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Behavior Analysis Providers
Provider Alert from the Agency For Health Care Administration:

Public Meeting for Proposed Behavior Analysis Changes

The Agency will host the first public meeting in a series of statewide meetings to introduce proposed changes to behavior analysis services covered under the Florida Medicaid program. Changes are being made to ensure children receive the right service, at the right time, and by the right provider.

The Agency is proposing to implement changes related to provider enrollment, service authorization, electronic visit verification, and payment of behavior analysis services over the next several months, with full implementation by July 2019.

The meeting will take place on Friday, March 29, 2019, from 10:30 – 11:30am EDT, at:
Agency for Health Care Administration
2727 Mahan Drive
Building 2
Tallahassee, Florida 32308

There will not be a phone call-in number available however, future statewide public meetings will take place and be noticed to providers.


Public Meeting for Proposed Behavior Analysis Changes (Click Here)


Attention All Hospital Providers:

As part of eQHealth Solutions’ contract with the Florida Agency for Health Care Administration (the Agency), eQHealth Solutions is required to annually review the utilization plans for all Medicaid participating hospitals to ensure compliance with the Code of Federal Regulations Title 42 Part 456 (Utilization Control §456.60–§456.145). Please be aware that hospitals must adhere to the submission timelines provided by eQHealth Solutions, which reflect the Agency’s guidelines.

• ALL 2019 UR PLANS MUST BE SUBMITTED NO LATER THAN JUNE 15th, 2019.

•INCLUDE YOUR MEDICAID PROVIDER ID # ON YOUR PLAN AND ALL HOSPITALS YOUR ID# COVERS.

•INCLUDE A CONTACT PERSON WITH THEIR EMAIL AND A PHONE NUMBER SHOULD WE HAVE ANY QUESTIONS.

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, the corrections must be received prior to the deadline.


Provider Alert from the Agency For Health Care Administration:


Important Upcoming Policy Change Reminder: New and Enhanced Self-Service Web Portal Features FL Medicaid Policy Change Reminder (Click Here)



Behavior Analysis Providers:


Untimely Authorization Requests:

This is a reminder that Behavior Analysis Services are to be submitted as Prior Authorization.  Any cases submitted for dates of service that are not current are considered untimely and will be cancelled. Please refer to our Phase 2 Provider Training, Page 40 and 43. You can also refer to AHCA’s Authorization Requirements Coverage Policy Bullet 2.0 via the following link FL Medicaid Authorization Requirements Policy  Retrospective requests will be permissible if the recipient has Retroactive Medicaid eligibility or as specified in the policy. 

2.0 Authorization Requirements 
   2.1 When to Request Authorization 

  • Providers must obtain authorization prior to rendering Florida Medicaid-covered services, except in an emergency, when: 
  • Specified in the service-specific coverage policy or the applicable Florida Medicaid fee schedule(s).
  • Services will be performed out-of-state.

Thank you in advance for your cooperation.







 




 

 

    
eQSuite

 

eQSuite Login

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

Standard corporate-wide system patching is done on the third Wednesday of each month. Please be advised that users may experience intermittent connectivity issues, between the hours of 8pm and 1am Central time. We appreciate your cooperation and understanding as we work to maintain peak efficiency with our system(s).



eQHealth Solutions Customer Service:

Monday-Friday (Except Florida state Recognized holidays)
8:00 am-5:00pm (Est)
Phone:855-444-3747
Fax:855-440-3747


Provider Alerts
The Florida Medicaid program has an email alert system to supplement the present method of receiving Provider Alerts information and to notify registered providers or interested parties of "late-breaking" health care information.  To sign up click on the link below.

FL Medicaid Provider Alerts (Click Here)



 

eQHealth Staff Login Only

 

 

 

 

 

 

 

 

 

  
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
    Behavior Analysis
    Personal Care Services
    Advanced Diagnostic Imaging (ADI)
    Home Health Services 
    Prescribed Pediatric Extended Care (PPEC) Services
    Therapy Services 
    Durable Medical Equipment (DME)
    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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