Quality Metrics Tracking Improvement Program

(QTIP) resumes operations

Empower is pleased to announce that the Quality Metrics Tracking Improvement Program (QTIP) has resumed conducting site visits and data distribution with participating Psychiatric Residential Treatment Facility (PRTF) and sub-acute inpatient providers this quarter.

Through the QTIP, Empower shares provider specific and aggregate data on key performance measures, including seven day and thirty day outpatient follow up after inpatient discharge, readmission rates to inpatient or residential levels of care, length of stay patterns, and trends related to discharge planning and care coordination. These measures are aligned with broader quality improvement priorities and help identify opportunities to strengthen continuity of care, reduce avoidable readmissions, and promote stabilization in the community.

The QTIP works to build collaborative relationships between Empower and these high-impact providers while sharing data that otherwise would not be accessible. The program is intentionally collaborative. Data is not shared in isolation, but reviewed together to better understand root causes, barriers to timely follow up, and opportunities for process improvement. Discussions often include strategies to enhance discharge planning, improve communication with outpatient providers, address social determinants of health, and reinforce member and family engagement prior to discharge. By working cooperatively, Empower and providers can implement targeted interventions that support sustained recovery and improved long term outcomes for members.



Empower remains committed to enhancing the QTIP and will continue to stay actively engaged with providers as we advance this mission together.



Empower announces 2025 Medical Record Documentation Review results

The 2025 Empower Medical Record Documentation Review (MRDR) has been successfully completed, and results were shared with all participating providers by Dec. 11, 2025. We are proud to report that 100 percent of participating providers submitted records for review, demonstrating strong program engagement and collaboration across provider partners.

The Scoring Categories were as follows:

Excellent: 85-100%

Acceptable: 70-84%

Needs Improvement: Below 70%

The overall quality of documentation was solid, and providers achieved the following results:

Primary Care and Pediatric Care                

·      Excellent: 1 provider

·      Acceptable: 4 providers

Behavioral Health

·      Excellent: 4 providers

·      Acceptable: 1 provider

These results reflect our collective commitment to accurate, high-quality medical record documentation. They highlight both areas of excellence and opportunities for continued improvement as we work to further strengthen documentation practices across all services.

Process Overview

For this project, documentation records from 50 members who received care in 2024 were randomly selected from a list of paid claims. Ten providers across primary care, pediatrics, psychiatry, and psychology were included in the review, with five member records per provider requested. Up to 60 desirable documentation items were assessed for each member.

Medical record requests, tailored by specialty, were sent via mail, fax, and/or email beginning in October 2025. Follow-up efforts continued through November 2025, including outreach to both the providers’ clinics and third-party medical record vendors.

The most commonly missing documentation items were:

• HIPAA/Privacy Policy signed by the patient and/or guardian
• Consent for Treatment with the member’s dated signature
• Documentation that an Advance Directive was offered to members aged 18 and older
• Documentation of a Chlamydia screening for sexually active women
• Clear and organized immunization documentation, including past and current vaccines, and record of all administrations by the provider
• Guardianship information for minors or adults with a legal guardian

Thank you to all providers for your participation and dedication to maintaining top-tier documentation standards. Any provider receiving a letter, who has questions, should reach out to Kacy Forrester BSN RN, Medical Records Review Coordinator at kacy.forrester@empowerarkansas.com.

Empower's new Third Party Administrator (TPA) brings faster, smarter systems to all providers

Empower is thrilled to announce that Empower's new Third Party Administrator (TPA) is here, bringing with it a suite of faster, smarter systems designed to enhance the healthcare experience for both providers and members! This exciting advancement is set to streamline processes and improve care coordination, especially for those with complex needs. Empower encourages providers to share this vital information with the individuals in your organization who are responsible for implementing these action items, as collaboration is key to our collective success.

While we’re excited about our new platform and all the benefits it can bring, we acknowledge that some providers have had some issues with the transition. We sincerely apologize for these issues and thank them for their patience. We look forward to continuing to partner with them moving forward.

For your convenience, please note the important resource information:

Important Resource Information

BH/IDD UM Fax –

Prior Authorization

800-886-6839

Medical UM Fax –

Prior Authorization

800-878-8264

Pharmacy Express Scripts Fax –

Prior Authorization

877-251-5896

Mailing Address

PO Box 211446, Eagan MN, 55121

Provider Services Phone Number

855-429-1028

New Portal Link

https://getempowerhealth.com/for-providers/provider-portal/

Provider Services (Intake)

855-429-1028

Intake Email

intake@empowerarkansas.com

UM Email

UM@empowerarkansas.com


Zelis Registration https://empowerhealthcaresolutions.epayment.center/Registration

Zelis Client Service Phone Number

855-774-4392



Zelis Provider Support

https://empowerhealthcaresolutions.epayment.center/

The Empower Provider Portal is now available, Prior Authorization feature is live

The Empower Provider Portal is now available to use and the Prior Authorization feature is now live. Please see the user guides below that will help providers navigate the new portal and tools.

When registering on the portal as an Administrator, please select “Vendor Administrator” in order to prevent delays in the approval process.



Click on user guides below to help you navigate the new portal:

1. Provider Portal Registration User Guide
2. Provider Portal New User Setup User Guide
3. Provider Portal User Creation User Guide
4. Provider Portal Claims Details User Guide
5. Provider Portal Claims Submission User Guide
6. Provider Portal Prior Authorization User Guide
7. Provider Portal How to Submit a Claim Video



If you need assistance, contact Empower’s Provider Service Line at 855-429-1028 or email at EmpowerHealthcareSolutionsPR@empowerarkansas.com.

Need assistance submitting a claim?

Submitting a claim doesn’t have to be difficult. At Empower Healthcare Solutions, we want to make the process as simple as possible for our provider partners.

To help, Empower created a short step-by-step video that shows how to submit a claim in the Provider Portal. The video walks through how to find a member, enter provider information and complete the claim details. It also shows how the portal can help save time by automatically filling in some information.

The claim process has three main steps. Providers search for the member, enter provider and facility information, and then add the claim details. Members can be found using their Empower Member ID or by entering their name and date of birth.

The portal also helps save time by filling in some information automatically when providers enter their NPI number or tax ID. After entering service dates, diagnosis codes, procedure codes, and billing amounts, providers can review their information.

If everything looks correct, providers can simply click the submit button to send the claim.

This video can be found on the Empower website.

Empower Provider Network and Portal Overview Webinar

Please join us for the "Empower Provider Network & Portal Overview Webinar" hosted by our Provider Relations team on Thursday, April 2 at 3 p.m. which you can register for at the button below.

First, we would like to extend our sincere appreciation for your patience and understanding throughout the launch of our new administrative enhancements. We recognize that transitions like these can bring challenges, and your flexibility, collaboration, and continued commitment have made a meaningful difference every step of the way.

Your partnership is truly valued, and we are grateful for the trust you place in us as we work to improve processes and better support you and the members we serve. Thank you for your dedication, your resilience during this transition, and for being such an important part of our provider community.

This webinar will cover the process of credentialing providers with Empower. We will also give a brief overview on how to navigate the provider portal which will include where to find detailed user guides and videos for more in-depth training as needed.

Please register for the webinar at the button below.

If you have questions, please contact Provider Relations at: EmpowerhealthcaresolutionsPR@empowerarkansas.com.

Thank you for your continued partnership and commitment to serving our members.

Empower Healthcare Solutions

www.getempowerhealth.com