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District of Columbia, Department of Health Care Finance


Qualis Health provides a broad range of services for the District of Columbia, Department of Health Care Finance (DC Medicaid).

Our regional office in the District is staffed by people who live in and around the District and whose work helps improve and advance the efficiency, economy, effectiveness and quality of healthcare services provided to enrolled District of Columbia Medicaid clients.


Services We Provide for DC Medicaid

  • Utilization management
    • Prior authorization review
    • Pre-admission review
    • Emergency admission review
    • Continued stay review
    • Retrospective review
    • Long term care review


Announcements

Please check this page regularly for updates regarding ongoing provider training and resources.

April 29, 2019: Qualis Health and HealthInsight are now Comagine Health
In 2018, Qualis Health and HealthInsight merged, combining the two organizations’ strengths, experience and operations across the U.S. This month, we are introducing our new name, Comagine Health.

For more information, please read the letter from Janet Blackwood, our DC Medicaid services director.

June 5, 2018: New Reference for Service Authorization Time Spans
We’ve posted a new document that lists prior authorization/approval time spans and services by review type. “Time Spans for Prior Authorizations and Approval Letters” provides a quick way to look up the approval period for many of the services Qualis Health reviews. You can also find it on the Provider Resources page under “Provider Manual & Appendices.”

 

 

Adobe Acrobat® PDF files can be opened using Adobe Acrobat Reader. If you do not have Reader, you can get it free from the Adobe website.

Contact Qualis Health

»send an email to Qualis Health Provider Portal Help

»sign up for email alerts

Do not send patient PHI via email.

(800) 251-8890

Contact DC Medicaid

Provider Inquiry Line

(202) 906-8319
(866) 752-9231

»visit the DC Medicaid website


»more contact information