Quality Results
News and Updates for Providers
March 1, 2018
Medical Record Review for HEDIS Reporting
QualChoice is compiling data on 2017 clinical outcomes to demonstrate performance on Healthcare Effectiveness Data and Information Set (HEDIS) standards, which are designed to help consumers compare performance across plans. The process started in February and will continue through mid-May 2018. Complete Provider Resource, a medical record retrieval company, will contact your office by fax and telephone to collect medical records on our behalf.
NEW! AutoAuth ® Maternity and DRG Notifications
We're excited to announce that online maternity and DRG notifications are now available through AutoAuth! 
Helping PCPs Improve Healthcare
We're making healthcare better by working with providers, other insurance firms, and state and federal groups to help PCPs move from volume-based care to value-based care . QualChoice participates in the Patient Centered Medical Homes (PCMH) and Comprehensive Primary Care Plus (CPC+) programs.  And we're  educating our members  about these initiatives.
CPC+ News
Our medical policy  Tele-Screening for Diabetic Retinopathy (BI570)  went into effect on January 1, 2018. Coverage for this service can help improve metrics for diabetic eye screenings.  New reports are available online and we have some important reminders.
Health Tips for Members at QualChoice.com
To encourage our members to discuss their health concerns with you, we regularly post helpful information at QualChoice.com. During 2018, this includes a monthly post to assist with quitting tobacco. 
Stay Up-to-Date on Medical Policies
Check your inbox on the first day of each month to find QualChoice New & Amended Medical Policies and Coming Amendments.

Medical Coverage Policies Updates for March 2018

View a specific medical coverage policy.

Updated Forms
To make sure you are using current QualChoice forms, please download directly from the Forms page at QualChoice.com each time you need to use one.
In the Media
Yvette Coleman of QualChoice joins THV11 to discuss the reasons everyone should know their blood pressure numbers.

In the Community
2018 Springfest  ---  Save the date! Join us on April 7, 2018!

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