Submit Additional Data
A key element of
our CPC+ value-based care program
is the monitoring of provider data on 10 quality measures. Most is generated from claims, but you may have additional data that can improve your quality scores. Examples:
- Medical records of a member who had a colonoscopy before enrolling with QualChoice.
- Removal of a total hysterectomy patient from the cervical cancer screening measure.
To send additional data, complete the
Supplemental Data Submission Form
, available on the
: Category II CPT codes must be submitted as eCQMs for these measures:
- Controlling Blood Pressure
- HbA1c Poor Control
- Tobacco Use
QualChoice Individual Plans ONLY Transferred to Ambetter
As of January 1, 2020, QualChoice
individual plans only
are being administered by Ambetter from Arkansas Health & Wellness. This includes Arkansas Works, Health Insurance Marketplace (Healthcare.gov) and IQChoice ACA-compliant plans.
Wellness Appointment Outreach
The CPC+ program includes incentives for member wellness visits.
QualChoice has established a prospective risk adjustment program to assist at-risk members in scheduling their annual wellness visits. Dedicated analysts connect the member and provider by phone to schedule the visit.