eQHealth Solutions, the QIO-like organization for the Arkansas Department of Human Services (DHS), provides utilization and quality control peer review for Personal Care services to qualifying Arkansas Medicaid beneficiaries ages 21 and older.

 

eQ Health will review and process Personal Care PA Requests (including without limitation new, renewal, modification, closure, and provider change requests) for Medicaid beneficiaries who are twenty-one (21) years of age or older and who are not ARChoices Medicaid Waiver beneficiaries. For each request, eQHealth shall make determinations to approve or deny, in whole or in part. eQ Health will also refer each beneficiary with the request of Personal Care for an Independent Assessment. 

 

               

Provider Update

Vol 1 No 2    July 12, 2019 

Personal Care Services – Extension Requests

 

eQHealth Solutions has received important clarification from Arkansas Department of Human Services (DHS) for Personal Care Services regarding extension requests.

 

The following grid highlights the various scenarios regarding when an extension request for a temporary authorization will be reviewed by eQHealth and the corresponding determination.

 

Please note these changes will take effect immediately.

                                    

PCS Extension Request

Action

Member has scheduled assessment in ARIA

eQHealth will approve extension until the reassessment is completed. Once eQHealth has received the completed Individual Assessment from Optum, we will review and make a final determination.

Extension is requested during the 20-day period that Optum is attempting to contact the member for reassessment.

eQHealth will approve an extension through the 20-day period. eQHealth will send notice of action letter during this time so the end date of the extension aligns with the end date of Optum’s 20-day period.

Extension is requested after the 20-day period and referral  has been closed by Optum.

Extension requests received after the 20-day period will be denied unless an Individual Assessment has been scheduled by Optum.

 

          

Your Help in Making Responses to Inquiries Timely

                                          

eQHealth thanks you for your continued patience and understanding as we process Prior Authorizations for Personal Care Services. We would appreciate your assistance with submitting requests for assistance with PCS reviews. If you have already have spoken with a member of our Intake Customer Support Team, who creates a Help Ticket on your behalf OR you have submitted a Help Ticket electronically through the Provider Portal in eQSuite®  please do not submit another or multiple requests unless it is for a new unrelated item where you need assistance

 

Multiple requests for the same inquiry are creating an abundance of duplicate tickets, slowing our ability to respond timely to your initial request. We understand the importance of your receiving prior authorization notifications timely and if you can help us minimize duplicate requests, we will be able to improve our level of efficiency.  Thank you for your assistance and cooperation!

 

For questions regarding the information presented in this provider update, please create a Help Ticket in eQSuite®  or contact our Intake/Customer Support Team at 888-660-3831, Monday through Friday from 8:00 a.m. to 5:00 p.m., CST, except during holidays.

 

We appreciate your continued support!

Webinars

 

Personal Care

Prior authorizations and/or extension of benefits will be requested through eQHealth Solutions beginning on 3/1/19.  Webinar trainings are available:

 

 

General Policy information: 

Provider Manual