New AutoAuth Services
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New AutoAuth Services

Thank you to all providers who are using our AutoAuth online pre-authorization system! We’re happy to announce that two new services have been added to the system.

Keeping Spirits Bright in the Winter
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Keeping Spirits Bright in the Winter

More than 50% of people will be diagnosed with a mental illness or disorder during their lifetime. Winter weather and holiday stress can affect our mental well-being, so now is a great time to take stock of your mental state.

Manage your blood sugar. Protect your eyes.
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Manage your blood sugar. Protect your eyes.

Besides being American Diabetes Month, November is also Diabetic Eye Disease Awareness Month.

Change in ACH Provider Payment System
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Change in ACH Provider Payment System

Providers: Effective July 1, ACH payments and the corresponding 835 remittances will no longer be distributed through Optum Bank.

Risk Adjustment Data Validation Audit
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Risk Adjustment Data Validation Audit

HHS has recently initiated audits of health plans subject to risk adjustment under the Affordable Care Act (ACA). QualChoice is included in this audit and we, along with our contracted providers, are required to fully comply.

Winner of Flu Shot $1000 Prize Drawing
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Winner of Flu Shot $1000 Prize Drawing

Jimmy Dean, an employee of QualChoice customer Dreamline Manufacturing in Cabot, was presented with a check for $1000 by Martha Borders, QualChoice Sr. Account Service Representative.

Requests for Urgent or Expedited Pre-authorization
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Requests for Urgent or Expedited Pre-authorization

PROVIDERS: For urgent or expedited pre-authorizations, please use the Pre-authorization Request Form—Clinically Urgent or Expedited, found at QualChoice.com. The patient must be in an urgent condition when using this form to request pre-authorization of services.

Winner of First Flu Shot Prize Drawing
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Winner of First Flu Shot Prize Drawing

Logan Hoskins, an employee of QualChoice customer Adventure Subaru in Fayetteville, was presented with a check for $2000 by Bonnie Pruett, QualChoice Regional Sales Manager.

Coverage UDPATE—Mental Health and Substance Use Disorder
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Coverage UDPATE—Mental Health and Substance Use Disorder

MEDICAL PROVIDERS: Please review these updated guidelines for our Outpatient Therapy for Mental Health & Substance Use Disorder medical coverage policy (BI273).

Final AutoAuth Drawing Winners
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Final AutoAuth Drawing Winners

Thank you for the great participation in our AutoAuth® online pre-authorization system! We’re proud to offer you this improvement, to help make healthcare better.