eQHealth Solutions Customer Service:

Monday - Friday (except Florida state recognized holidays)
8:00am - 5:00pm (ET)
855-444-3747 (toll free phone)
855-440-3747 (toll free fax)

Fair Hearing
As of March 1, 2017 The Fair Hearing Process has moved from being managed by DCF to now being managed by AHCA.  The letters from eQHealth will be updated with the new information by the first of April until that time please be notified that the contact information for Fair Hearing is as follows:

You may ask for a fair hearing by contacting AHCA by telephone at (877)-254-1055, by fax at (239)-338-2642, in writing at, Agency for Health Care Administration Medicaid Hearing Unit P.O Box 60127 Ft.Myers, FL 33906 or by email at MedicaidHearingUnit@ahca.myflorida.com

Hospital UR PLANS

The review process for 2017 UR PLANS has begun.  We will review your submission, suggest any recommendations if needed and respond back with the results.  If recommendations are made you will be afforded the opportunity to make any changes or corrections and resend the UR PLAN back in for review.  Please note that the deadline for your submissions are May 31st 2017.  Any submissions received after the deadline will not be reviewed.  

If you have any additional questions please contact urplans@eqhs.org

Please note that as of April 10th, 2017, eQHealth Solutions will no longer be accepting faxed or emailed requests for PACWAIVER requests. These reviews will need to be entered in by your organization online via eQSuite.  

Please note that on August 1st, 2016, eQHealth Solutions will no longer be accepting faxed in inpatient or advanced diagnostic imaging requests. These reviews will need to be entered in by your organization or the respective provider via eQSuite online. Any faxed in requests specified above on or after August 1st, 2016, will not be reviewed.

Please note that as of October 15, 2016, eQHealth Solutions will no longer be accepting faxed in multispecialty requests. These reviews will need to be entered in by your organization or the respective provider via eQSuite online.  Any faxed in requests specified above or after October 15th, 2016 will not be reviewed.

If you would like assistance regarding entering in review requests via eQsuite, please refer to our online User Guide for assistance.  If you have questions, please contact Provider Outreach at PR@EQHS.ORG.

How To Enroll As A Provider To Submit Reviews Online Using eQSuite

1) Find and download the appropriate Contact Form below for your service type.

2) Fill out the contact form, making sure that it is legible and knowing that the system administrator will receive an email with the initial username and password once the Contact Form has been processed.You may fax, email or mail this form in. FAX 855- 440-3747 EMAIL: pr@eqhs.org

3) After receiving the email with the username and password, the system administrator will then have access to login and to submit requests online. The system administrator can then assign additional usernames and passwords to those under that provider Medicaid number assigned. For more information regarding the System Administrator, please see the link below.

4) If you need further assistance with the process, please call customer service at 855-444-3747 or EMAIL: pr@eqhs.org

Please  note that if you are submitting CDC+ reviews or Care Coordination requests, these are not currently submitted online and instead should either be faxed or mailed in. Authorization forms are under Forms and Downloads under each appropriate tab at the top. Thank you.

Statewide Inpatient Psychiatric Services (SIPP) Access Form

Dental Access Form

Diagnostic Imaging Access Form

DME Access Form

Home Health /PCS Access Form

Inpatient Access Form

Physician Access Form

PAC WAIVER Access form

Therapy Access Form

System Administrator Guide


eQSuite Login

eQSuite is our proprietary web-based, HIPAA compliant prior authorization system which offers providers 24/7 accessibility to the information they need.

#1  How to Improve your DRG Review Outcome – Helpful FAQs from eQHealth Solutions

 Please provide supportive rationale for inpatient admission on the day of admission, including presenting signs and symptoms and medication administration (especially intravenous fluids and medications) as well as all other treatments or interventions.  Please provide the patients previous medical history, including outpatient management, as relevant to the admission.  For surgical admissions, please clarify if the request is for a pre-op day or day of surgery.  If the patient is being converted from observation to inpatient, please provide supportive rationale for the day the patient is converted to inpatient.       

# 2   How to Improve your Undocumented Citizen Review Outcome

These reviews are for consideration of  the clinical support of a life threatening emergency requiring acute admission and the determination of dates covered is through the stabilization of that emergency.

Clinical supporting documentation should include relevant past medical history; the reason for admission to the hospital with focus on the emergent condition and all interventions delivered to relieve that emergent situation. Daily supporting documentation should address the need for continued inpatient treatment.  Daily documentation should include, at a minimum, interventions performed and medication administration.  Documentation in the record of when the health care team identifies stabilization of the emergent condition occurs is helpful as the staff caring for the recipient has the most knowledge of the status of the recipient.

 For Dialysis:

If patient has history of End Stage Renal Disease or presents with Acute Renal Disease the supporting documentation should indicate the first date of dialysis and all subsequent dates of dialysis during that hospital stay.

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eQHealth Solutions - Florida Division

The Agency for Health Care Administration (Agency)  entered into a contract with eQHealth Solutions, Inc.  for utilization management, including prior authorization of the following Medicaid services: 

    Inpatient Medical and Surgical Services
    Personal Care Services
    PAC Waiver Services
    ADI (Advanced Diagnostic Imaging)
    Home Health Services 
    Prescribed Pediatric Extended Care (PPEC) Services
    Therapy Services 
    Durable Medical Equipment (DME)
    Dental Services
    Multi-Specialty Services

 eQHealth Solutions, Inc. is a non-profit health care quality improvement, utilization management and health information technology organization, providing a wide range of efficient and effective solutions to our clients.  Services include: prior authorization and  utilization review, care coordination, quality improvement activities, medical record review, health and wellness, and quality review services for home and community based waiver programs. eQHealth Solutions is a market leader in assisting health care providers to adopt  information technology services to improve the quality of care offered to their patients.

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