Provider News

Quality Results

2023

Winter 2023

• Integrated Data Solutions to Improve Patient Care
• Act 575 and Provider Exemption Status
• Medicare and Marketplace Medical Record Retrieval
• Clinical Documentation Improvement
• Medical Coverage Policies Updates

Fall 2023

• Introducing our 2023 Primary Care Quality Program
• Prenatal and Postpartum Service Codes
• Individual and Small Group Metallic Plans Chart Chase Program
• CPT® II Codes
• Medical Coverage Policies Updates

Summer 2023

• Individual and Small Group Metallic Plans Chart Chase Program
• End of the Federal Public Health Emergency
• Glucagon-Like Peptide 1 (GLP-1) Agonists for Weight Loss: Drug Shortages and Labeled Indications
• Medical Coverage Policies Updates 

Spring 2023

• QualChoice Performing Post-Payment DRG Clinical Validation Audits of Facility Claims
• Updated Forms Available on the Find a Form or Document Section of QualChoice.com
• Health Literacy and Patient Outcomes
• Appointment Accessibility Standards
• 27th Edition of Care Guidelines Now Available from MCG Health: Changes Effective June 1, 2023, for QualChoice Providers
• Medical Coverage Policies Updates

2022

Spring 2022

• Updating Demographic Information
• Prior Auth Updates for Some Imaging Services
• Medicare and Marketplace Medical Record Retrieval Projects (MRR)
• Managing Symptoms in Members with Allergies
• Medical Coverage Policies Updates

Winter 2022

• Submit Requests With Appropriate Documentation
• COVID-19: Vaccine Information
• Update for 270/271 Eligibility Requests
• Temporary Changes to Admission Requirements
• eRemits: An Enhancement for the Paper Check Process
• Medical Coverage Policies Updates

2021

Summer 2021

• Updated Telehealth & Virtual Services Guide
• COVID Update Effective June 1, 2021
• Updated MCG Guidelines
• Providing Quality Care
• Updated Provider Manual
• Medical Coverage Policies Updates

Spring 2021

• COVID Waiver Updates
• Upcoming Changes to Clinical Editing Rules
• High Tech Imaging Change
• Lawrence Health Hospital Services Pre-authorization List
• Avoid Imaging for Lower Back Pain
• Medical Coverage Policies Updates