Quality Results
News and Updates for Providers
December 21, 2020
New Requirements for Availity 270/271 Eligibility Request
Effective December 15, 2020, QualChoice eligibility verification is being provided by Availity. Thank you for your patience as we make this transition from the services of Optum to the Availity system. To protect member information, the following elements are now required for all 270 requests:
  • Patient ID Number
  • Patient Date of Birth
  • Patient First Name and Last Name
For a successful eligibility test, please be sure to include all information specified above. Learn more and link to Availity registration information.
CMS Guidance on COVID-19 Vaccine Coverage
QualChoice is closely following advancements in the prevention and treatment of COVID-19, including vaccinations. To prepare for vaccine administration, CMS has begun to publish guidance for providers. Similar to other COVID-19 services, the vaccines will be offered at no cost to your patients. Review QualChoice coverage details and medical codes.
Coverage for COVID-19 Acute Transfers
In an effort to help facilities accept patients during the COVID-19 pandemic, QualChoice will auto-approve the initial seven days for lower levels of care for patients moving from an inpatient hospital setting. Review coverage details. 
Members to Receive New ID Cards
New ID cards, effective January 1, are being sent to members this month. The new card will feature the NovaSys Alliance Network logo on the back. There will be no changes to member benefits.
New Drug Formularies
New formularies for 2021 have been posted at QualChoice.com in the Member section: https://www.qualchoice.com/already-a-member/pharmacy-and-drug-formulary
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.
The QualChoice Communications team provided tips for caring for special needs kids during difficult times, published online by Little Rock Family magazine. 
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