Quality Results
News and Updates for Providers
December 5, 2018
Medical Record Review ---   Affordable Care Act (ACA) 2018 Dates of Service
QualChoice is required by the Department of Health & Human Services (HHS) to submit data regarding our members enrolled in certain ACA-covered health plans. We have engaged Optum and CiOX Health (CiOX) to conduct a medical record review of a certain number of your patients enrolled in such plans.

A CiOX representative will work with you to provide retrieval options and a list of the requested members' medical records for services rendered from January 1, 2018 to December 31, 2018. Chart collection must be completed by March 15, 2019.

Thank you for your cooperation in this project. View medical record review letters and FAQs.
Coverage Guidelines: Mental Health and Substance Use Disorder (BI273)
Please review the guidelines for Outpatient Therapy for Mental Health & Substance Use Disorder medical coverage policy (BI273). 
Improving Healthcare with PCMH
QualChoice is proud to participate in the statewide Patient-Centered Medical Homes (PCMH) value-based care program. Participating PCPs are rewarded with population-based care management fees and performance-based financial incentives. QualChoice was one of the first payers to award performance payments for the 2017 CPC+ program and we look forward to doing the same for the 2018 PCMH program.  Learn more about PCMH and how to get started.
Value-Based Care Program Reminders
Thank you to our CPC+ and PCMH program participating providers for helping us improve healthcare! To complete our 2018 programs, please review care plan date and quality measure reminders.
New for Arkansas Works Program
Beginning January 1, 2019, Arkansas Works members ages 19-29 will be required to report an exemption or monthly work hours at accessarkansas.govMembers ages 30-49 became subject to the requirement last June.
Our dedicated Arkansas Works customer service reps can act as registered reporters to log in and report for members each month. We are also working to contact these members by email, text message, phone and in-home visits to ensure that they do not lose their coverage by failing to report. 
Starting in January, ID cards for new QualChoice members with coverage through the program will include the Arkansas Works logo. Arkansas Works information is also available at QualChoice.com.
Arkansas Works Coverage Now Available in NE Arkansas
Effective January 1, 2019 QualChoice will offer Arkansas Works coverage in NE Arkansas. No coverage through the program is offered in the Southwest and West Central regions of the state. View Arkansas Works coverage map.
It Pays to Use AutoAuth!
Thank you to all providers who are using our AutoAuth® online pre-authorization system! To encourage even more use, we've been drawing names from users of the system and awarding cash gift cards. October winners of $100 gift cards
Medical Coverage Policies Updates
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
Jacqueline Hilburn joined KATV's Good Morning Arkansas to discuss how consuming too much sugar can lead to health problems like weight gain and obesity, type 2 diabetes, and heart disease.

In the Community
Youth Home helps youth, adults and families become healthier contributing members of the community by providing compassionate emotional and behavioral health care. The Dove Tree program provides gifts to residential patients. In December, volunteers help wrap donated gifts.

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