Coming Soon - ECHO Health EFT Provider Payment System
Electronic Funds Transfer (EFT) is required for all QualChoice participating providers. Beginning in early January, EFT will be through ECHO Health, Inc. If you are not already registered with ECHO Health, please sign up now by calling 844.586.7463 or
email Change Healthcare.
Get pre-authorization with MCG Cite AutoAuth now for many common inpatient surgical procedures and Home Health visits. More procedures will be added in the near future. With AutoAuth, you receive immediate authorization and confirmation-and you can print your approval letter!
No Out-of-State Coverage for Individual Metallic Members in 2018
Non-emergency services provided outside the QualChoice service area for Individual Metallic Members will require pre-authorization in 2018. This means elective services by out-of-network providers outside Arkansas will not be covered by the member's policy.
QualChoice is evaluating freestanding imaging centers as alternatives to outpatient departments. The goal is to provide members with access to safe, quality MRIs and CT scans that are also cost-effective.
Because there is limited evidence that routine Intraoperative Neurophysiologic Monitoring (IOM) procedures can prevent damage in certain surgeries with increased risk for nervous system injury, IOM requires pre-authorization. In addition, remote IOM procedures are not covered and the member will incur the total expense.
Changes Coming to Member Explanation of Benefits (EOB)
To improve member communications, QualChoice is making important changes to member statements (EOBs). These changes include delivery at 14-day intervals. All services by all providers in a statement period will be contained in a single EOB.
Effective December 1, 2017, QualChoice will implement limits on the number of Morphine Milligram Equivalents (MME) a member can receive at any given time of a Short-Acting Opioid (SAO) medication (brand or generic). These limits are based on The Centers for Disease Control (CDC) Guideline for Prescribing Opioids for Chronic Pain-2016.
In 2017, all members of QualChoice individual metallic plans (Bronze, Silver, Gold, Platinum and Catastrophic) were required to choose a primary care provider in 2018, and this policy will continue in 2018. Members who do not choose a PCP will be assigned one based on their claims history, but will be allowed to change their PCP if needed. Members who have not seen their assigned PCP will be placed in an unassigned PCP status. Before seeing these members, specialists will need to refer them to PCPs.
