Quality Results
News and Updates for Providers
January 15, 2020
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.

Claims for these members for 2020 dates of service should be sent to Ambetter. For information about services dated before 1/1, use your My Account portal at QualChoice.com. For information about services dated on or after 1/1, please use the Ambetter secure provider portal .

Pre-authorization requests for 2020 dates of service for members on these plans are being transferred to Ambetter.

QualChoice members on commercial employer group plans are not affected by this transition. 
Two New Services Added to AutoAuth
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: Wound Care in Home and Sleep Study in Lab. Learn more.  
New Change Healthcare/ECHO Health URL
The Change Healthcare Settlement Interface will move to a new web address on January 11, 2020. Please note the new URL and update your records and any bookmarks you may have. The original Settlement Interface URL will re-direct users to the new web address: https://UI.ECHOHealthinc.com/CHC.aspx

Read the ECHO Health announcement. For questions or concerns, contact ECHO Customer Service at CS_Requests@ECHOHealthinc.com or call 888.834.3511. 
Value-Based Care Programs Quality Data
A key element of our CPC+ and PCMH value-based care programs is the monitoring of quality data. We report data back to participating providers on 10 quality measures. Most data is generated from claims. However, you may have additional data that can improve your quality scores. Examples:
  • Medical records of a member who had a colonoscopy prior to enrollment with QualChoice.
  • Removal of a member who had a total hysterectomy from the cervical cancer screening measure.
Clinics must submit Category II CPT codes as eCQMs for these measures:
  • Controlling Blood Pressure
  • HbA1c Poor Control
  • Tobacco Use
To help improve your quality measure ratings, submit the Supplemental Data Submission Form , available on the My Account portal. For questions, email CPC+@qualchoice.com or PCMH@qualchoice.com
Medical Record Review—HEDIS 2019 Data 
QualChoice is compiling data for reporting on our 2019 clinical outcomes to measure performance against Healthcare Effectiveness Data and Information Set (HEDIS) standards. 

Change Healthcare will be collecting the medical records needed for HEDIS reporting on our behalf. Your office will be contacted by fax/telephone to coordinate record collection.  

Thank you for your help in this important project.  
Updated Forms
In The Media
To make sure you are using current QualChoice forms, please download from the Provider Forms page at QualChoice.com each time you need to use one.
Susan Jones joined KARK News at Noon to talk about how winter weather and holiday stress can affect our mental well-being. 

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