№ lp_1_2_41427
File format: docx
Character count: 9684
File size: 78 KB
A form for submitting prior authorization requests to KePRO for Medicaid services, including initial certifications, recertifications, and service changes.
Year:
2026
Region / City:
South Carolina
Theme:
Medicaid, Prior Authorization
Document Type:
Form
Organization / Institution:
KEPRO-SCDHHS
Author:
KePRO
Target Audience:
Medicaid providers
Period of Validity:
Ongoing
Approval Date:
Not specified
Date of Changes:
Not specified
Price: 8 / 10 USD
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The product description is provided for reference. Actual content and formatting may differ slightly.
RFP Number:
8070001252
Issuing Organization:
Oklahoma Health Care Authority (OHCA)
Contact:
Gina Kwiatkowski
Email:
[email protected]
Issue Date:
December 1, 2020
Proposal Due Date:
January 12, 2021
Contract Start Date:
Upon execution
Contract End Date:
June 30, 2021
Optional Renewal:
Up to six additional one-year periods
Scope:
External Quality Review Organization (EQRO) and Quality Improvement Organization (QIO) services
Target Audience:
Bidders capable of providing EQRO/QIO services
Mandatory Requirements:
Federal compliance, minimum three years experience, QIO certification or in process, medical/utilization review experience
Budget:
Competitive procurement process, value-based purchasing included
Year:
2012
Region / City:
United States
Topic:
Quality Improvement, Medicare
Document Type:
Report
Organization / Institution:
Centers for Medicare & Medicaid Services (CMS)
Author:
Not specified
Target Audience:
Policymakers, healthcare administrators, Medicare beneficiaries
Period of Validity:
FY 2012
Approval Date:
Not specified
Date of Changes:
Not specified
expenditures:
$372.8 million
Contract Duration:
August 1, 2011 – July 31, 2014
QIOs Involved:
53 contractors
Monitoring and Evaluation:
Ongoing quarterly performance assessments
Program Objective:
Improve quality of care for Medicare beneficiaries
Background:
Adjustments to QIO contract requirements after January 1, 2012
Context:
This report provides an overview of the Quality Improvement Organization (QIO) Program for fiscal year 2012, detailing its cost, administration, and the impact of its activities for Medicare beneficiaries.
Year:
Not specified
Region / jurisdiction:
South Carolina
Program:
Medicaid
Document type:
Administrative form
Purpose:
Prior authorization review for inpatient services
Submitting method:
Fax
Fax number:
1-855-300-0082
Responsible organizations:
KePRO; South Carolina Department of Health and Human Services
Provider identification:
National Provider Identifier (NPI); Medicaid ID
Mandatory provider location data:
9-digit ZIP code
Review types:
Initial; Recertification; Change; Cancel; Retrospective review
Service setting:
Inpatient; freestanding inpatient psychiatric
Population focus:
Medicaid members; psychiatric services for children under 21 and adults 65 and older
Eligibility window:
Up to 30 days prior to scheduled services
Clinical information required:
Diagnosis; severity of illness; intensity of services
Approval process:
Subject to medical necessity and eligibility verification
Note:
Year
Theme:
Prior Authorization
Document Type:
Fax Form
Organization / Institution:
Acentra Health, SCDHHS
Target Audience:
Medicaid Providers
Year:
N/A
Region / City:
N/A
Topic:
Medicaid, Prior Authorization, Targeted Case Management
Document Type:
Fax Request Form
Agency / Institution:
Acentra Health
Author:
N/A
Target Audience:
Healthcare providers, Medicaid service providers
Effective Period:
N/A
Approval Date:
N/A
Amendment Date:
N/A
Organization:
Acentra Health
Program:
South Carolina Department of Health and Human Services (SCDHHS)
Document type:
Administrative form
Purpose:
Prior authorization, recertification, change, or cancellation of outpatient Medicaid services
Submission method:
Fax
Fax number:
1-855-300-0082
Applicable services:
Mental Health Counseling, Therapies (PT, OT, SP), DME, Home Health, Hospice, Autism Spectrum Disorder
Provider identification:
National Provider Identifier (NPI) with 9-digit ZIP Code
Member identification:
Medicaid ID Number
Geographic scope:
South Carolina
Review types:
Initial, Recertification, Change, Cancel, Retrospective Prepayment Review
Governing criteria:
SCDHHS and InterQual guidelines
Associated system:
Atrezzo Connect
Submission timing:
Up to 30 days prior to scheduled services, excluding weekends and holidays
Year:
2019
Region / City:
North Carolina
Subject:
Data Privacy and Security
Document Type:
Best Practices Guide
Institution:
North Carolina Department of Public Instruction
Author:
Division of School Data, Research and Federal Policy
Target Audience:
NC Department of Public Instruction (DPI) staff, school and LEA staff
Period of Validity:
Ongoing
Approval Date:
August 30, 2019
Date of Modifications:
Not specified
Note:
Year
Year:
Not specified
Region / City:
Western Australia
Theme:
Healthcare, Continence Management
Document Type:
Referral Form
Organization / Institution:
Silver Chain
Author:
Not specified
Target Audience:
Medical practitioners, healthcare facilities, and clients
Period of validity:
Not specified
Approval Date:
Not specified
Date of amendments:
Not specified
Year:
2007
Region / City:
USA, Malaysia, Australia
Theme:
Telephony, Fax Solutions, Integration
Document Type:
Product Information
Organization / Institution:
FaxCore Software
Author:
FaxCore Software
Target Audience:
Small and Medium Enterprises (SMEs)
Period of Validity:
N/A
Approval Date:
N/A
Date of Changes:
N/A
Year:
2014
Region / City:
California
Document Type:
Compliance Notice
Organization:
Signature Networks PLUS
Author:
Signature Networks PLUS
Target Audience:
Medical Providers, Physician Offices
Period of Action:
Starting January 1, 2014
Approval Date:
Not specified
Amendment Date:
Not specified
Year:
Not provided
Region / City:
Greenville, NC
Topic:
Not specified
Document Type:
Contact Information
Organization / Institution:
East Carolina University
Author:
Not provided
Target Audience:
Not specified
Effective Period:
Not specified
Approval Date:
Not provided
Amendment Date:
Not provided