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Qualis Health

Nebraska Medicaid, Web-Based Utilization Review

OverviewTools & FormsContactsWeb-Based Utilization Review

Qualis Health Introduces Web-Based Utilization Review via iEXCHANGE® A browser-based application that uses a secure Internet connection to allow healthcare providers to submit utilization review requests

Features

  • Submit requests and review status at any time
  • Complete questionnaires that may impact the request status
  • Enter only information pertinent to InterQual criteria
  • Receive authorization number for billing automatically when request is approved
  • Print confirmation page with request information
  • Application is intuitively designed, and requires minimal training
  • No software required only Internet access
  • No cost to providers for usage or training

Security
To support compliance with HIPAA regulations, providers will be uniquely identified by the combination of their iEXCHANGE identification and individual user identification. Providers will be able to change passwords and have the ability to add and maintain users. Additionally, users will automatically be logged off after a designated period of inactivity.

Accessibility
To access iEXCHANGE, open a browser and use the Internet address (URL) to connect. To enter data, select your group and the type of review requested. Then, enter all necessary information to submit the request. After users submit their request, it is immediately available to Qualis Health to begin the review. Users will receive confirmation of the days authorized and the next review due date and Case ID number. Providers can view updated status or comments from Qualis Health and respond to those comments. A treatment update message displays when the provider selects the group. Updates are triggered if the status has changed or a comment has been added.

Questions or Comments?
Please contact:

Flipper Harris, RN, CCM, Provider Relations Coordinator at 800-949-7536 ext. 2762, or flipperh@qualishealth.org

Char McElligott, Customer Relations Coordinator at 800-949-7536 ext. 2652 or
charm@qualishealth.org


 














 










Do you have previous experience with web-based utilization management?



Your Preference for scheduling a 2-3 hour training session for you and your staff would be during the month of:


  
Last updated on: Thursday, June 19, 2008 2:55 PM
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