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Secure Provider Portal Update InterQual Connect

Date: 05/17/21

We value our relationship with you, and believe a key component of meeting your needs is through our Secure Provider Portal, which enables you and your team to work with Arizona Complete Health (AzCH) from the convenience of your computer, seamlessly and in real time.

REDESIGN OF THE PRIOR AUTHORIZATION REQUEST SECTION OF THE PROVIDER PORTAL

Effective June 14, 2021, a redesign of the authorization request section in our Secure Provider Portal will go live. This affects our AzCH-Complete Care Plan (Medicaid), Ambetter from AzCH (Marketplace), and Allwell from AzCH (Medicare) lines of business. This redesign includes the integration of InterQual Connect™.

The web authorization request redesign and InterQual Connect offer improvements and new capabilities:

  • The web authorization request process is being simplified. The Service type drop down is being replaced by Provider type, and will have a shorter list of options to choose from.
  • You will be advised whether or not a service requires authorization, or is not covered.
  • Following the submission of your request, the tool identifies if one or more service lines were not submitted as part of your request and provides the reason for non-submittal; e.g. an authorization is already on file, the service doesn’t require authorization, etc.
  • An assigned Authorization ID on submitted web authorization service lines will be provided to you when a request is submitted.
  • For a small subset of codes, you also will have the ability to access InterQual Connect and complete a medical review.
  • If a code has the option for medical review via InterQual Connect, the tool will tell you.
  • If you proceed, the completed InterQual medical review will automatically be included with your web authorization submission.
  • When you opt to use the medical review process, it reduces the need for the prior auth team to outreach and/or follow up with you regarding clinical documentation because you submit the documentation as part of the process.
  • For AzCH-Complete Care Plan and Ambetter, there is the potential for instant approval of your request based on the outcome of a completed InterQual medical necessity review. You will check your authorization page for the determination status. (Automatic approval is not yet an option for Allwell).

TRAINING ON THESE CHANGES
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We believe these updates to our Provider Portal will create a more user-friendly experience and enhance your ability to work with us.  We hope you will take a moment to explore the changes.

If you have questions regarding the information contained in this update please feel free to contact our Provider Customer Service center (866-796-0542). If you need your assigned Provider Engagement Specialist contact information, please email us at: AzCHProviderEngagement@azcompletehealth.com