Resources and Support for Our Provider Partners

Take advantage of these updates and enhancements to our online tools

New Pharmacy Benefit Manager (PBM) and 2025 Forms:

The documents on our pharmacy page have been updated to reflect the change to our new PBM, Express Scripts (ESI). On this page, you can find our updated network list and formulary. You can also find forms specific to ESI for prior authorizations, home delivery, and override exception requests.

Visit our pharmacy page today to learn more. 

Provider Portal Enhancements:

We are pleased to announce that we have upgraded our provider portal. The new portal is faster and more secure, allowing for a seamless user experience. You can also manage your account on the go with a new mobile-friendly interface. 

Key features include:

• Check member eligibility and benefits
• Search and view claims and RAs
• Search and view referrals and prior authorizations
• Generate useful reports

For an overview of things you can do in the portal, view the full list here.



Policy Updates

QualChoice routinely reviews and updates policies in accordance with state and federal guidance. For detailed information on our 2025 policy updates, please visit our policy page.

Speed Up Approvals With Evolent’s Conservative Treatment Forms

When you’re working to get a patient’s treatment approved, timing is crucial. Denials or delays can be frustrating for providers and patients. To reduce the likelihood of denials or delays when requesting services managed by our vendor, Evolent, please be mindful that there are service-specific forms for your use that relay necessary information about your request.

If you are requesting services for advanced imaging, musculoskeletal surgery, or interventional pain management and need to document and submit conservative treatment history for these issues, please utilize the forms available at RadMD.com/resources/conservative-treatment-forms. They provide information essential to understanding the patient’s care history and can reduce the amount of time needed to gather additional information by the utilization team.

Thank you for trusting QualChoice as your healthcare partner. If you have any questions or concerns, please call us at 501-228-7111 or 1-800-235-7111 (TTY: 711). We are available Monday through Friday from 8 a.m. to 5 p.m. CT.