min.. ago.. #Meaningfuluse.. payments reach $24.. 8B as of the end of July.. co/WoDHo6GMua.. #EHR.. #EMR.. #healthIT.. 8 hours 8 min.. Fast Healthcare Interoperability Resources (#FHIR) catching on as open healthcare data standard.. co/Fs11F1e52a.. 9 hours 8 min.. Washington Health Care Association Fall Conference.. American Health Quality Association 2014 Annual Meeting.. WPSC Patient Safety Webinar.. National Health IT Week.. View All.. Connect with Qualis Health.. |.. Disclaimer.. Privacy Policy.. Sitemap..

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  • Title: Healthcare Professionals | Qualis Health
    Descriptive info: Alaska Medicaid - Division of Health Care Services.. Share.. Print This Page.. Text Size.. A.. Qualis Health advances healthcare and improves health in partnership with healthcare professionals nationwide.. Our services promote efficiency and reliability, support care coordination, facilitate care transitions and leverage health information technology (HIT) to improve care delivery.. We provide care management services that support cost-effective, patient-centered, high-quality care.. Our case management and utilization management programs serve Medicaid agencies, self-funded health plans and health insurance plans.. Healthcare Quality, Safety and Efficiency Consulting.. Our teams assist healthcare providers to make transformational changes to become more efficient and effective healthcare delivery systems.. As the.. Medicare Quality Improvement Organization for Washington and Idaho.. , we work with healthcare professionals to redesign processes, build sustainable  ...   the.. , a five-year initiative sponsored by The Commonwealth Fund, to accelerate patient-centered medical home transformation in 65 practices across the country.. Healthcare Information Technology Consulting.. We provide consulting services to assist providers to leverage HIT in order to improve care delivery, to support effective business operations and to comply with regulatory requirements.. From guiding physician practices in electronic health record adoption to assisting state Medicaid agencies in the modernization of Medicaid Management Information Systems, our approach supports our clients and stakeholders through the transformation of healthcare.. Qualis Health leads the.. Washington Idaho Regional Extension Center (WIREC).. , which offers technical assistance services to participating practices to reach meaningful use standards, earn incentive payments and improve their systems of care.. Learn More.. info@qualishealth.. org..

    Original link path: /healthcare-professionals
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  • Title: Alabama Medicaid Agency | Qualis Health
    Descriptive info: Contacts.. Provider Resources.. ».. Alabama Medicaid Agency.. Our work advances healthcare and improves health for people in Alabama through our expertise in utilization management and quality review.. From our Birmingham office, we collaborate with the Alabama Medicaid Agency (AMA).. Our staff is composed of Alabamians who provide services within their own community to support the needs of Alabama residents.. We are privileged to provide this vital work for the state of Alabama.. Services We Provide for the AMA.. Our current work in Alabama includes medical and quality review for the AMA for the following healthcare services, equipment and supplies provided to Medicaid recipients:.. Hospice reviews, including admission and concurrent review.. Institutional admission review, including review of nursing homes, post-extended care, swing beds and inpatient psychiatric facilities.. Prior authorization review, including review of  ...   the.. Provider Resources page.. As of November 1, 2013, Qualis Health has begun a new scope of work with the Alabama Medicaid Agency for hospital inpatient quality reviews.. In January 2014, Qualis Health will send requests for medical record documentation for quarterly retrospective reviews of inpatient admissions.. The first review timeframe will cover dates of service from April 1, 2013, through June 30, 2013, and July 1, 2013, through September 30, 2013.. We will also send requests for your Hospital Utilization Review Plan (UR Plan) and Medical Care Evaluation (MCE) study.. Training presentation:.. Institutional Review Record Request (October 2011).. Download the current.. AMA Provider Manual.. AMA News and Notices.. Phone:.. (888) 213-7576.. Fax:.. (888) 213-8548.. Contact the Alabama Medicaid Agency.. Medicaid Providers Helpline:.. (800) 688-7989.. visit the AMA website.. more contact info..

    Original link path: /healthcare-professionals/alabama-medicaid
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  • Title: State of Alaska, Department of Health and Social Services, Division of Behavioral Health | Qualis Health
    Descriptive info: Provider Education.. State of Alaska, Department of Health and Social Services, Division of Behavioral Health.. From Qualis Health s Anchorage office, our Alaskan staff administers behavioral health utilization review programs through public sector contracts.. Services We Provide for Alaska Medicaid - Behavioral Health.. Pre-admission concurrent review for residential psychiatric treatment facilities (RPTC).. Pre-admission concurrent review for acute inpatient.. Retrospective review for both RPTC and acute inpatient.. Appeals.. Care coordination.. In the fall of 2014, Qualis Health will transition from iEXCHANGE to the new Qualis Health Provider Portal (QHPP), a state-of-the-art platform for electronic submission of utilization management (UM) review requests.. We are pleased to introduce the exciting new features of QHPP, including:.. An intuitive review process that guides the user  ...   and submitt a.. QHPP registration packet.. no later than August 31, 2014.. Training information will be available to providers following QHPP registration.. Presentation slides from the 2014 Annual Behavioral Health Provider Education Conference are now available.. You can find them on the.. April 2014: An updated list of.. Alaska In-state Providers by Region.. is now available.. The.. Provider Manual.. has been updated and is current as of July 2012.. Adobe Acrobat PDF files can be opened using Adobe Acrobat Reader.. If you do not have Reader, you can get it FREE from the.. Adobe website.. Initiate a Review.. (877) 200-9046.. (907) 550-7620.. (877) 200-9047.. Contact State of Alaska Medicaid - Behavioral Health.. visit the Alaska Medicaid - Behavioral Health website..

    Original link path: /healthcare-professionals/alaska-medicaid-behavioral-health
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  • Title: State of Alaska, Department of Health and Social Services, Division of Health Care Services | Qualis Health
    Descriptive info: State of Alaska, Department of Health and Social Services, Division of Health Care Services.. From our Anchorage office, we collaborate with Alaska s Medicaid - Health Care Services.. Our staff is composed of Alaskans who serve their fellow community members with services specifically tailored to the needs of Alaska residents.. We are privileged to continue providing this vital work.. Services We Provide for Alaska Medicaid - Health Care Services.. Utilization management activities.. Pre-admission review.. Concurrent review.. Retrospective review.. Expedited and standard appeals.. Case management.. Special case review.. Assessment  ...   for submitting certain imaging requests in iEXCHANGE.. Please see this.. Alaska Medicaid Provider Notice.. for details.. You can also find the Provider Notice on the.. page.. A new.. Select Diagnoses/Procedures Pre-certification List.. is effective beginning April 1, 2014.. You can find it on the.. Adobe Acrobat PDF files can be viewed using Adobe Acrobat Reader.. Utilization Management.. (888) 240-0437.. (800) 826-3630.. Case Management.. (888) 578-2547.. (907) 550-7600.. (877) 265-9549.. Physician Hotline.. (877) 292-2615.. Contact Alaska Medicaid - Health Care Services.. visit the Alaska Medicaid - Health Care Services website..

    Original link path: /healthcare-professionals/alaska-medicaid-health-care-services
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  • Title: State of Alaska, Department of Health and Social Services, Division of Public Assistance Tax Equity and Fiscal Responsibility Act Program | Qualis Health
    Descriptive info: State of Alaska, Department of Health and Social Services, Division of Public Assistance Tax Equity and Fiscal Responsibility Act Program.. The Tax Equity and Fiscal Responsibility Act of 1982, known as Alaska Medicaid - TEFRA, is a program for children (under 19 years old) with disabilities and significant medical, developmental or psychiatric needs.. The program was developed with specialized requirements that may allow children who would not typically qualify for Medicaid because of family income to receive specific Medicaid benefits.. What are the eligibility requirements?.. The child needs to meet the medical, developmental or psychiatric condition that fits the Supplemental Security Income definition of disability.. Only the child s personal income and resources are used when determining eligibility―not the parent s.. Not all children who are determined disabled  ...   the medical, developmental or psychiatric requirements for this program.. We assist care coordinators, families and state agencies to provide administrative management and oversight throughout the application process, and assist participants in completing the application process within specified timelines.. A Qualis Health nurse reviewer reviews documentation for level of care determination.. We also provide physician support and consultation.. The DPA administers the contract and the DPA long term care coordinator provides contract management and oversight.. Contact State of Alaska Medicaid - TEFRA.. Cheri Herman.. Long Term Care Coordinator.. Division of Public Assistance.. 3601 C Street, Suite 460.. Anchorage, AK 99524.. (907) 269-7854.. cheryl.. herman@alaska.. gov.. more contact info.. More Information About Alaska Medicaid - TEFRA.. TEFRA Family Friendly Information.. TEFRA Brochure.. TEFRA Definitions.. TEFRA Application Process Chart.. Case Examples..

    Original link path: /healthcare-professionals/alaska-medicaid-tefra
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  • Title: District of Columbia, Department of Health Care Finance | Qualis Health
    Descriptive info: District of Columbia, Department of Health Care Finance.. Qualis Health provides a broad range of services to the District of Columbia, Department of Health Care Finance (DC Medicaid).. Our regional office in the District is staffed by people who live in and around the District and whose work helps improve and advance the efficiency, economy, effectiveness and quality of healthcare services provided to enrolled District of Columbia Medicaid clients.. Services We Provide to the District of Columbia.. Utilization management.. Prior authorization review.. Emergency admission review.. Continued stay review.. Long term care review.. Please check this page frequently for updates regarding ongoing provider training and resources.. Checklists Expedite Prior Authorization Process for EPD Waiver and DME, Vision and Hearing.. Services.. Do you provide EPD Waiver, DME, Vision or Hearing services? If so, use Qualis Health s new checklists to make sure your Prior Authorization requests for services are complete.. If you do not submit all of the required documentation, the request will be denied and you will have to start the process over.. DME, Vision and Hearing: download the checklist.. here.. or find it on the.. EPD Waiver Services: download the checklist.. August Informational Meetings for Hospital Care Management and DME Providers.. This month, the District of Columbia Department of Health Care Finance and Qualis Health will be holding informative meetings for Hospital Care Management and DME Providers.. The Hospital Care Management meeting is on August 12 and the DME meeting is on August 28.. Get all the details on the.. Provider Education page.. Dental Providers: Submit Digital Radiology Images via the Qualis Health Provider Portal.. Attention dental providers! Did you know you can submit digital dental radiology images via the Qualis Health Provider Portal? Simply upload them just like you would any other document.. Please see the.. Provider Portal Manual.. section on adding documents (Provider Tab New Request Proceed to Step 8: Add Documents) for instructions.. Appeals and LTAC/Rehab Authorization Fax Numbers  ...   fax your review request.. Please note that the preferred method of submission of UM reviews is via the Qualis Health Provider Portal, so completing the training and registration packet is essential.. Learn more about the.. fax option.. Go to the.. Contacts page.. for a complete list of toll-free request for authorization fax numbers.. Download Forms 719A and 1728.. Forms 719A: Prior Authorization Request and 1728: Request for Medicaid Nursing Facility Level of Care are available online.. Download Form 719A.. - scroll to bottom of page.. Download Form 1728.. You can also find links to these forms on our.. Download the Provider Portal User Guide for Training and Reference.. Provider Portal User Guide.. contains comprehensive instructions for accessing, using and administering the Qualis Health Provider Portal.. Provider Portal Training Video Now Available.. Watch the.. video for Windows (WMV).. video for Mac (MP4).. You can also find the video on the.. Care Management Overview Helps You Get Started.. We have created a presentation to help providers familiarize themselves with Qualis Health s DC Medicaid UM program.. This presentation:.. Describes the DC Medicaid utilization management program administered by Qualis Health.. Provides training on how to submit a review to Qualis Health.. Provides Qualis Health contacts and resources available.. Download the.. DC Medicaid Care Managment Overview presentation.. now, or find it on the.. DC Medicaid Announces Details of Qualis Health Contract.. Transmittal No.. 14-09.. from DC Medicaid announces its contract with Qualis Health and specifies the services we will provide.. You can find past transmittals and bulletins on the.. DC Medicaid website.. Action Needed to Submit Fee-for-Service Medicaid UR Requests.. In order to submit District Fee-for-Service Medicaid utilization review requests, you must register in advance to use the Qualis Health Provider Portal.. Visit the.. to download the Qualis Health Provider Portal Registration Packet.. Contact Qualis Health.. join our email list to receive updates on training opportunities and transition activities.. Contact DC Medicaid.. visit the DC Medicaid website..

    Original link path: /healthcare-professionals/dc-medicaid
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  • Title: Idaho Department of Health and Welfare, Division of Medicaid | Qualis Health
    Descriptive info: Idaho Department of Health and Welfare, Division of Medicaid.. Qualis Health provides case management and utilization management services to the Idaho Department of Health and Welfare, Division of Medicaid.. We are staffed by qualified healthcare professionals who provide services tailored to the needs of enrolled Idaho residents.. Who We Serve.. The Idaho Medicaid program provides healthcare for eligible elderly and disabled individuals and eligible low-income pregnant women,  ...   240,000 Medicaid clients in Idaho.. We are privileged to be instrumental in this vital work.. Services We Provide for Idaho Medicaid.. Focused case review.. Provider education sessions.. June 16: A new.. info sheet.. under Other Resources.. The January 2014 Provider Manual is now available.. Download it now.. (800) 783-9207.. (800) 826-3836.. Contact Idaho Medicaid.. Dori Boyle.. Medical Program Specialist.. (208) 364-1835.. boyled@dhw.. idaho.. visit the Idaho Medicaid website..

    Original link path: /healthcare-professionals/idaho-medicaid
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  • Title: Web-based Utilization Review (iEXCHANGE®) | Qualis Health
    Descriptive info: Web-based Utilization Review (iEXCHANGE®).. iEXCHANGE is a browser-based application that uses a secure Internet connection to allow healthcare providers to submit utilization review requests electronically.. Features.. Submit requests and review status at any time.. Complete questionnaires that may impact the request status.. Enter only information pertinent to InterQual criteria or evidence-based guidelines and receive authorization number for billing when request is approved.. Print confirmation page with request information.. No software required―only Internet access.. No cost to providers for usage or training.. Security.. To support compliance with HIPAA regulations, providers are uniquely identified by the combination of their iEXCHANGE and individual user identification.. Users can change passwords, as well as add and maintain  ...   Health upon registration with iEXCHANGE.. Select your group and the type of review requested.. Enter all necessary information and submit the request.. After Submission.. After a user submits a request, it is immediately made available to Qualis Health to begin the review.. Users receive confirmation with information including when the review was completed, the days authorized (for inpatient stays), the next review due date and their case ID number.. A treatment update message displays when the provider selects the group.. Updates are triggered if the status has changed or a comment has been added.. Providers can view and respond to status updates or communication from Qualis Health.. contact info for iEXCHANGE users..

    Original link path: /healthcare-professionals/iexchange
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  • Title: Medicare Quality Innovation Network-Quality Improvement Organization (QIN-QIO) | Qualis Health
    Descriptive info: Medicare Quality Innovation Network-Quality Improvement Organization (QIN-QIO).. The Centers for Medicare Medicaid Services (CMS) leads the Quality Improvement Organization (QIO) Program, one of the largest federal programs dedicated to improving health quality at the local level.. Qualis Health is the Quality Innovation Network QIO (QIN-QIO) for Idaho and Washington, working to improve care for  ...   quality improvement consultants, data experts and clinical leaders partners with healthcare providers and communities on data-driven quality initiatives to improve patient safety, reduce harm, and maximize patient and family engagement in healthcare.. Learn more about our projects and initiatives on our.. Medicare QIN-QIO website.. Qualis Health.. PO Box 33400.. Seattle, WA 98133.. (800) 949-7536..

    Original link path: /healthcare-professionals/medicare
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  • Title: Patient-Centered Medical Homes | Qualis Health
    Descriptive info: A recognized leader in patient-centered medical home (PCMH) transformation, Qualis Health has supported more than 1,000 practices to streamline their processes, improve their quality and get them on the road to NCQA PCMH Recognition.. We lead multi-state demonstration projects, support regional collaboratives and provide customized practice-level assistance to local networks.. We also support State Primary Care Associations that are helping community health centers in their regions become patient-centered medical homes.. Learn more about  ...   Qualis Health co-developed a PCMH transformation framework, the Change Concepts for Practice Transformation.. This framework has been intensively tested in 65 practices and is used by dozens of other practices and collaboratives.. To continue that support, we ve created a free library of training materials to provide detailed descriptions and real examples of transformation strategies.. Learn more about the Change Concepts for Practice Transformation.. visit the Patient-Centered Medical Home website.. inquire about our services..

    Original link path: /healthcare-professionals/patient-centered-medical-homes
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  • Archived pages: 257