How to Register for the Qualis Health Provider Portal for Wyoming Medicaid Teresa Kirn, RN Manager, Care Management Department Sept 18, 2017 Advancing Healthcare Improving Health
One of the nation’s leading healthcare consulting organizations, partnering with our clients across the country to improve care for millions of Americans every day www.qualishealth.org Advancing Healthcare Improving Health
Qualis Health • A private nonprofit organization established in 1974 • Corporate Office located in Seattle, Washington with regional offices in Alabama, Alaska, District of Columbia, Idaho, Kansas, and New Mexico • Have provided care management to Medicaid and Private contracts since 1984 3
What We Do • Contract with Wyoming Medicaid to review for select outpatient services: – Durable Medical Equipment (DME), – Home Health Services (HHS) and soon to add Physical Therapy (PT), – Occupational Therapy (OT) and Speech Therapy (ST) and Behavioral Health visits. • We will use InterQual and organizational policies to conduct our review • Offer telephonic provider education • Provider review support resource accessibility on our webpage 4
What We Don’t Do We do not receive financial incentives to deny or limit services 5
Objectives • How to register for the Qualis Health Provider Portal (QHPP) • Review upcoming training sessions specifically for Therapies (PT, OT and ST) and Outpatient Behavioral Health on how to submit a request. 6
How to Get Started • Go to http:www.qualishealth.org • At top of the page hover over ‘ Healthcare Professionals ’ and choose ‘ Wyoming Medicaid ’ • Left side navigational panel: select ‘ Provider Resources ’ • Scroll to middle of ‘ Provider Resources ’ page to download the registration packet 7
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What to return to Qualis Health • Executive Agreement • Provider Portal Administration Agreement • Provider Portal Administration Registration Form After Qualis Health processes your registration packet, you will receive an email with your QHPP access information. 9
Where to Send your Packet Submit via: • Email : jorgw@qualishealth.org and teresak@qualishealth.org or • Fax : 206-288-2356 (1-877-523-1148) or • Mail : Qualis Health Attn: WY Medicaid PO Box 33400 Seattle, WA 98133 10
To Launch the QHPP 11
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Lost Password • Qualis Health Provider Portal enables users to reset their user password by answering a predefined password reset question. This password reset question is created in Edit My Profile . If you have not created a password reset question and answer in your Profile page, you will not be able to generate a new password yourself. • In this case, you will need to ask your Provider Portal Administrator to reset your password for you. • If you are the Provider Portal Administrator and you need your password reset, please email Qualis Health: jorgw@qualishealth.org and teresak@qualishealth.org . • In the case of lost password or to reset your password, in the Qualis Health Provider Login screen, click the Forgot Password link. This displays the Login Details screen. 14
QHPP User Guide • The Qualis Health Provider Portal user guide is located on our home page just below the download of the registration packet. (http://www.qualishealth.org/sites/default/files/WY-Medicaid-QHPP-User-Guide.pdf) 15
Qualis Health Website Wyoming Medicaid Provider Resources • www.qualishealth.org • Click on Healthcare Professionals (top of page) • Select Wyoming Medicaid http://www.qualishealth.org/healthcare-professionals/wyoming-medicaid 16
Training WebEx Schedule Date Time (MST) Training Topic 9/18/2017 11am-12pm How to register for the QHPP 10/3/2017 10-11am Provider Review Request for Therapy (PT,OT & ST) 10/5/2017 10-11am Provider Review Request for Behavioral Health 10/10/2017 2-3pm Provider Review Request for Therapy (PT,OT & ST - repeat of 10/3/17 morning session ) 10/12/2017 2-3pm Provider Review Request for Behavioral Health ( repeat of 10/5/17 morning session ) 11/2/2017 1-2pm Question and Answer session after 11/1/2017 go live 17
Qualis Health Contact Information Qualis Health Phone: (800) 783-8606 Fax: (877) 810-9255 Teresa Kirn RN Manager, Clinical Care Management (208) 383-5960 teresak@qualishealth.org Deon Westmorland RN BSN CCM Director, Wyoming Medicaid Services (206) 288-2347 deonw@qualishealth.org 18
Qualis Health Contact Information Utilization Review Toll-free Phone (800) 783-8606 Toll-free Fax (877) 810-9265 Utilization Review Hours 8:30am to 7:00pm MST Monday through Friday 19
Qualis Health Provider Portal Questions? 20
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