Our Medical Review Activities
Qualis Health performs medical reviews of care provided in Idaho and Washington—at the request of Medicare, a local Medicare beneficiary, or the coding staff of a local hospital.
Our review team helps ensure that people with Medicare coverage receive the healthcare they are entitled to, and that the care they receive meets nationally recognized quality standards.
Federal laws control the types of reviews we conduct, as well as the methods we use to complete them. Each type of medical review we perform as part of our Quality Improvement Organization contract with Medicare is listed below:
Our reviews must be completed within tight timeframes. To facilitate our communication with hospitals, please help us maintain an accurate contact database by submitting any changes regarding the personnel designated as your official QIO Contact or Discharge Appeals Contact.
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Using Medicare’s Patient Notices |
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Healthcare providers must follow Medicare guidelines regarding the proper timing and distribution of patient notices such as the Medicare Notice of NonCoverage (NNOC) and the Important Message from Medicare. Our team will help you keep up-to-date with these requirements. |
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Contact |
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For information about the medical review work we perform for Medicare in Idaho or Washington, please contact: Sandy Salinas, RHIT CPHQ |
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