How to Register for the Qualis Health Provider Portal for Wyoming Medicaid

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1 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

2 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 Advancing Healthcare Improving Health

3 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

4 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

5 What We Don t Do We do not receive financial incentives to deny or limit services 5

6 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

7 How to Get Started Go to 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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9 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 with your QHPP access information. 9

10 Where to Send your Packet Submit via: and or Fax: ( ) or Mail: Qualis Health Attn: WY Medicaid PO Box Seattle, WA

11 To Launch the QHPP 11

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14 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 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

15 QHPP User Guide The Qualis Health Provider Portal user guide is located on our home page just below the download of the registration packet. ( 15

16 Qualis Health Website Wyoming Medicaid Provider Resources Click on Healthcare Professionals (top of page) Select Wyoming Medicaid 16

17 Training WebEx Schedule Date Time (MST) Training Topic 9/18/ am-12pm How to register for the QHPP 10/3/ am Provider Review Request for Therapy (PT,OT & ST) 10/5/ am Provider Review Request for Behavioral Health 10/10/ pm Provider Review Request for Therapy (PT,OT & ST - repeat of 10/3/17 morning session) 10/12/ pm Provider Review Request for Behavioral Health (repeat of 10/5/17 morning session) 11/2/ pm Question and Answer session after 11/1/2017 go live 17

18 Qualis Health Contact Information Qualis Health Phone: (800) Fax: (877) Teresa Kirn RN Manager, Clinical Care Management (208) Deon Westmorland RN BSN CCM Director, Wyoming Medicaid Services (206)

19 Qualis Health Contact Information Utilization Review Toll-free Phone (800) Toll-free Fax (877) Utilization Review Hours 8:30am to 7:00pm MST Monday through Friday 19

20 Qualis Health Provider Portal Questions? 20