Washington State Department of Labor & Industries (Department) has contracted with Qualis Health to provide Utilization Review (UR) services for its Workers’ Compensation Program.

Qualis Health reviews inpatient admissions, a select list of outpatient procedures and physical medicine services, which include physical therapy, occupational therapy and work conditioning. These are conducted on a prospective, concurrent and/or retrospective basis utilizing the Department’s Medical Treatment Guidelines, if applicable; otherwise, Qualis Health will apply InterQual criteria.

Our UR services are quality-focused and centered on achieving positive outcomes for workers in support of the Department's mission: to ensure that the medical care received by occupationally injured and ill workers is of the highest quality so that such care meets national and community standards for safety and efficacy.

The success of the program depends on a collaborative partnership between providers, the Department and Qualis Health. This web site was designed to provide providers with educational tools to assist in the UR process.