QualChoice Health Insurance                                                                      Spring 2014
Quality Results QualChoice Provider Newsletter
Alerts & Reminders
 
Online Provider Manual 
is Complete!
We are happy to announce that our online Provider Manual is now complete!  Read More

Be Sure to Use In-Network Services 

Referring patients to out-of-network laboratory or pathology groups violates your provider's agreement with QualChoice, and causes patients to pay significantly more for these services.  Read More

 

Fee Schedules
Effective April 1, 2014, QualChoice will adopt the 2014 Resource Based Relative Value System (RBRVS) Relative Value Units (RVUs). RVUs are used as a basis for fee schedule calculations. If you have any questions regarding your contracted fee schedule, please contact your Provider Relations Representative

ARBenefits Requires Pre-Certification
Reminder: ARBenefits now requires pre-certification for all inpatient hospital admissions. Read More
 
Verbal Approvals for Authorization Requests

As a QualChoice network provider, you will receive a verbal approval when requesting an authorization. Please inform your patient at that time that the request has been approved. Thank you for your cooperation.

 

CareCore Pre-Authorization Process  

Effective January 1, CareCore National, LLC, manager of our high-tech radiology pre-authorization, no longer accepts faxed case initiations for QualChoice members. New cases must be initiated at the physician web portal at CareCoreNational.com. Read More

 

Updated Drug Formularies 

Updated Basic, Core and Enhanced formularies, effective January 1, have been posted, as well as the Essential Formulary for all ACA Qualified Health Plans -- Gold, Silver, Bronze, Catastrophic.

QualChoice & Industry News
QualChoice in Arkansas Health Insurance Marketplace

QualChoice is participating in 5 of the 7 exchange regions of the state. Read More


Mike Stock -- One on One

Read an in-depth interview with QualChoice CEO Mike Stock in the January/February issue of Healthcare Journal of Little RockRead More 

Claims Corner

ClaimCheck Plus Modifier Tips 

Make sure modifiers are valid for procedures; if they are not, the claim line will be denied. Read More

 

Medical Policy Review


In This Issue

Provider Network Territory Map 

Find your QualChoice Provider Representative 
and their contact information by viewing the 

 


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QualChoice Health Insurance | newseditor@qualchoice.comhttp://www.qualchoice.com
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Issue 1402 NS 002 -- Spring 2014
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