ABS partners with eQHealth Solutions to provide utilization management for all services that require prior authorization. eQHealth Solutions is a population health management and IT solutions company that is accredited by URAC in Health Utilization Management and has more than 30 years of experience providing utilization management expertise in all 50 states. ABS requires prior authorization for all inpatient hospital stays, certain outpatient procedures, MRI & MRA imaging, DME and other various services.
With eQHealth, providers can initiate an authorization via telephone, fax, or provider portal. Submission of a request through the portal allows for quicker processing, viewing of authorization status, and the ability to receive automatic authorization for certain services if criteria is met.
eQHealth uses InterQual® CP criteria to ensure decision-making consistency and medical necessity as industry standard, and eQHealth gives providers the opportunity for peer-to-peer conversations and reconsideration reviews.
For all documents related to Utilization Management please visit the Forms & Resources page.