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Webinars endstream endobj 42 0 obj <>/Subtype/Form/Type/XObject>>stream EMC Prior Authorization Request Form Fax to 586-693-4829 Effective: 01/01/2020 Version: 12/10/2019 Page 2 of 2 SUPPORTING DOCUMENTATION The following documentation is not required but may be submitted. ��LZ�6Ȫ�cI��P`��Z�jw�i�F�?x��e�af ��*� �����aT�Շ��j(�3 endstream endobj 87 0 obj <>/Subtype/Form/Type/XObject>>stream EMC Forms - il.eqhs.com. endstream endobj 122 0 obj <>/Subtype/Form/Type/XObject>>stream /Tx BMC How To Guides; Register for a webinar; Archived Bulletins; Behavior Analysis. endstream endobj 56 0 obj <>/Subtype/Form/Type/XObject>>stream endstream endobj 41 0 obj <>/Subtype/Form/Type/XObject>>stream Prior Authorization Request Form Fax to 586-693-4829 Effective: 01/01/2020 Version: 12/05/2019 Page 2 of 2 SUPPORTING DOCUMENTATION The following documentation is not required but may be submitted. EMC endstream endobj 38 0 obj <>/Subtype/Form/Type/XObject>>stream Induction of Labor - Clinical Considerations and Recommendations. /Tx BMC endstream endobj 49 0 obj <>/Subtype/Form/Type/XObject>>stream Only submit clinical information that supports the request for service(s) to determine medical necessity or specifically requested byeQHealth Solutions. eQHealth Solutions is here to collaborate with your organization to help decrease your burden by managing your utilization review and prior authorization needs. 0 0 18 18 re The Prior Authorization Template can be used by hospitals as a tool to gather all the pertinent clinical information from the attending (surgeon) physician prior to submitting a request via eQSuite™. Health Details: Womens Health New in 2020 Prior Authorization with eQHealth Details: The portal is the preferred method for the submission of prior authorization requests, however requests can still be sent via fax by completing the new prior authorization form or by calling eQhealth directly at 866-356-3666. smart health prior authorization request form 0.749023 g Providers must complete and submit the Request for eQSuite Access form. 2 0 obj %%EOF �sr � � f EMC Type of Review Request Documentation All Types of Review Requests Documentation not included in the review request form that supports the medically necessity of the requested services. endstream endobj 70 0 obj <>/Subtype/Form/Type/XObject>>stream 0 0 18 18 re 225 0 obj <>stream H�2�37�402VH�2P0P0� ��T�4�B.C 4!�@8W����$�r� R�@Q��+� � Rn' endstream endobj 114 0 obj <>/Subtype/Form/Type/XObject>>stream H�2�37�402VH�2P0P0� ��T�4�B.C 4!�@8W����$�r� R�@Q��+� � Rn' �sr � � Details: eQHealth Solutions is the new vendor partner that is providing utilization management services for Ascension SmartHealth beginning Jan. 1, 2020. eQHealth has a portal to submit prior authorization requests which allows for immediate authorization in certain cases when criteria is met based on clinical documentation provided. endstream endobj 65 0 obj <>/Subtype/Form/Type/XObject>>stream ���2�s����BD*( /Tx BMC /Tx BMC Webinar Power Point Trainings. EMC endstream endobj 60 0 obj <>/Subtype/Form/Type/XObject>>stream EMC endstream endobj 73 0 obj <>/Subtype/Form/Type/XObject>>stream Only submit clinical information that supports the request for service(s) to determine medical necessity or specifically requested byeQHealth Solutions. endstream endobj 106 0 obj <>/Subtype/Form/Type/XObject>>stream endobj endstream endobj 75 0 obj <>/Subtype/Form/Type/XObject>>stream endstream endobj 34 0 obj <>/Subtype/Form/Type/XObject>>stream endstream endobj 111 0 obj <>/Subtype/Form/Type/XObject>>stream 30 0 obj <> endobj Solutions eQSuite® Technology Clinical Integration Framework Business Intelligence & Healthcare Analytics … Overview of Services A. eQHealth Solutions – Illinois’ Quality Improvement Organization eQHealth Solutions… endstream endobj 51 0 obj <>/Subtype/Form/Type/XObject>>stream Providers must complete and submit the Request for eQSuite Access form. endstream endobj 81 0 obj <>/Subtype/Form/Type/XObject>>stream Overview of Services A. eQHealth Solutions – Illinois’ Quality Improvement Organization eQHealth Solutions, Inc. (eQHealth), under contract to Healthcare and Family Services (HFS) since 2002, H�2�37�402VH�2P0P0� ��T�4�B.C 4!�@8W����$�r� R�@Q��+� � Rn' f /Tx BMC endstream endobj 36 0 obj <>/Subtype/Form/Type/XObject>>stream endstream endobj 104 0 obj <>/Subtype/Form/Type/XObject>>stream %PDF-1.7 /Tx BMC endstream endobj 113 0 obj <>/Subtype/Form/Type/XObject>>stream /Tx BMC /Tx BMC Access Forms; Provider Manuals; Codes that require prior authorization The Agency for Health Care Administration has contracted with a certified Quality Improvement Organization (QIO), eQHealth Solutions, Inc. to provide medical necessity reviews for Medicaid home health services. /Tx BMC H�2�37�402VH�2P0P0� ��T�4�B.C 4!�@8W����$�r� R�@Q��+� � Rn' /Tx BMC endobj 0 0 18 18 re It is intended to assist providers by streamlining the data submission process for selected services that require prior authorization. EMC Disclaimer Statement eQHealth Solutions … /Tx BMC H�*�2T B3*J� �sr � � EMC h�bbd```b``�� �)D2����"��"�p�����v�ɕ8��F�� �sr � � EMC endstream endobj 118 0 obj <>/Subtype/Form/Type/XObject>>stream /Tx BMC H�*�2T B3*J� endstream endobj 63 0 obj <>/Subtype/Form/Type/XObject>>stream ϰ�Spq��� ���2�s����BD*( EMC 0 0 18 18 re �h�,D�. eQSuite is eQHealth Solutions' proprietary, web-based, HIPAA-compliant prior authorization request system, which offers providers 24/7 accessibility to the information and functions providers need. endstream endobj 35 0 obj <>/Subtype/Form/Type/XObject>>stream 0 0 18 18 re /Tx BMC �sr � � EMC H�2�37�402VH�2P0P0� ��T�4�B.C 4!�@8W����$�r� R�@Q��+� � Rn' If the primary dx code submitted for Prior Authorization review changes, do we need to contact eQHealth to change it on the review? /Tx BMC %PDF-1.6 %���� �sr � � Effective March 1, 2016, eQHealth Solutions began performing prior authorization reviews for advanced imaging services, in accordance with Mississippi Administrative Code Title 23, Part 220 Radiology Services. f In the menu above, there are links to eQHealth Solutions Education resources, Contact information, the Advanced Imaging Provider Manual and forms, and Reconsideration Information. endstream endobj 83 0 obj <>/Subtype/Form/Type/XObject>>stream /Tx BMC 0.749023 g endstream endobj 62 0 obj <>/Subtype/Form/Type/XObject>>stream Access Forms; Provider Manuals; Codes that require prior authorization h�b```e````g`P�� Ȁ �@1v��yN0��I��{�l��i^uX D�@ `c`\% �s��,������Q����v]!���,���d� ˺0X1f0)0^�vd�k��(f4`P�p�|f� v`h`dPa�`�``P`p`d` ��\0W���8 � (��)V� e�1�/oSa�&tEn�Ƀ��G��i�p�N�wDd>P9� ���f`�(� ����=�Nf`�{$��"�.�F!�S�:1'��S�����KE��Ʒw��ޞ�6rc�֨)/ڕܜ��s��IĄ�� ?_�kYpwsX�MÄ�EW��j�X�"����F�e�b L�n� Home; Provider Resources. H�*�2T B3*J� /Tx BMC /Tx BMC EMC EMC 0.749023 g EMC eQSuite® Login. Fax request form - Non-Personal Care Providers. endstream endobj 103 0 obj <>/Subtype/Form/Type/XObject>>stream Solutions. endstream endobj 82 0 obj <>/Subtype/Form/Type/XObject>>stream endstream endobj 50 0 obj <>/Subtype/Form/Type/XObject>>stream �sr � � endstream endobj 99 0 obj <>/Subtype/Form/Type/XObject>>stream endstream endobj 100 0 obj <>/Subtype/Form/Type/XObject>>stream /Tx BMC EMC /Tx BMC Parent or Legal Guardian School Schedule Form. 0 0 18 18 re Our Utilization Review (UR) and Utilization Management (UM) workflows and processes include a network of professional service representatives backed by a highly experienced clinical staff of nurses and physicians. Home; Provider Resources. endstream endobj 57 0 obj <>/Subtype/Form/Type/XObject>>stream ��k�� Untitled Page. ���2�s����BD*( �sr � � EMC eQSuite® Provider Portal is an all access entry into your prior authorization requests and determinations. endstream endobj 84 0 obj <>/Subtype/Form/Type/XObject>>stream eQHealth Solutions 2050 - 10 Finley Road, Lombard, IL 60148 Business Phone: 630.317.5100 Business Fax: 630.317.5101 /Tx BMC /Tx BMC 0 0 18 18 re f EMC EMC Q14. H�*�2T B3*J� 0.749023 g ���2�s����BD*( /Tx BMC ɰI/�d�wdqd���DV!��I�*$�+0ԯDW��B���F����B�4g5�W���� ���dQ�l�`v��Nc�`��TT��@��=�d��"�� ���N30�'�P\��#����� � `~JM H�*�2T B3*J� How To Guides; Register for a webinar; Archived Bulletins; Behavior Analysis. eQHealth Solutions keeps the hospital community informed of Healthcare and Family Services (HFS) program changes and sends review notices and updates through communication sent by fax, mail or phone. Running multiple copies of eQHealth Suite at the same time will cause errors! Effective: March 1, 2014 Prior Authorization of Elective Procedures eQHealth Solutions 4 of 27 II. endstream endobj 86 0 obj <>/Subtype/Form/Type/XObject>>stream [zq�D/����u��(�U��W�>�n�V��G���Ի��7�{u�������4�3���{�y�{ww���>�:�2��+��x����;�HDzq��n6���F�7��|������|p���j&��*�f�Ö/��C��u��������̗+פ7�͗뼮�r�\n�&ϊ���0�l��ի�1�wL�C��˘�̴@��B�/��kJ�>����!kr�i����x&��m0������v��q�V`�|; b�6"�of�p2�AI衅��~ۺ�Iβ���Æ'� h'�� �K5G�,x,��L��s�C��� ��*��}�ᝪ�CU/Tup�3�T8���G�Pg /Tx BMC It is intended to assist providers by streamlining the data submission process for selected services that require prior authorization. 0.749023 g endstream endobj 116 0 obj <>/Subtype/Form/Type/XObject>>stream endstream endobj 121 0 obj <>/Subtype/Form/Type/XObject>>stream /Tx BMC EMC /Tx BMC endstream endobj 94 0 obj <>/Subtype/Form/Type/XObject>>stream f <> endstream endobj 123 0 obj <>/Subtype/Form/Type/XObject>>stream /Tx BMC Key dates for the eQ to Kepro transition Effective: March 1, 2014 Prior Authorization of Elective Procedures eQHealth Solutions 4 of 27 II. /Tx BMC Multi-faceted ability to receive UM requests via web-based entry on a provider portal, call center and/or fax submission and tracking.
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