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NOTICE:
  • ***DETOX UPDATE***: HFS recently issued a Provider Notice stating they have removed the prohibition for hospital readmissions for inpatient alcohol or drug detoxification within 60-days of a previous detoxification stay. Detoxification inpatient admissions are no longer subject to 60-day readmission policy. Continue to submit your reviews online using DRG Med/Surg review process. Please see your hospital Liaison/ UR Manager for information.
  • IMPORTANT MESSAGE:: eQHealth/Kepro office has moved to 500 Waters Edge, Suite 125 Lombard, IL 60148. A Provider Update was sent on September 9, 2022
  • DRG Disharge Reviews: You must submit a discharge review (Cont. Stay) for all Med/Surg stays of 2 days or greater. If it is 1 day stay please enter the d/c date using the Utilities tab in eQSuite.
  • IMPORTANT REMINDER: MCO Edit Error?: REMINDER: After insurance verification, if patient does not have MCO, please submit a Helpline Ticket requesting us to remove MCO edit in eQSuite.
  • LOG IN CORRECTLY: Please check that you are using your correct log on for our system if you have more than one user name. Your log on is directly linked to Provider ID. Many hospitals have new Provider IDs for inpatient Med/Surg and/or Psychiatric.
  • DETOX Reviews: Weekend detox admissions Friday/Saturday should be entered online during the weekend; if no weekend coverage they must be submitted online by NOON on the next business day (Monday).
  • MCO Edit Pop Up: If you confirm the patient does NOT have MCO, please submit a helpline ticket to remove the MCO edit.
  • TROUBLE WITH D/C REVIEW?: Create a New Review, select cont stay and put in TAN. Click Retrieve data to enter in the Discharge Review, you will include the discharge date, answer quality screening questions and include brief d/c summary.
  • How Do I Put in D/C for 1 day stay?: If you have ALREADY PUT IN ADMISSION REVIEW and patient is d/c (1 day stay only). Click on utilities tab and submit just the d/c date. For stays 2 or more days, please submit a d/c review (cont stay)for quality screening.
  • Physician CONTACT: It is VITAL to have an updated phone number for the Physician in eQSuite. Please verify that the phone on file is correct or add new phone number in the Physician grid.
  • PRIOR AUTH IMPORTANT: The grace period for late requests is over. Effective August 1st we will not accept any Prior Auth request less than 3 business days prior to the procedure.
  • ADX Reminder: ADX CODE: The admit dx code field requires all digits and no decimal.
  • PSYCH Review: No Axis grids I-V to fill out! Please include any addtl dx codes in dx grid
  • MCO - save time: If patient is covered under MCO at admission - no eQHealth review is needed. Check with your insurance verifier or HFS eligibility at 800-842-1461. Contact MCO.